A Community of Partners - Taney County Health Department

Transcription

Taney County Health Department MAPP Community Health Assessment
THIS PAGE INTENTIONALLY LEFT BLANK
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2012
Taney County Health Department
MAPP Community Health Assessment
______________________________________________________________________________
______________________________________________________________________________
July 24, 2012
“A Community of Partners”
Prepared and Written By:
Kimberly Foster, MPH REHS
Robert Niezgoda, MPH
Wennekota Tamara, MPH-Intern
Cover Design:
Donna Gold
Kimberly Foster
Amanda Modayil
Kim Conway
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Contents
INTRODUCTION ..................................................................................................................................................... 6
METHODOLOGY ..................................................................................................................................................... 7
PRIORITIES ............................................................................................................................................................. 8
TOP THREE PUBLIC HEALTH PROBLEMS ................................................................................................................. 9
VISION ................................................................................................................................................................. 12
VALUES ................................................................................................................................................................ 12
COMMUNITY HEALTH ASSESSMENT .................................................................................................................... 12
Demographic Characteristics ..............................................................................................................................12
Socioeconomic Characteristics ............................................................................................................................14
Behavioral Risk Factors .......................................................................................................................................17
Environmental Health Indicators ........................................................................................................................19
Housing Concerns................................................................................................................................................24
Agricultural Activities ..........................................................................................................................................26
Environmental Public Health Services .................................................................................................................27
Animal Control Services ......................................................................................................................................28
Health Resource Availability ...............................................................................................................................29
Communicable Disease .......................................................................................................................................30
Sexually Transmitted Diseases ............................................................................................................................30
Social and Mental Health ....................................................................................................................................31
Maternal and Child Health ..................................................................................................................................33
Senior Issues ........................................................................................................................................................34
Mortality .............................................................................................................................................................35
Community Resources Assessment .....................................................................................................................37
PHYSICAL ACTIVITY OPTIONS IN TANEY COUNTY ................................................................................................. 37
FORCES OF CHANGE ASSESSMENT ....................................................................................................................... 52
COMMUNITY THEMES AND STRENGTHS ASSESSMENT ........................................................................................ 55
LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT ...................................................................................................... 56
APPENDIX A ......................................................................................................................................................... 61
APPENDIX B ......................................................................................................................................................... 63
APPENDIX C ......................................................................................................................................................... 70
REFERENCES......................................................................................................................................................... 83
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Acknowledgement
MAPP membership
Sincere appreciation is given to the following community partners who were instrumental in
providing research, data, editing, and assistance. Thank you.
Bradleyville Public Schools
City of Branson
Hollister Parks and Recreation Department
City of Branson Parks and Recreation
Downhill Bikes
City of Branson Public Works
City of Hollister
Ozarks Regional YMCA
Branson RecPlex
American Cancer Society; Relay For Life
College of the Ozarks
Hollister Public Schools
Any Body’s Gym
First Baptist Church Life Center
James River Basin Foundation
Anytime Fitness
Kirbyville Public Schools
Maples Training and Fitness Center
Mark Twain Public Schools
Curves For Women
Missouri Department of Agriculture
Missouri Department of Conservation
Shape Shifters Pilates
Branson Creek Golf Club
Don Gardner Golf Course
Missouri Department of Elementary and
Secondary Education
Missouri Department of Health and Senior
Services
Holiday Hills Golf Course
Thousand Hills Golf Resort
Payne Stewart Golf Club
Missouri Department of Mental Health
Point Royale Village Country Club
Missouri Department of Natural Resources
Murder Rock Country Club
Missouri Department of Social Services
Branson Public Schools
My Neighbor’s Pantry
Missouri State Highway Patrol
Midwest Dance Revolution
Skaggs Community Foundation
Skaggs Regional Medical Center
Music In Motion
Skate World
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Dogwood Lanes
Taneyville Public Schools
Ozark Mountain Trailblazers
United States Corps of Engineers
United States Environmental Protection Agency
Branson Community Center
Christian Action Ministries
Ozarks Area Community Action Corporation
United States Department of Agriculture
White River Basin Foundation
Older Adult Transportation System
Veterans Affairs Outpatient Clinic
Angel Food Ministry
University of Missouri Extension
Loaves and Fishes
Forsyth Senior Friendship Center
Meals on Wheels
Boys and Girls Club
Faith Community Health
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Introduction
Assessing the community’s health is an ongoing process that requires the regular and systematic
collection, assembly, analysis and dissemination of information regarding the health needs of the
community. This process is the foundation for improving and promoting the health of community
members through identification of the factors that affect the health of Taney County residents and
determining the availability of resources to adequately address health issues.
Beginning 2011, the Taney County Health Department (TCHD) engaged in an 18-month process to assess
the health of the community. MAPP (Mobilizing Action through Planning and Partnerships) was chosen
as the best practice for assessing the community. This health assessment is a community driven project
involving health care providers, public health officials, stakeholders and the community at large. A
coalition was formed through this process called the Community Health Improvement Coalition (CHIC).
The intent was to mobilize and engage the community by conducting assessments, planning sessions,
developing partnerships and developing an action plan to address the priorities identified.
Taney County Health Department is continually organizing partnerships to address the issues by creating
plans for change, implementing those plans and evaluating the outcome so that we know that the
strategies that are put into place are creating a positive change which in turn will improve the health of
our community.
Objectives of the CHIC were to:
o Complete comprehensive assessments to gather data on the health status of the
community.
o Define goals and strategies to address the priorities identified.
o Take action to provide positive health outcomes.
The health of the community process involved using four assessments which contained several
components.
1. Community Health Assessment
2. Forces of Change Assessment
3. Community Strengths and Themes Assessment
4. Local Public Health Systems Assessment
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Methodology
The MAPP process was a collaborative effort facilitated by the Taney County Health Department which
included leaders and representatives from a broad array of city and county departments, health
systems, community organizations and the community at large.
Data for the 2012 Taney County Community Health Assessment was collected from a variety of primary
data sources, secondary data sources and four assessments. Existing databases containing local, state
and national health and behavior data were used for comparison between communities where possible.
Databases include Behavioral Risk Factor Surveillance System (BRFSS), Youth Risk Behavior Survey
(YRBS), death certificate data, birth certificate data, hospital discharge data, and data, surveillance
systems and statistical reports provided by the Missouri Department of Health and Senior Services. To
ensure accuracy, data from sources were examined to clarify reporting sources, data collection
methods, and population or sample sizes.
In all sections of the Community Health Assessment, the most recent data available was used to compile
this report.
A nine page survey in English and in Spanish was made available through SurveyMonkey on the TCHD
website as well as paper version for those who did not have access to a computer. Members of the
Community Health Improvement Coalition (CHIC) as well as other partners were asked to distribute a
link to the survey via email to their staff, friends, family, clients and coworkers. Members were also
encouraged to provide a paper version of the survey for their contacts to fill out and return if necessary.
The survey was made available to staff at the three health department locations and to clients to fill out
before their appointments. The survey was made available for a total of four weeks. Approximately a
week after the survey began, a reminder call was made to all CHIC members to complete the survey and
distribute it to their staff. CHIC members were also asked to keep record of the number of surveys
distributed and completed. The purpose of the community survey was to gather baseline data on
demographics and health care access as well as to assess the community’s insight on what they
considered to be community health priorities. The survey was also conducted to guide the coalition in
creating our strategic plan to address the health needs of the community over the next five years.
The survey resulted in 485 total responses. Only Taney County residents were able to complete this
survey. If a respondent was not a Taney County resident, he or she would answer “NO” to the question,
“Are You a Resident of Taney County?” and the survey would end for that participant. Of the total
responses, 35 were not residents of Taney County and 450 were residents of Taney County. After
determining the participants’ eligibility for the survey, they were directed to answer demographic
information including weight, height, health care and health priority questions. It appeared that of the
450 residents, only 344 respondents answered questions two to twenty-four. Two of the 450 were
eliminated due to incorrect zip codes.
Every reasonable effort was made to collect and present reliable, accurate information for
dissemination. Efforts were made to update the charts with the most recent information available from
the reporting agencies. Presented data that seemed to be misleading, or of questionable quality, was
compared to other sources to check for errors.
Rate calculations were based on the methods of the Missouri Department of Health and Senior Services
and on the population estimates provided by the United States Census Bureau. Efforts were made to
review calculations to determine accuracy and reliability. The charts and graphs presented in the
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chapters were developed using the data collected from the referenced sources. Every effort was made
to present the reader with charts and graphs that provided as much information as possible in an
understandable format. When charts and graphs were found to be unclear, efforts were made to clarify
and reformat the information.
Every effort was made during the editing process to limit the possibility of errors in the presentation of
data and calculations. However, we are unable to prevent errors due to the collection, compilation, and
dissemination of data by reporting agencies. Data cited from reporting agencies is provided with the
understanding that data is only as reliable and as valid as the methodologies and processes employed to
collect, evaluate, standardize, and report the data. Additionally, reliability and validity of locally
collected data was limited because of collection procedures that narrowed the ability for randomization.
Consequently, locally collected data should be considered to be representative of the population groups
sampled and cautiously representative of the county as a whole. All of the information presented in this
assessment was reviewed and edited for accuracy. Any errors within this assessment are purely
unintentional and are deeply regretted. If an error is noted, please notify us so that we may identify,
correct, or clarify the information.
Priorities
Taney County Health Department and community partners have provided some initial success by
illustrating the willingness among community members to participate in efforts addressing these
problems. Examples of local collaborative efforts include:
Tobacco use prevention as well as efforts with the Alcohol and Drug Abuse Prevention
Team (ADAPT) Taney County have brought together health care providers, elected officials,
local public health, and other community organizations.
School-based prevention programs to address tobacco use prevention among junior high
school students.
Partnerships with schools to provide nutritional education for students.
Presentation of community health assessment data to community leaders and elected
officials to increase awareness and request input.
Plans to reconvene community member focus groups to gather qualitative data regarding
community health issues, barriers accessing programs, and other issues.
The health priorities identified through the MAPP process have impacted many residents of Taney
County. Many other health problems such as diabetes, heart disease, cancer, and stroke can be
decreased in the county by addressing tobacco use and overweight/obesity problems. Child and Family
Safety issues will focus not only on abuse and neglect, but will now include issues such as injury
prevention.
The following Health Priorities were identified through the MAPP process.
1. Unhealthy Body Weight due to poor nutrition
2. Tobacco, Alcohol and Drug Abuse
3. Child and Family Safety
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Top Three Public Health Problems
Unhealthy Body Weight due to poor nutrition
Body Mass Index (BMI) in adults is defined as a ratio that is determined by height and weight. Between
25 and 29.9 is considered overweight and BMI of 30 or greater is considered obese. Developmental
processes for adults and children are defined differently in regards to overweight and obese. According
to the CDC, a child’s weight status is determined by using age and sex specific percentile for BMI instead
of BMI categories used for adults. For children, overweight is defined as a BMI at or above the 85th
percentile and lower than the 95th percentile for children of the same age and sex. Obesity is defined as
a BMI at or above the 95th percentile for children of the same age and sex. Obese children are more
likely to be obese as an adult than children who are not obese (CDC, 2012).
Childhood obesity can have harmful effects on the body and can contribute to a variety of health risks
such as high blood pressure, high cholesterol, glucose intolerance, diabetes, sleep apnea, asthma, joint
problems, and most importantly it can have a social and psychological impact. Obese children and
adolescents have a greater risk of discrimination and poor self-esteem which can go well into adulthood
(CDC, 2012).
Many factors contribute to obesity in children as well as adults, such as increased caloric intake with
limited physical activity. Sugary drinks, less healthy options at schools, and lack of physical activity in
most schools may contribute to the rise in obesity among children. At home, parents may find it
cheaper to order dinner from a fast food restaurant than go to the grocery store and purchase fresh
fruits, lean meats and vegetables to cook. The increased use of television viewing and electronic usage
has increased through the years limiting activity of children and youth which can go into adulthood
(CDC, 2012).
Public Health Goals
If diet and nutrition is not properly aligned with physical activity, weight may become an issue. Healthy
People 2020 address diet/nutrition as well as physical activity in its goals and objectives. The goals of
Healthy People 2020 are to improve access to healthy foods, especially for children, and to increase
physical activity for all ages. The objective for Healthy People 2020 is to reduce the proportion of the
population that is obese by 10% to 30.6% by 2020. Obesity, nutrition and overweight/obesity are listed
as one of the Winnable Battles by the CDC, which advocates environmental and policy-level changes to
facilitate healthy eating and physical activity levels (CDC, 2012).
Tobacco, Alcohol and Drug Abuse
Alcohol
Alcohol in excess is the third leading cause of lifestyle death in the U.S. resulting in approximately 79,000
deaths per year. Binge drinking is defined as four or more drinks per day for women and five or more
drinks per day for men. Heavy drinking is defined as more than one drink per day for women on a single
occasion and two or more for men (CDC, 2012).
Excessive drinking can lead to immediate effects and harmful health conditions such as, unintentional
injury, violence, risky sexual behavior, miscarriage, alcohol poisoning. Long term effects of alcohol
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abuse can lead to liver disease, social problems, cardiovascular disease, cancer and other issues
including pancreatitis and gastritis (CDC, 2012).
Tobacco
Tobacco, worldwide, causes more than 5 million deaths a year and will cause more than 8 million by
2030. In the U.S. tobacco use is responsible for about one in five deaths. For every person who dies
from a smoking related illness, 20 more suffer with at least one illness from smoking (CDC, 2012).
Smoking increases the risk of coronary artery disease, stroke, lung cancer and chronic obstructive
pulmonary disease (COPD) (CDC, 2012).
Drug Abuse
Drug abuse is associated with many mental and physical health problems. It can disrupt relationships,
employment and financial stability. Drug abuse can lead to hepatitis B, C, TB and STD’s. No single factor
determines whether a person will become addicted to drugs. The overall risk for addiction is impacted
by the biological makeup of the individual. It can be influenced by gender or ethnicity, developmental
stage, and surrounding social environment (e.g., conditions at home, at school, and in the
neighborhood) (CDC, 2012).
Public Health Goals
Healthy People 2020 addresses substance abuse in a ten year national plan for improving the lives and
the health of Americans. The goal is to “reduce substance abuse to protect the health, safety and
quality of life for all, especially children”. The Leading Health Indicators for Healthy People 2020 for
substance abuse are: to reduce the proportion of adolescents reporting use of alcohol, marijuana or
illicit drugs and reduce the proportion of people of all ages engaging in binge drinking (Healthy People
2020, 2012).
Child and Family Safety
Family Safety
Any instance of physical or sexual violence, threats of violence or emotional abuse with a spouse or child
is considered domestic abuse or Intimate Partner Violence (IPV). This type of violence can occur among
heterosexual as well as homosexual couples and does not require sexual intimacy.
Public health’s role is to “break the silence” of intimate partner violence. It must be aimed at reducing
the occurrences through promotion of healthy, respectful, nonviolent relationships. Nearly 3 in 10
women and 1 in 10 men in the U.S. have experienced rape, physical violence and or stalking by a partner
with IPV-related impact. IPV has resulted in 2,340 deaths in 2007, and of these 70% were female (CDC,
2012).
Child Maltreatment
A safe and stable environment among children and adults is a buffer against maltreatment or other
adverse exposures during childhood. Unfortunately, not all children are exposed to positive
relationships. Child maltreatment is a significant public health problem in the United States. In 2009,
Child Protective Services confirmed more than 700,000 cases of abused or neglected children. These
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confirmed cases, however, represent only a fraction of the true magnitude of the problem. Most cases
are not reported, and child maltreatment remains a largely hidden problem. Some studies estimate that
1 in 8 U.S. children experience some form of child maltreatment (CDC, 2012).
Child maltreatment can lead to a wide range of physical and emotional health problems. It can also lead
to permanent physical disabilities and cognitive impairments. Not all injuries are visible that are a result
of abuse. Victims of maltreatment may suffer long term anxiety and depression and possibly later in life
have difficulty with relationships, abuse drugs and alcohol and possibly abuse those around them as well
(CDC,2012).
Public Health Goals
The goals and objectives in Healthy People 2020 for Injury and Violence Prevention is reduction of
intimate partner violence, sexual violence and exposure of children to violence. Prevention IVP will
require changes at all levels of the community and society as a whole (Healthy People 2020, 2012).
Goals and objectives for maltreatment are highly recognized by Healthy People 2020 and address the
problem under Violence Prevention. First is to reduce all cases of child maltreatment and second, is to
reduce the number of child deaths due to abuse and neglect (Healthy People 2020, 2012).
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Vision
T
aney County is a community of healthy people living in a safe environment.
Values
We value improvement through teamwork, learning, and sharing of information. We strive to make a
positive difference through education and communication; treating each other and those we serve with
respect.
Community Health Assessment
Demographic Characteristics
Taney County is located in Table 1
Southwest Missouri, 35 miles Demographics
Taney County
Missouri
south of Springfield, Missouri and Population
51,675
5,988,927
is ranked 20 for overnight leisure Persons Under 18 Years Old
18.2
26.7
vacation destinations in the Persons 65 Years and older
17.7
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country. Branson, Missouri is a Female
51.3
51
Class IV city with a permanent Male
48.7
49
population of approximately White
93.6
82.8
7,400 located in the west-central Black or African American
0.9
11.6
area of Taney County. The city of American Indian and Alaska Native
0.8
0.5
Branson includes approximately Native Hawaiian and Other Pacific
0.1
0.1
268 restaurants, 53 theaters, Islander
three shopping malls, 207 Two or More Races
2.2
2.1
lodging facilities and three lakes. Hispanic or Latino (of any race)
4.8
3.5
Approximately eight million
U.S. Census Bureau, 2010
guests per year visit this area,
and 65% of those guests travel from outside a 300 mile radius. The average visitor stay is 2.4 days.
Table 1 illustrates the diversity of Taney County those include Whites, Black or African American, Asians,
American Indian and Alaska Native, Two or More Races as well as Hispanic or Latino. Compared to
Missouri, Taney County has 1.3% more Hispanic and Latino. 17.7% of the population in Taney County is
65 Years and older and 18.2% are 19 years and younger. Respondents to the survey were distributed as
follows, in percent: White 96.5; Two or more races 3; and Asian 0.6.
The urban population in Taney County and Missouri showed an increase in the 2010 census. The rural
population in Taney County was higher than the state which shows 26.9% of the Missouri population is
rural (Table 2).
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Table 2
Percent of Population Classified as Rural and Urban, 2010
Total Population
Urban Population
Rural Population
Taney County
51,675
50.0
50.0
Source: US Census, 2011
Missouri
5,988,927
73.1
26.9
69.4
Figure 1 shows a comparison of Missouri Information for Community Assessment (MICA) data from
2000 to 2009 with regard to the age distribution of the population in Taney County. This graph shows an
overall increase in the number of residents in the county, especially from 15 years old to about 55 to 64
years old where the county has experienced the highest increase.
Figure 1
Source: Missouri Department of Health and Senior Services, MICA, 2011
Figure 2 illustrates the age distribution of respondents to the health priority survey which resembles the
age distribution according to the U.S. Census Bureau, 2010 of residents of Taney County. Respondents
to the survey were over the age of 18.
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Figure 2
Source: TCHD, 2012
Socioeconomic Characteristics
The overall percent of all people below
poverty level living in Taney County is
significantly higher than the state and U.S.
levels according to the U.S. Census Bureau
for 2010. Taney County poverty rate in
percent is 16.5% compared to Missouri
poverty rate at 14.5% and 14.4% nationally
(ACS, 2010). Taney County youth under the
age of 18 living in poverty is 26.2%
compared to 20.2% in Missouri and 20.1% in
the U.S. (ACS, 2010).
Table3
Percent Poverty Rate For The Population 25 Years and
Over For Whom Poverty Status Is Determined By
Educational Attainment Level-Taney County 2008-2010
Less than high school
graduate
High school graduate
(includes equivalency)
Some college or
associate's degree
TOTAL
MALE
FEMALE
25
22.3
28
16.6
14.1
18.8
8.5
8
8.9
Table 3 provides the poverty rate of the
population 25 years of age and over for Bachelor's degree or
3
3.4
2.7
whom poverty status is determined by higher
Missouri Department of
educational
attainment
by
gender. Source:
Health and Senior Services, (MoDHSS)
According to the data, female poverty levels
are higher than males regardless of education obtained. As of 2010, 14% of Taney County Residents
have less than a high school education compared to 13.9% Missouri and 14.4% in the U.S. (U.S. Census
Bureau, 2010). The County Health Rankings (2011) place Taney County 99th in social and economic
factors out of Missouri’s 115 counties.
Table 4 shows some social and economic profiles of Taney County and Missouri in 2006, 2008, and 2010.
According to the data, Taney County had a higher unemployment rate compared to the state rate. The
county generated a total of $1,355,815,000 from personal income in 2008, and the per capita income
was $28,680 compared with $36,356 for Missouri. In the winter (December through March), the
unemployment rate is higher compared to the rest of the year due to area businesses closing for the
winter season as illustrated in Figure 4.The median household income in Taney County is $39,405 which
is lower that the state at $45,829 and the national median of $51,222.
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Table 4
Social and Economic Profiles of Taney County and Missouri,
2006 and 2010
Taney County
Missouri
$1,355,815
$216,546,820
Personal income per capita, 2008
$28,680
$36,356
Civilian labor force, 2008
24,046
3,016,749
Unemployment rate, 2010
10.70%
8.70%
Full-time and part-time employment by place of
work, 2008
34,385
3,672,794
Full-time and part-time employment, net change
2000 to 2006
2,936
174,117
1,950
917,403
$28,247
279,133
147,421,561
$40,155
Personal income, 2008 (in thousands)
Employment in government, 2008
Earnings, 2006 ($1000)
Average earnings per job, 2006
Source: OSEDA, 2011
Socioeconomic
and
demographic
characteristics have been shown to be
important health indicators of health status.
Understanding
our
population
age
distribution, race and ethnic composition as
well as income characteristics is essential in
identifying health needs which will aid in
the planning of health programs. The most
recent health insurance estimated show an
uninsured rate of 15.5% in the U.S.
Figure 4 details the unemployment rate by
month for Taney County. January, 2011,
unemployment rate of 22.4% represents
US Census; 2008-2010 American Community Survey, 2011
businesses such as hotels and restaurants
that are closed for the off season, forcing the establishments to lay off employees.
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Figure 4
Unemployment Rate
Unemployment Rate By Month- Taney County,
January to September 2011
24%
22%
20%
18%
16%
14%
12%
10%
8%
6%
4%
2%
0%
22.40%
8.50%
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
Month
Source: Missouri Economic Research and Information Center, 2011
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Behavioral Risk Factors
Table 5 and Table 6 show adult as well as youth behavioral risk factors that significantly impact health
outcomes. Many causes of death can be attributed to either tobacco use or obesity. Obesity rate for
Taney County is in line with Missouri and the U.S. with percentages of 65, 65.8 and 64.5 respectively.
According to the National Initiative for Children’s Healthcare Quality, “Obesity constitutes a grave threat
to the health and well-being of our nation, as rates have risen dramatically over the past decades with
particularly strong impact on diverse and disadvantaged communities. The US now has the highest rate
of obesity among all developed nations. Unless industry, the public and the government work together
to address
Table 5
Southwest
the
issue,
Missouri
U.S.
Region
three in four 2010 BRFSS (Percentages)
Americans will Overweight and/or Obesity, Adults over 18
years of age
65
65.8
64.5
become
27.2
51
50
overweight or Physical Activity among Adults
*
39.3
41.8
obese
by Alcohol Use among Youth
2020” (NICH, Tobacco Use among Adults
20.5
21.1
17.3
2012).
Source: CDC, Behavioral Risk Factors *No Data Available
Childhood
obesity
rates in Missouri are Table 6
15% to 20% (NICH, 2010 Youth Risk Behavior Surveillance-BRFSS
2012). Linked to (Percentages)
obesity are sedentary Obesity
lifestyles. 27.2% of Physical Inactivity
residents
in
the Smoking
Southwest region did Source: CDC, Youth Risk Behavior Surveillance
not participate in any
physical activity in the past 30 days, compared to 51% of Missouri.
Missouri
14.4
26.7
9.3
U.S.
12
18.4
8.9
Another contributing factor to poor health is smoking and Behavioral Risk Factors Surveillance System
(BRFSS) data show that 20.5% of adults in the southwest region currently smoke among adults ages 18
and above and 9.3% of Missouri residents’ youth ages 17 and below currently smoke. Out of 115
counties in Missouri, Taney County ranks 80 in health behaviors on the 2011 County Health Rankings.
The BMI rates of the survey respondents to the survey revealed that 69% of the respondents were
either overweight or obese along with 30% of them being in the normal BMI range and 1% being
underweight, which is consistent with the BRFSS data provided. (Figure 5)
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Figure 5
Source: Taney County Health Department (TCHD), 2012
BMI averages were further distributed by Taney County zip codes reported in the survey by four
categories: Underweight, Normal, Overweight and Obese. The obese category had quite a few
communities; Rockaway Beach’s BMI was the highest at 33 with seven other communities following
closely. The overweight category (25-29.9) involved five communities with four of them at 28. There
was only one community that had normal BMI distribution and that was Point Lookout. Point Lookout is
considered a “college town”, an unincorporated community near Branson and Hollister where College of
the Ozarks in located. The overall overweight/obesity rate is in line with Missouri average as well as the
nation.
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Environmental Health Indicators
The physical environment impacts the lives of individuals and their quality of life. Clean air and water
are some examples of factors that may influence health. However, access to recreational activities and
healthy foods also impact health of the community. Physical activity can be affected if there are no
sidewalks, bike lanes, trails, parks or fitness centers (Table 7).
Taney County is ranked 19 out of 115 counties in physical environment. This includes air pollution,
access to recreational facilities, limited access to healthy foods and percentage of fast food restaurants
in Taney County.
Table 7
Taney
National
Sixty-five percent of the
BRFSS
(Percentages)
County
Missouri
Benchmark
survey
respondents
considered access to Air pollution-particulate matter
0
0
0
exercise as either “most days
0
7
0
important”
or Air pollution- ozone days
12
10
16
“extremely important” Access to recreational facilities
.Other
concerns Limited access to healthy foods
1%
8%
0%
included: 34.6 % air Fast food restaurants
38%
47%
25%
pollution, 73.6% clean County Health Rankings 2012
water/pollution
and
47.4% mold among adults. For children, 74.1% access to exercise, 38.6% air pollution, 64% clean
water/pollution and 41.1% mold.
Regulated Facilities
Local businesses are required to report information to the state of Missouri. However, in some cases,
information is collected at the federal level.
Toxics Release Inventory data are reported by individual facilities via yearly reports to federal EPA. The
EPA converts these forms into an electronic database. A facility must report if the facility:
Has 10 or more full-time employees, and
Manufactures or processes over 25,000 pounds of the approximately 600 designated chemicals
or 28 chemical categories specified in the regulations, or uses more than 10,000 pounds of any
designated chemical or category, and
Engages in certain manufacturing operations in the industry groups specified in the U.S.
Government Standard Industrial Classification Codes (SIC) 20 through 39, or
Is a federal facility which are all now required to report per the August, 1995 Executive Order
signed by President Clinton.
EPA data regarding hazardous waste and regulated facilities in Taney County is listed in Table 8. A total
of 456 facilities were registered with the EPA in 2010. This was an increase of 112 facilities since 2007 or
a 32.56% increase.
According to the environmental protection agency, the following facts for Taney County were noted:
o
o
o
Facilities that produce and release air pollutants: 5
Facilities that have reported toxic releases: 0
Facilities that have reported hazardous waste activities: 12
 Number of CESQG’s: 4
19
o
o
o
o
o
o
 Number of Unspecified Universe:8
Potential hazardous waste sites that are part of Superfund that exist: 1
 Number of Superfund: 1
Facilities that generate hazardous waste from large quantity generators: 0
Facilities issued permits to discharge to waters of the United States: 34
Transient Non-Community Water Systems that do not consistently serve the same people
(e.g. rest stops, campgrounds, gas stations): 53
Community Water Systems that serve the same people year-round (e.g. in homes or
businesses): 55
Non-Transient Non-Community Water Systems that serve the same people, but not yearround (e.g. schools that have their own water system): 9
Table 8
List of EPA-Regulated Facilities-Taney County, 2010
2010
Total
Sites
Total
Sites
2007
236
2010
294
Permitted
Discharges
to Water
184
Toxic
Releases
1
Hazardous
Waste
Handlers
53
Active or
Archived
Superfund
Reports
1
Air
Releases
Reported
13
City
Branson
ZIP
Code
65616
Bradleyville
65614
4
4
3
0
0
0
0
Cedar Creek
65679
0
0
0
0
0
0
0
Forsyth
65653
21
27
11
0
9
0
0
Hollister
65672
38
64
36
1
8
0
5
Kirbyville
65679
7
9
6
0
0
0
1
Kissee Mills
Merriam
Woods
65680
4
4
2
0
0
0
1
65740
2
1
0
0
0
0
0
Point Lookout
65726
3
3
2
0
1
0
1
Protem
65733
1
1
0
0
0
0
1
Ridgedale
65739
15
23
18
0
2
0
2
Rockaway
Beach
65740
4
7
4
0
1
0
0
Taneyville
65759
4
4
2
1
0
0
1
Walnut Shade
65771
5
10
0
0
0
0
0
344
456
268
3
74
1
25
Total
Source: EPA, EnviroFacts Online Database, 2011
In 2010 a total of 25 air releases and 3 toxic releases were reported to the Environmental Protection
Agency. Additionally, a total of 74 hazardous waste handlers were located in Taney County in 2010.
Map 1 provides information on the geographical locations of hazardous waste, water discharges, air
discharges, toxic releases, and waterways in Taney County for 2010.
20
These regulated facilities or documented releases can create potential negative health impacts in the
county. Exposure to toxic or hazardous chemicals can cause immediate health consequences as well as
possible long-term effects. Health impacts would depend on several variables including, route of
exposure, amount of the substance, and length of exposure.
Map 1
Source: EPA, EnviroMapper, 2011
Watershed and Drinking Water
Taney County crosses two watersheds, the Beaver Reservoir and Bull Shoals Lake. Information regarding
the identified impaired waterways in these two watersheds is provided in the following maps and tables.
11010001: Beaver Reservoir; state(s): AR, MO
11010003: Bull Shoals Lake; state(s): AR, MO
21
Map 2
Source: EPA, 2011
Map 3
Source: EPA, 2011
Water systems in Taney County are shown below in Tables 2-3. These tables show the water system
name and primary water source.
Community water systems are those water systems that serve the same people year-round, e.g. in
homes or businesses. A total of 38,818 people are served by these types of water systems in Taney
County. Transient Non-Community Water Systems are water systems that do not consistently serve the
same people, such as those systems that supply rest stops, campgrounds, and gas stations.
Non-Transient Non-Community Water Systems are those water systems that serve the same people, but
not year-round. These types of systems would include schools that have their own water system. A total
of 3,650 people are served by these types of water systems in Taney County.
Waste Water and Sewage Disposal
The Taney County Regional Sewer District was formed under Missouri Revised Statutes Chapter 204 and
was approved by voters in 1986. Currently the Sewer District has 1,945 customers on the existing sewer
lines. These customers are located mainly in rural areas of the county. The sewer district also inspects
all new septic systems in the county and addresses complaints in the County outside of municipal areas.
Currently, there are approximately 6,200 private onsite wastewater treatment systems (OWTS) in Taney
County. This number is approximate because records of OWTS prior to 1998 are incomplete.
The largest municipal sewage system in the county is in the City of Branson with 7,638 customers as of
July 2008. Branson has an ordinance regulating the amount of oil, grease and fat allowed into the
system from food service establishments. This ordinance requires a 1,000 gallon in-ground grease
interceptor for every 250 seats of a food service establishment.
22
The municipalities of Forsyth, Hollister, and Rockaway Beach also have sewage systems for their
residents. However, there are still a few private septic tanks in each of the municipal areas. Table 9
provides additional information regarding wastewater treatment systems.
Improperly maintained septic systems could result in
contamination of water. Possible gastrointestinal
illnesses due to E. coli or other bacteria may result if
private wells become contaminated with this runoff.
As the Taney County Sewer District and municipal sewer
systems expand, the number of septic tanks in the
county will decrease. This will have a positive impact on
the water quality in the county. The following tables give
you numbers of homes hooked up to public sewer and
the number and types of onsite wastewater treatment
systems used by residents as well as the violations and
complaints of those systems.
Table 9
Sewer Systems in Taney
County, 2007
Number
Taney County Regional Sewer
District
City of Branson
Forsyth
1,945
7,638
1,144
Hollister
1,530
Rockaway Beach
332
Total
12,589
Source: Taney County Regional Sewer District
Taney County Planning and Zoning recently took over the responsibilities of Taney County Sewer District
in regards to onsite wastewater treatment systems. Taney County Planning and Zoning now inspects
new and existing onsite wastewater treatment systems, while complaints for failing systems will be
investigated by the Taney County Sewer District and the Taney County Health Department.
Table 10
Onsite Wastewater Treatment SystemsTaney County, 2007
Total Onsite Wastewater Treatment Systems
Malfunctioning OWTS Complaints
OWTS Violations
Systems Under Violation Notice Brought Into
Compliance Without Prosecution
Systems Under Violation Notice Brought Into
Compliance Through Prosecution
Number
6200
58
10
10
0
Source: Taney County Regional Sewer District
Table 11
Gravel
and
Pipe
49
Number and Type of Distribution and Soil Treatment Systems PermittedTaney County, 2007
Conventional Lateral Trench Systems
Dilution Systems
Large
Expanded
Pressure
D-Box Dosed
Low
Diameter
Polystyrene
Network in
D-Box
Pressure
Pipe
Bundle
Conventional
Pipe in Pea
Without
Lateral Trench
Gravel
Gravel
Lateral
Trench
39
88
1
12
2
1
Drip
Irrigation
Dispersal
2
Source: Taney County Regional Sewer District, 2011
23
Housing Concerns
Several environmental health concerns are related to housing including exposures to radon and lead.
Increase of housing structures in Taney County have increased over the years. Table 12 illustrates the
number of housing structures built from 1939 to 2005. With increased structures, problems may occur
especially with the older homes. According to the 2000 Census, a total of 1,274 houses in Taney County
were built prior to 1950. (Table 12) Additionally, those houses built prior to 1978, when lead paint was
prohibited, may also have been painted with some lead paint.
Table 12
Number of Housing Structures by Year
Built- Taney County, 2009
Radon
Total Housing Units
24,528
Built 2005 or later
1,314
Built 2000 to 2004
2,571
Built 1990 to 1999
8,790
Built 1980 to 1989
4,013
Built 1970 to 1979
3,420
Built 1960 to 1969
1,883
Built 1950 to 1959
1,105
Built 1940 to 1949
572
Built 1939 or earlier
860
Source: US Census, 2011
Radon (Rn) is a radioactive gas that occurs from the natural breakdown of uranium in the soil and rocks.
It is colorless, odorless, and tasteless. Radon is the second leading cause of lung cancer in the nation
and is classified as a “Class A” carcinogen according to EPA.
Radon becomes a risk indoors because as it continues to break down, it emits atomic particles that enter
the lungs and can alter the DNA increasing lung cancer risk. Radon can be tested and measured (in
picocuries per liter (pCi/L) of air) and there are estimated risks to health from the exposure depending
on the concentration.
The Missouri DHSS in conjunction with the EPA recommends that if the concentration of radon is 4pCi/L
or greater, then remediation should be done to lower risks. Smoking in conjunction with radon
exposure greatly increases the risk of cancer. It's never too late to reduce your risk of lung cancer. Don't
wait to test and fix a radon problem. If you are a smoker, stop smoking.
Lead
Lead poisoning is one of the most common and preventable environmental health problems in the
United States. An estimated one million children have elevated blood lead levels of at least 10
micrograms per deciliter (10 µg/dl) in the U.S. According to 2003 Missouri blood lead testing data, three
thousand children under the age of six, were identified with elevated blood lead levels in the state.
24
Lead is a shiny silver colored metal found naturally in the earth's crust. Lead has been used in our
society in a variety of ways including in paints, gasoline, and some vinyl products, such as mini-blinds.
Processed or recycled lead can become a health hazard. Fine particles of processed or recycled lead
and/or lead dust become a health hazard when they are taken into the body through inhalation
(breathing) and/or ingestion (swallowing).
25
Agricultural Activities
Information related to agricultural activities in Taney County is shown in Table 13 and 14. These
activities are important to monitor for possible health consequences associated with runoff from these
operations. Contamination of water sources used for swimming or private wells has occurred in other
areas. No updated census for cattle and calves since 2008 for Taney County at the time of publication.
Table 13
Cattle and Calves-Taney County, 2007-2008
Total
Beef Cows
22,000
13,500
20, 800
13,000
Year
2007
2008
Milk Cows
150
550
Source: United States Department of Agriculture (USDA), 2011
In the year 2010, a total of 704 tons of fertilizer were used in Taney County. This represents a decrease
of 6.05 percent as compared to the year 2007.
Table 14
Fertilizer Use, Taney County
Tons Used By Year
Percent Change
Year
1985
2000
2007
2010
1985-2000
2000-2007
2007-2010
Fertilizer
454
287
753
704
-36.8
162.4
-6.05
Nitrogen
55
16
57
6
-70.9
256.3
-89.5
P2O5
59
7
43
--
-88.1
514.3
-100
Potash
60
--
--
--
-100
--
--
Source: University of Missouri Annual Fertilizer Tonnage Report, 2011
The environmental services provided by the Taney County Health Department include inspections of:
food, lodging, swimming pools and spas, body art and massage facilities, daycares, and animal acts.
Additional environmental services include animal control and bite investigations, nuisance compliance,
well water testing, West Nile mosquito
surveillance
programs,
emergency Table 15
preparedness, as well as handling threats or
Taney County Geographical Statistics, 2011
situations that may present an imminent hazard Land Area (sq miles)
632
to public health.
Water Area (sq miles)
19.1
Area Growth
Taney County has an area of 632 square miles,
421,871 acres, with the majority of this land in
natural forests and woodlands. Only 2.9% land
use of Taney County is lake coverage and 2.6%
being used for roads and highways (Table 15).
Acreage
Population Density
421,871
76 people /sq mile
Percent of Lake Coverage
Land Use for Roads and
Highway
2.90%
2.60%
Source: City-Data.Com; Accessed March 14, 2011
26
Environmental Public Health Services
Table 16 provides a review of the change in active establishments in Taney County from 2009 to 2010.
Active establishments are those facilities that are currently in operation or capable of beginning
operations.
Table 16
Tables 16 also provides a summary of inspections of
Restaurants, Pools, Lodging facilities, Child Day Care
facilities, and Tattoo/massage establishments that
occurred in 2010. For all jurisdictions in 2010, the
Health Department provided 215 routine lodging
inspections, 1,121 routine food inspections, 32 routine
childcare inspections and 1,023 routine pool
inspections for all jurisdictions.
Active Facilities 2009-2010 City of Branson, Hollister, and Taney County
Total
Total
Percent
2009
2010
Change
Childcare
32
32
0
Food
Temporary
Events
629
645
2.54
89
97
9
Lodging
212
187
-11.79
The Taney County Health Department, Environmental
397
391
-1.51
Public Health Specialists also respond to food-borne Pools
illness complaints and outbreak investigations. From Tattoo/
28
27
-3.57
2009 to 2010 the number of food illness complaints Massage
increased by 318%, however from 2008 to 2009 the Source: Taney County Health Department, 2011
number of complaints decreased from 130 to 34 (74%) (Table 17).
Table 17
Food Illness Complaints- 2006-2010
Food illness complaints
2006
108
2007
116
2008
130
2009
34
2010
142
Percent Change
2009-2010
318%
5-Year
Average
106
Source: Taney County Health Department, 2011
Food borne illnesses are a high concern for Taney County. The many restaurants that depend on the
local tourism industry are required to have managers on duty who have attended food safety classes.
Additionally, local businesses are provided the opportunity to attend training focused on the prevention
of the spread of norovirus. Norovirus are very contagious and cause a sudden onset of vomiting and
diarrhea. Often, ill visitors to the area may expose others to the illness as they visit attractions,
restaurants, theaters, and hotels. Because of this, the Taney County Health Department directs
substantial resources to the identification of these types of illnesses and to the prevention of the spread
of illnesses once identified.
Water samples are routinely analyzed by the Health Department to determine levels of Total Coliform
and E. coli that are present. The numbers of these tests are presented in Table 2.10. From 2006 to 2010,
the demand for public water tests increased by 35.82%, while private water samples decreased by
28.48%.
27
Animal Control Services
Animal Control Services are providing services in the City of Branson as well as areas outside of the City
of Branson city limits through mutual aid or other contractual agreements. During 2010, a total of 666
animal complaints were investigated, and 89 animal bites were reported. During 2009, a total of 738
animal complaints and 105 animal bites were reported (TCHD, 2011). Animal control has been
responsible for collecting both domestic and wild animals, as well as transferring certain wildlife to other
appropriate agencies. Animal control is also involved in inspecting
Table 18
theatres and issuing permits to facilities in Branson that perform
Number of Field Complaints By
with animals in their show. This responsibility ensures that the
Jurisdiction, 2011
animals are properly cared for and maintained. In 2010, six theatres
Total
Percent
Jurisdiction
and 15 facility inspections were conducted within Branson.
Number
of Total
The total number of complaints to animal control in 2011 is
presented in Table 18 by jurisdiction.
Additionally, bite
investigations averaged 90 per year for the past few years. Both of
these factors have resulted in increased man-hours worked by the
Health Department animal control officers.
Table 19 provides a summary of activities provided by the Taney
County Health Department regarding emerging disease
surveillance. From 2006 to 2011 decreases were observed in
mosquito pool testing and collection. These activities were related
to West Nile Virus funding which has decreased substantially over
the past few years. Further funding cuts are expected for 2012.
Branson
500
41.9
Taney
County
549
46.1
Hollister*
0
0
Forsyth
82
6.9
Merriam
Woods
61
5.1
Total
1,192
Source: Taney County Health Department,
2011; *Field complaints – officer assist only
Table 19
Emerging Disease Surveillance, Taney County, 2006-2011
% Change
2006
2007
2008
2009
2010
2011
(2006-2011)
Mosquito Trap Nights
104
106
-
-
-
-
-100
Mosquito Pools (50 each) Tested
Complaints investigated
(Mosquito/vector)
220
105
86
83
183
130
-40.91
22
-
-
11
7
4
-81.82
WNV and Mosquito Activities
Source: Taney County Health Department, 2011
28
Health Resource Availability
Access to health care reduces death, disability and health inequities as well as improves quality of life for
all citizens. Skaggs Regional Medical Center is a 165 licensed bed, community-owned and supported,
healthcare facility dedicated to improving the health of all area residents. Health education classes for
diabetes, health disease and other conditions meet regularly on certain days of the month. These
classes are aimed toward benefitting patients and their families with useful information relayed through
various topics and presentations. Skaggs holds the highest national accreditation available for medical
facilities from the Joint Commission on Accreditation of Healthcare Organizations and has earned the
Gold Seal of Approval™ for its advanced inpatient diabetes care and is an Advanced Primary Stroke
Center through the Joint Commission on Accreditation (SRMC, 2011)
The Community Health Status Indicators project (2009) reports Taney County had a rate of 65.9 primary
care physicians and a rate of 51.0 dentists per 100,000 population. The report also states that Taney
County is not a health professional shortage area (U.S. Department of Health and Senior Services, 2009).
Currently, there are three hospice care agencies, one professional home care facility, and one outpatient
physical therapy clinic. In 2010, there were seven licensed nursing homes in the county with 519
licensed beds. There are four levels of care provided by nursing homes in the state of Missouri, and
three levels are provided by nursing homes in Taney County. Within the long term care facilities, there
are one Alzheimer’s unit and one with ventilator care (MODHSS, 2012). Medicare beneficiaries in Taney
County include 7,679 elderly (65+) and 1,620 disabled residents or 17.9% of the population. There are
11,212 Medicaid beneficiaries that total 21.6% of the population (U.S. Department of Health and Senior
Services, 2009). Of the respondents to the community health survey, only 21.6% claimed they had
trouble getting medical care, and not because of the lack of providers, but because of the cost of
medical care and prescription medication regardless if they had insurance coverage or not (TCHD, 2012).
Respondents were asked what issues they have in order to get care. Answers varied and included cost of
medical care, prescription drugs are too expensive, not enough health insurance coverage, deductible
too high, and no insurance coverage.
Faith Community Health (FCH) provides healthcare for the working uninsured. Through a partnership
with the Ozark Mountain Family YMCA, patients can participate in the Healthy Lifestyles Program. This
program includes classes which focus on nutrition, fitness, relationships, faith, etc. Registration for Faith
Community Health is available at Ozarks Regional YMCA. (36) (4) Services include medical and pharmacy
services with future plans for optometry and dental services. Client fees are based on a sliding scale for
visits to FCH, including access to prescribed classes at the YMCA. Eligible clients must prove income at or
below 200% of the federal poverty guidelines and proof of employment status within last 6 months in
Stone or Taney counties.
Veterans’ Affairs Outpatient Clinic administers primary care services for veterans in Branson and the
surrounding area. The Veterans’ Affairs Outpatient Clinic includes a Behavioral Health service which
offers individual or group counseling and programs such as Quit Smart Smoking Cessation. Branson
Veterans Outpatient Clinic is a branch of Veterans Health Care System of the Ozarks which is based in
Fayetteville, Arkansas. As part of their value system, the Outpatient Clinic focuses on quality, cost
effectiveness, and healthy communities. Routine prescriptions may be processed through the mail or
picked up at the facility. There is a possibility of a number of co-pays as a result of treatment; the clinic
will file claims with the patient’s insurance company.
29
Communicable Disease
Sexually Transmitted Diseases
Sexually transmitted diseases have decreased in Taney County compared to 2007. However, an
increasing trend the past two years is of concern and may indicate that a need exists for additional
community education regarding the prevention of sexually transmitted diseases. Table20 illustrates the
trends in the county for Chlamydia, Gonorrhea and Syphilis cases. Taney County was ranked 89 out of
115 counties in Missouri in health factors, which included health behaviors such as sexually transmitted
infections, clinical care, social and economic factors and physical environments (County Health Rankings,
2012).
Table 20
Chlamydia
Gonorrhea
Syphilis
Number of Sexually Transmitted Diseases Reported - Taney County 2000-2010
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Average
48
53
74
74
84
75
88
109
47
53
59
69.45
7
13
11
22
22
20
23
23
6
6
2
14.09
1
0
0
0
0
2
1
4
2
1
0
1
Source: MODHSS, 2012
Table 21
HIV and AIDS Cases, 2010 and Cumulative*-Taney County
Taney County
HIV
AIDS
HIV Diagnosed 2010
Cumulative*
4
29
1
Rate Per 100,000
45.3
69.1
2.4
SW HIV Region
Cumulative*
451
770
62
Rate Per 100,000
40.4
122.8
5.6
Source: MODHSS, 2011
Immunizations
Table 22 shows the percentage of 2 year olds that have been adequately immunized as assessed by
Missouri Department of Health and Senior
Services during quality assurance contract Table 22
monitoring in 2010.
Immunization Statistics: Adequately ImmunizedThe Table 23 is a summary of selected
vaccination series and the percent of children 2
years of age that were classified as being up-todate with their immunizations. Approximately
86% of children were adequately immunized for
Polio and MMR.
Taney County, 2010
Child’s Age: 2
Taney County
2005
2010
67.00%
73%
Source: Missouri Department of Health and Senior Services, 2011
30
Total
764
155
11
Table 23
Percent of School Children Adequately Immunized, Grades K-12Taney County, 2008-2009 School Year
Select Series/Antigens
Percent Adequately Immunized
Diphtheria/Pertussis/Tetanus
Polio
Measles
Mumps 2 Dose
86.7
86.7
86.7
78.5
Mumps 1 Dose
93.2
Rubella 2 Dose
78.5
Rubella 1 Dose
93.3
Hepatitis B
Varicella
86.7
74.5
Source: State of Missouri Immunization Assessment Survey Results, 2011
Social and Mental Health
Social and mental factors affect the health of an individual and a community’s quality of life. These may
be influenced by substance abuse and violence within the home and within the community. While the
overall numbers of these incidents are currently relatively low in Taney County compared to other areas
of the state and country, these issues will continue to increase along with population growth present in
the county. 2010 adult BRFSS reported that eighty-two (81.9) percent of adults always or usually
received the social and emotional support needed.
Significantly more adults with annual household incomes of $75,000 and greater (54.2 percent) always
received the support needed compared to those with incomes of less than $15,000 (40.2 percent).
Ninety-four (93.7) percent of adults were very satisfied or satisfied with their life. Significantly more with
annual household incomes of $75,000 or greater (54.7 percent) were very satisfied with their lives than
those with incomes of less than $25,000.
Fifteen (14.9) percent of adults had never been told by doctor or other health care provider that they
had an anxiety disorder. Twenty-one (20.7) percent had never been told by a doctor or other health care
provider that they had a depressive disorder. Adults experienced the following on more than three days
over the past two weeks: 16.2 percent had little interest or pleasure in doing things; 12.7 percent felt
down, depressed or hopeless; 27.0 percent had trouble falling asleep or staying asleep or sleeping too
much; 37.8 percent felt tired or had little energy; 23.2 percent had a poor appetite or had eaten too
much; 9.5 percent felt bad about themselves or that they were a failure or had let themselves or their
family down; 10.7 percent had trouble concentrating on things, such as reading the newspaper or
watching TV; 6.3 percent moved or spoke so slowly that other people could have noticed, or the
opposite, being; so fidgety or restless that they were moving around a lot more than usual (MOBRFSS,
2010).
31
In Taney County, a total of 641 incidents of domestic violence were reported in 2010.
The rate of domestic abuse
reports was higher in Branson Table 24
than any other part of the
Domestic Abuse Reports-Taney County, 2009-2010
county—164.1
per
10,000
Rate Per 10,000
population (Table 24). In general,
Population
domestic abuse reports were
2009
2010
2010
higher in 2010 compared to 2009
120
132
164.1
reports. Three year average for Branson
aggravated assaults dominated Forsyth
15
20
117.4
the violent crime offenses totals
58
53
136.2
Hollister
for 2010 in Taney County, and
2
5
84.9
was 247.3. Larceny theft was the Rockaway Beach
largest criminal offense in 2010 Taney County Rural
374
431
141.4
with 1,413 cases with a 1,383 Village of Merriam
1
0
0
three year average. The total Woods
property crime offenses for 2010
550
641
95
Total
in Taney County were 1,887 and Source: Missouri State Highway Patrol, UCR,
in line with the three year 2011
average of 1895.7 (Missouri
State Highway Patrol, UCR, 2011).
A greater issue is illegal substance use. Methamphetamine and marijuana use accounted for 22% of the
individuals who were cited for treatment admissions. Of those who were not successful in seeking
treatment, or never had the opportunity, 5% of deaths in Taney County were drug related and 5% were
alcohol related.
Figure 6
Source: Missouri Department of Mental Health, 2011
Suicide rates for Taney County are about the same rate for the state. 12.8 Per 100,000 for the years of
1999-2009 with an average for Taney County of 5.25 per year and for Missouri, 684.25 per year.
32
Maternal and Child Health
An important area to monitor and compare the health of individuals in the vulnerable population is
infants and children. Birth data and outcomes are the focus of this category as well as mortality rates
for infants and children. Maternal care is correlated with birth outcomes and this section will
concentrate on maternal access to and/ or utilization of care.
Table 25
Maternal, Infant and Child Health
Taney County
2005-2009
Missouri
20052009
Birth Weight: Low (less than 2500 g)
239
Rate per
100
7.3
Education Status: Less Than 12 Years
771
23.7
18.1
Gestation: Preterm (less than 37 completed weeks)
383
11.8
13
Prenatal Care: Began First Trimester
Prenatal Care: None
Prenatal Service Utilization: Mother on Food Stamps|
Prenatal Service Utilization: Mother on Medicaid
Prenatal Service Utilization: Mother on WIC
Smoked During Pregnancy: Yes
Smoked During Pregnancy: Yes, 1 or More Packs Per Day
Weight for Height (Overweight): Mother's BMI Between 25.0 and 29.9
Weight for Height (Obese): Mother's BMI 30 or Greater
2,581
80.7
86.7
12
0.4
0.7
1,002
31.7
26.2
2,163
68.4
47.7
2,018
63.8
43.1
849
26.1
17.7
91
2.8
2.5
676
21.7
23.7
667
21.5
23
Live Births
3,259
N/A
N/A
Indicator
Number
Rate per
100
8.1
Rates Per 100
Source: MoDHSS, 2011
Indicators for mothers on WIC between 2000 and 2008 are shown in Table 26. Comparison between
Taney
County Table 26
rates and the
WIC Infants Statistics, Rate Per 100 - Taney County and Missouri, 2000-2008
state rates are
Taney
provided (Table
Indicator
County
Missouri
26). According
7.9
9.3
to the table, the Birth weight - low (less than 2500 grams and includes very low)
rate of breast Birth weight - high (4000 grams or more)
7.6
7.2
fed children is
Currently breast feeding - fully
62.3
46.3
higher in Taney
Immunizations - up to date
85.4
72.1
County
4.7
13.7
compared
to Underweight for length - (less than or equal to 10th percentile)
that of the state Overweight for length - WIC (greater than or equal to 95th percentile)
5.2
4.9
as a whole (62%
At Risk of becoming overweight
13.3
9.3
vs.
46%).
Likewise, up-to- Source: MoDHSS, MICA, 2012
date immunization rates are higher in the county. However, the rate of underweight for length infants in
33
Taney County is lower than the state rate. In addition, the rate of infants at risk of becoming overweight
in Taney County is higher than the state rate.
Senior Issues
Taney County has a diversification of age typical of most areas in the Midwest that are a combination of
rural areas and small cities. Table 27 outlines the demographics as it relates to different age groups
within Taney
Table 27
County.
Population Estimate By Age Group - Taney County, 2009
Table 28 depicts the
85 and
Total for
population of older
45 - 54
55 - 64
65 - 74
75 - 84
Over
Selection
adults aged 45 years
Taney
old and over in
County
6,419
6,135
4,977
2,550
916
20,997
Taney County in
2009.
The Source: Missouri Department of Health and Senior Services, MICA, 2011
population is stratified by age and
gender. The overall percentages were Table 28
47.5 percent male and 52.5 percent
Population By Age and Gender -Taney County, 2009
female in 2009. By age group, the
Total
Total
Percent
Age Group
Male
Female
percentages were 48.4 percent male
2008
2009
Change
and 51.6 percent female in the 45-54
3,107
3,312
6,414
6,419
0.1
age group; 46.6 percent male, 53.4 45 - 54
2,860
3,275
6,031
6,135
1.7
percent female in the 55-64 age 55 - 64
2,314
2,663
4,769
4,977
4.4
group; 46.5 percent male, 53.5 65 - 74
percent female in the 65-74 age 75 - 84
1,134
1,416
2,472
2,550
3.2
group; 44.5 percent male, 55.5 85 and Over
357
559
889
916
3
percent female in the 75-84 age
Total
9,772
11,225
20,575
20,997
2.1
group; and 39.0 percent male, 61.0
percent female in the 85 and over Source: Missouri Department of Health and Senior Services, MICA,2011
age group. The percentages of older female adults are higher than those of their male counterparts in all
age groups, especially in the last age group. In addition, the table shows that the number of people in all
age groups increased from 2008 to 2009. The 65-74 age group experienced the highest growth rate in
2009.
34
Mortality
The leading causes of death in Taney County is heart disease, cancer, chronic lower respiratory diseases,
stroke, Alzheimer’s disease, pneumonia and influenza, motor vehicle accidents, kidney disease, chronic
liver disease and cirrhosis and septicemia (Table 29). Rates for heart disease, cancer, Alzheimer’s
disease, motor vehicle accidents, chronic liver disease and cirrhosis are slightly higher than the state of
Missouri rates. In health outcomes, which included mortality and morbidity, Taney County ranked 65
out of 115 counties.
Table 29
Top Ten Leading Causes of Death in Taney County 2005-2009
Taney
Numbers
Total
2005 2006 2007 2008
2009
Number
Heart Disease
Cancer
Chronic Lower Respiratory Diseases
Stroke
Alzheimer's Disease
Pneumonia and Influenza
Motor Vehicle Accidents
Kidney Disease
Chronic Liver Disease and cirrhosis
Septicemia
Taney
Rate per
100,000
134
125
105
119
125
608
216.4
106
118
123
128
114
589
200.8
20
23
28
33
29
133
45.7
17
15
22
18
25
97
33.6
11
11
15
21
14
72
26.2
11
15
13
9
7
55
20
13
11
12
9
9
54
24
11
7
14
10
7
49
17.5
3
6
4
12
6
31
11.6
6
9
7
4
4
30
10.4
Missouri
Rate per
100,000
216.3
191
50.1
48.2
25.4
20.7
17.3
17.9
7.2
11.8
Table 30
Chronic Disease (Crude Mortality Rate/100,000 Population 2009
Heart Disease
Cancer
Chronic Lower Respiratory Diseases
Stroke
Taney
County
Missouri
265.9
257.6
57.7
42.4
244
210.5
54.1
54.4
Source: DHSS MICA 2012
Table 31 provides a comparison of mortality rates for those over 65 years of age in Taney County and
Missouri. Taney County had higher mortality rates for atherosclerosis, pneumonia and influenza, liver
disease, and suicide deaths from 1999 to 2009.
35
Table 31
Mortality Rates Per 100,000 For Those Over 65 Years of
AgeTaney County, 1999-2009
Taney County
Cause of Death
Missouri
Number
Rate
Rate
Cancer
798
1,013.00
1,112.40
Diabetes
56
71.1
141.8
Alzheimer’s Disease
106
134.6
182
994.9
1,339.30
1,656.80
Cerebrovascular disease
(Stroke)
229
290.7
400.2
Atherosclerosis#
68
141.6
32.5
Pneumonia & influenza#
140
177.7
171.4
Liver Disease. Cirrhosis
22
27.9
22.4
Kidney
84
106.6
120.5
Motor Vehicle Accident
19
24.1
23.4
All other Accidents
54
68.6
88.5
Suicide
19
24.1
15.8
3,470
4,405.10
5,264.20
Heart Disease
Total all causes
Source: MoDHSS, 2012
36
Community Resources Assessment
Community resources are important to consider when assessing a community. The individuals in the
community use these resources as tools to address the health issues that are identified. Resources could
include programs, facilities, or organizations that are available and accessible free, low cost or at higher
costs. The following resources were identified during the assessment process in conjunction with a
number of community partners.
Physical Activity Options in Taney County
Many options for physical activity are available in Taney County; some of them are free of charge and
some require a fee to use. The options range anywhere from walking trails throughout the community
to fitness facilities to golf courses.
Public Parks and Recreation Centers
Alexander Park
A great 6 acre park that offers nice playground equipment, a tennis court, a pavilion with picnic tables,
public bathrooms, and two youth ball fields. These fields are often used for youth sports such as
baseball, softball, and soccer.
Branson North Park
Branson North Park, fittingly located at the Branson North subdivision, offers a great playground area
within the 1 acre park.
Branson RecPlex
The RecPlex is a great resource for physical activity in the community. It offers a wide range of activities,
and is conveniently located past Wal-Mart Supercenter at 1500 Branson Hills Parkway in Branson, MO.
The RecPlex offers the following features:
 4 Baseball/Softball Fields
 1 Full Size
Soccer Field
 A Playground
 Pavilions Available for
Rent ($15/4hrs; $25/8hrs)
 1 Mile Walking Loop
Around the Complex
 Fitness Center
(Skaggs)
 2 Indoor
Basketball Courts
 2 Indoor Volleyball Courts
 1/12 Mile Indoor Walking
Track
 Lounge and
Concessions
 Game Room
 Community Rooms
Adult Leagues
Adult softball games are held at the RecPlex and Stockstill Park;
16 years and older; Men, Co-ed, and Church teams

Churches or church organizations involved in the Church League include:
1.
Tri-Lakes Christian Church
2.
Promise Keepers
3.
Branson First Baptist
4.
Victor Baptist
5.
Sanctuary of Hope
6.
Exciting First
37
7.
8.
9.
Branson Bible Church
Woodland Hills
Church Army
Basketball: Five divisions of adult basketball are offered at the Branson RecPlex, depending on desired
competitive level.
Volleyball: A six-on-six Co-ed recreational league is offered at the RecPlex in two 10-week sessions; First
session starts in October, Second session in January.

16 years and older
Youth Sports and Leagues
Baseball/Softball: Kids from all around Taney County are encouraged to join the summer league.
Soccer: Nearly 500 youth participate annually in this fall program.
Basketball: A great way for children to have fun, learn basketball skills and develop teamwork.
Cheerleading: Open to girls 1st- 6th grade
Volleyball: Fall league for girls 3rd- 8th grade
Children’s Theater: Annual summer drama camp is held at Branson High School.
Cantwell Park
Cantwell Park is a beautiful park for the neighborhood which features not only playground
equipment but also a lighted basketball court.
Caudill Park
This 5-acre park contains a picnic area as well as a gazebo. Future plans exist which call for the
construction of walking and running trails throughout the wooded areas of the park.
Cedar Steps
Cedar Steps is an interesting park because it features 229 steps with 33 landings. These landings
offer a fitness option as well as beautiful views and landscaping.
Downing View Park
This park in Hollister features a covered pavilion as well as playground equipment for small
children.
Eiserman Park
Eiserman Park is found at the same location as the Branson Community Center and the Don
Gardner Par 3 golf Course. This park includes a playground area and a covered pavilion. Picnic
tables are also on location nearby.
John Nygard Memorial Park
A neighborhood park located on the corner of 5th and Long Street that contains a playground for
kids and benches dispersed throughout the premises.
38
Murphy Park
Murphy Park is a neighborhood park that offers a basketball court, a sand volleyball court, a
playground, and two pavilions including picnic tables. Murphy Park can be accessed off of
Highway 76.
Parnell Park
Parnell Park offers two tennis courts as well as a playground. It is located at the end of the
Parnell Circle in the same neighborhood as the Don Gardner Par 3 Golf Course.
Sagers Park
Sagers Park is a pleasant park which offers a basketball court, a playground, picnic tables as well
as a covered pavilion.
Stockstill Park
Stockstill Park is a large 62 acre recreational area which features two softball fields, six tennis
courts, two playgrounds, and four separate pavilions. Softball, tennis, and youth baseball and
softball leagues are often hosted here throughout the year.
Amenities at Stockstill Park include:
 1/2 mile walking path surrounding the park
 Public Restrooms available
 A lighted soccer field and a skate park
Sunset Park
Set on the banks of Lake Taneycomo, this park features a Frisbee golf course and a beautiful
walking trail going around the outskirts of the course. Frisbee golf is free, but tournaments are
hosted occasionally which require a fee.
Sponsored Runs/Walks
Dash to the Splash:
Dash to the Splash is a 5K run sponsored by White Water Park, The Caring People, and
numerous other sponsors. The event was just started two years ago, and has been a success. All
proceeds go to The Caring People, an organization which reaches out to single mothers.
o Event Start Location: White Water Theme Park, Highway 76 & Pat Nash Drive
Branson
The Firecracker 5000 1 Mile Walk/Run, 5K, 10K
The firecracker road race is a race along the Branson Landing and the surrounding area. It is in
its 10th year of operation and all proceeds go to the American Heart Association.
Fees: $15-$20
Freedom Run of THE OZARKS
Freedom Run of the Ozarks is a newly organized run with the option of running a 5K, 10K, or
half-marathon course. The course is along Table Rock Lakeshore Trail. Registration: Adults - $20;
Children 12 and under - $10. All proceeds go towards the Table Rock Freedom Center
Relay for Life: Taney and Stone Counties
Relay for Life is 24 hour walk/run fundraiser to celebrate those who have battled cancer,
remember loved ones lost, and fight back against the disease itself. Teams of people camp out
39
at the chosen site for that year, whether it is a local high school, park, or fairground, and take
turns walking or running around a track.
Run From the Couch 5K Run/Walk
This 5K walk/run is sponsored by the Junior Auxiliary of Taney County and is organized in order
to promote and encourage fitness in the community. Any age group is eligible to participate in
this event.
o
Numerous age divisions: 15 & under, 16-19, 20-29, 30-39, 40-49, 50 & over
Run to the Lights 5K walk/run
Run to the Lights is an annual walk/run in its 5th year, sponsored by Skaggs Regional Medical
Center, Elite Automotive Group and Silver Dollar City. It occurs during the holiday season,
so everyone can enjoy the lights and sounds of Christmas. Post-race refreshments are also
included. Proceeds benefit The Caring People, an organization which reaches out to single
mothers.
Tanger Outlet 5K Walk/Run
Tanger Outlets 5K walk/run is a newly organized event in the community. It aims to ensure
families participate in fitness activities to stay healthy. Proceeds from the registration fees
will benefit the Breast Cancer Foundation of the Ozarks.
Walking Trails
Hiking is a free or low cost opportunity to exercise while enjoying the weather and scenery of Taney
County. If you are going hiking please remember to observe some safe hiking practices. Make sure you
are comfortable and wear weather appropriate clothing. A proper fitting pair of shoes is important to
prevent blisters and other discomfort. Normal tennis shoes will suffice for the paved trails, but it is
recommended to wear hiking shoes when hiking on the natural trails. Bring water and maybe some
nutritious snacks, this will make the hike more enjoyable. Before leaving, make sure someone knows
where you are going and approximately when you will be back. Take your cell phone with you in case of
an emergency.
Branson Cedar Ridge Campus
Walking track open to the public
Branson RecPlex
A popular walking and biking destination for residents of the Branson area, the RecPlex
offers a paved path that encircles the 42 acre facility. An outdoor restroom is located near
the trail, as well as drinking fountains located at various points along the trail. Open 6am –
11pm.
40
Map 4
Chad A Fuqua Memorial Park
Chad A. Fuqua Memorial Park was built in memory of Chad A. Fuqua, former Director of
Hollister’s Park Department. Commemorative and memorial bricks, placed there to honor loved
ones, lie along the sides of the walking trail.
o Length: .6 mile
41
Hollister High School
o Walking track open to the public when not in use for school functions.
Lakeside Forest Wilderness Area
Lakeside Forest Wilderness Area is a great place to enjoy nature along its two woodland trails
that wind throughout the Lakeside Forest. The area is open daily from 7am – 7pm during
summer and 7am – 5pm during winter.
o
Closed Thanksgiving, Christmas and New Year’s Day
 Trail 1 – A 1/2 mile (one way) trail offers an aerobic exercise with its 315 stone steps.
This trail winds through woodlands, and offers a great view of the White River Valley
and Lake Taneycomo. Mostly level terrain, but the steps section may require some
agility.
 Trail 2 – This 1.3 mile trail is more family friendly because it is level and is ideal for those
desiring a leisurely walk. Also, a picnic area is located about halfway down the trail.
North Beach Park
North Beach Park is more than just a walking trail; this path includes two fishing docks, picnic
tables, barbeque grills, and horseshoe pits.
o
Length: 3/4 mile
Ruth and Paul Henning Conservation Area
A beautiful place to hike with varying types of trails. Anything from a paved trail leading to an
excellent view of the White River Hills, to rugged trails which will certainly give you a good
workout. Gates are opened at daylight and closed at dark. Pets must be on leash
o
Length: Varying lengths of trails, from .4 miles all the way to 3.4 miles
Shadow Rock State Park
Shadow Rock State Park is a great park surrounded by Ozark Hills right on Lake Taneycomo. It
has several tennis courts, wide open spaces, and a number of hiking trails throughout the park.
o
Length: N/A
Stockstill Park Walking Path
The walking path itself is located within the 62 acre Stockstill Park. It is a figure eight-shaped
path which wraps around two softball fields, two pavilions, and a large playground. Open from
6am – 11pm
o
Length: 1/2 mile
Sunset Park Walking Path
This park is set on the banks of Lake Taneycomo. The lighted and paved path stretches along the
perimeter of a 9-hole Frisbee golf course which is located at the center of the park. Open 6am –
11pm
o
Length: .6 mile
42
Table Rock Lakeshore Trail
This Lakeshore Trail feature a great 8 foot wide, paved walking path which provides a terrific
view of Table Rock Lake at all points along the trail. It is a perfect trail for any age and ability.
Open from dawn to dusk; and pets are allowed but they must be on a leash.
o
Length: About 2.2 miles
Woods Trail
Woods Trail is the newest trail opened by the city of Branson. It is a beautiful nature trail
through the trees and is great for any age
o Trailhead: Roark Valley Road next to the entrance of The Woods Development
o Length: 2/3 mile trail through the woods ending at a natural waterfall
Map 5
Public Swimming Pools
Branson Aquaplex:
The Branson AquaPlex features a full size swimming pool along with many fun water slides. It is
a great aquatic park which the whole family can enjoy. Group rates are available as well as
birthday packages and private party rentals.
o Pool open Memorial Day to Labor Day
o Lap Swim- $2; MWF 7-10 pm; Ages 18 and up.
o Daily Admission to Aquaplex is $4 youth (3-17) and $5 adult (18 & up)
o Open 12pm - 7pm Monday – Saturday, 12pm - 6pm on Sunday
o August 2-15 open from 12pm - 6pm everyday
o Aug 16 – Sept 6 from 12pm - 6pm Weekends only.
o Location: Branson RecPlex
43
Branson Waves Swim Team:
o The Branson AquaPlex offers a summer program which consists of competitive swimming
for kids ages 5-17. The swim team participates in the Tri-State Swim Conference which is
made up of summer and year-round swim teams from surrounding states.
o In order to be eligible, kids must to be able to swim the length of the pool (25 yards) on their
own
o Registration Fee: $25
o Practices start in May after school and continue through the summer Monday-Friday from
7:00 am to 9:30 am.
Bike routes
Downhill Bikes:
Downhill Bikes is a great bike shop in Branson which can supply you with all your bicycling needs
and also lend out information about bike trails in the Tri-Lakes area.
Table Rock Lakeshore Trail:
Lakeshore Trail is a great trail for walking and riding, and is suitable for any age and ability. It
runs from the Dewey Short Visitors’ Center next to Table Rock Dam, along the lake through the
Branson Belle parking lot, and down to Table Rock State Park near the marina. At any point
along the trail, a great view of Table Rock Lake can be seen
o
o
o
About 8 feet wide, paved, and 2.2 miles long
Free to the public
Open dawn to dusk. Pets allowed, but they must be on a leash.
Fitness Facilities
Any Body’s Gym:
Any Body’s Gym is a unique facility in that there is no joining fee. A punch card is scanned each
visit to the gym. It is not your typical fitness facility because it features intense workouts which
are only 4 minutes long.
o Cost for use of facility.
o Financial Assistance: Not available
o Age requirements: Must be 18 to work out without a parent
o Child care services: Not available since it is a 4 minute workout
Anytime Fitness:
Anytime Fitness is a fitness facility which focuses on helping people adopt a healthy lifestyle
through physical activity and fitness. They offer personal training programs to help you achieve
your fitness goals, and are open 24 hours a day 7 days a week for your convenience.
o Financial Assistance: Not available
o Age requirements: 14 years old with parent; Must be 16 to exercise without a parent
o Child care services: Not available
44
Curves for Women:
Curves for Women offers 30 minute workouts involving complete cardio and strength training
workouts. They also offer several nutritional programs such as weight management classes,
meal plans, and a complete line of vitamins and supplements.
o Cost for use of facility and joining facility.
o Financial Assistance: Available, call for more information
o Age requirements: Must be 13 years old; 16 is the preferred age
First Baptist Church Life Center:
Life Center is a great fitness facility operated by First Baptist Church which features many
amenities such as a gymnasium, a weight and cardio room, a walking track, and a children’s
room. Church involvement is not required to use the facilities.
o Financial Assistance: Not Available
o Age Requirements: 13 years old; parent must be present if younger than 13 yrs old
o Child care services: Children’s room for 3-8 years old
Maples Training and Fitness Center:
Maples Training and Fitness Center is a 24 hour a day facility which offers fitness equipment for
any style of exercise and various fitness classes. Every elliptical and treadmill comes with its own
television and personal DVD player. Along with the fitness portion, Maples also offers popular
supplements and a wide selection of vitamins.
o
o
o
o
Cost for use of facility.
Financial Assistance: Based on need
Age requirements: Must be 13 to work out without a parent, no age limit with a family
Child care services: Monday – Friday 9am – 10am & 5pm – 7pm
Ozarks Regional YMCA:
The Ozarks Regional YMCA is a well known organization within the community. It is a viable
option of health and fitness for all ages. The YMCA offers a variety of classes and programs such
as Aerobics, Boot Camp, Zumba dance, Gymnastics, and many more.
o Cost per month, fee rates for Individuals, Family, Student, Senior, and Senior Couple.
o Financial Assistance: Application for financial assistance available at www.orymca.org
o Age requirements: None
o Free child care is available to members during workouts for up to two hours. Child care is
available 8:30am – 11:30am and 4:30pm – 7:30pm
Shape Shifters Pilates:
Shape Shifters Pilates aims to increase people’s level of fitness through Pilates training such as
flexibility and core strength. Shape Shifters is great for anyone coming back from an injury, such
as athletes who want to regain balance and flexibility, or senior citizens who want to improve
back strength and posture.
o Costs for use of facility.
o Age Requirements: No strict regulations; young kids up to professional athletes and senior
citizens; Very individualized, personal training
45
Skaggs Health and Fitness Center:
Skaggs Fitness Center is located on the upper level of the Branson RecPlex. They offer a variety
of classes for people of all fitness levels as well as other programs such as nutritional
consultation and personal training.
o
o
o
o
o
Cost for joining and use of facility.
Financial Assistance: Student discount available
Age requirements: Under 18 need parent signature; Must be 16 to work out alone
Child care services: Monday through Friday 8am–1pm; 4pm–8pm $2/day, $12/month
1500 Branson Hills Parkway, Branson
Golf Courses
Branson Creek Golf Club (Public, 18 holes):
Branson Creek Golf Club is a beautiful course which offers a large
range of services including golf instruction, a practice facility,
beverage carts, rental shoes and clubs, on course player
assistance, and group arrangements. Branson Creek has been
rated #1 by Golf Magazine and Golf Digest in the “Top Public
Courses in Missouri”.
o
o
Cart and range balls included in the price
Special arrangements for groups available
Don Gardner Par 3 Golf Course (9 holes, Municipal)
Don Gardner Par 3 Course is operated by Branson Parks and Recreation Department. This course
is suitable for all ages and skill levels.
o No reservation required
o Open year-round, 8 am – dusk
o Golf Leagues, Clinics, and Tournaments are available.
Holiday Hills Golf Course (Public, 18 holes):
Holiday Hills Golf Course is a beautiful 18-hole facility which is designed for entry level golfers,
but still presents a challenge to even highly skilled players. The course also offers a restaurant
and lounge as well as a fully stocked Golf Shop. Each golf cart is equipped with a new ProLink
GPS System which enables the player to view distances, order food and beverages, view sales by
and communicate with the Pro Shop, and view the leader board while playing in tournaments
put on by Holiday Hills.
Murder Rock Country Club (Semi Private/ Open to the Public, 18 holes):
John Daly’s Murder Rock Golf and Country Club is a semi-private golf club which offers many
amenities such as a community clubhouse with dining, a pro shop, fitness room, tennis, and
swimming. The golf course is set on the magnificent landscape of the Ozark Mountains and
provides beautifully placed greens which offer great views of the surrounding area.
o
o
Cart and range balls included in price
Group Discounts available
46
Payne Stewart Golf Club (Public, 18 holes):
The Payne Stewart Golf Club is a course constructed in honor of golf legend Payne Stewart. It
was ranked one of the Top 40 new course layouts in 2009 by Golf Week magazine. Each hole is
interwoven with a story of Stewart’s life and golf experiences throughout his career. The Golf
Club also features a clubhouse which includes a full menu of food items. Annual membership
with the Payne Stewart Golf Club includes full use of all the golf, tennis, swimming, and social
amenities which it has to offer.
Pointe Royale Village Country Club (Resort/ Semi Public, 18 holes):
Pointe Royale Village Country Club offers nightly rental condominium housing, swimming,
tennis, an exercise center, lakeside trout fishing, and of course a premier golf course. The course
is newly renovated and presents a challenge for players, yet it still features tees for all levels of
play. A fully stocked Pro Shop is available along with a restaurant in the Pointe Royale club
house.
Thousand Hills Golf Resort (Open to Public, 18 holes):
Thousand Hills Golf Resort is a popular course because of its ability to cater to golfers of every
skill level. The course features three separate sets of tees which ensure challenging yet fair play
for every golfer at every skill level. Thousand Hills Golf Course was rated 4 stars by Golf Digest
magazine in 2009 and voted Best of the Ozarks for Branson Golf Courses by readers of the
Springfield News-Leader. The golf resort is part of the full service Resort which offers discounts
to their nightly rental guests.
Skating and Bowling
Dogwood Lanes:
Dogwood Lanes Bowling Alley offers a full deli. While not the most strenuous of physical activity,
it is a good option to get out and do something fun.
o
Cost for individuals
Skate World:
Skate World is a great option for group gatherings or families who are looking for fun and
physical activity. It features a large skating arena, full snack bar, free Wi-Fi Internet, and a
selection of arcade games.
o
Cost for individuals, Birthday Parties and Private Parties.
Community Groups and Centers
Branson Community Center:
The Branson Community Center is used for a plethora of activities such as a senior lunch
program, dancing, crafts, card playing, club meetings, bingo activities, and Wii games.
o
o
o
o
Wii Bowling League- six week league every fall, winter, spring and summer. Free
Monthly ballroom dance, fourth Saturday of every month, 7-10 pm. Free
Branson Senior Center offers lunch daily Mon-Fri 11:30 a.m. - 12:30 p.m.
o $3 suggested donation ages 60+; and $5 for anyone under 60
Guest speakers come to the Senior Center once a month after lunch to speak on the topics
of health and nutrition. They also occasionally bring in local entertainers to perform during
the lunch hour.
47
Forsyth Senior Friendship Center:
o The Forsyth Senior Friendship Center offers a variety of activities free of charge to seniors
including Yoga, Line dance, Pinochle, and other activities during weekday afternoons.
o 8-ball Pool tables available for free play; treadmill and stationary bicycles also available.
Ozark Mountain Trailblazers:
Ozark Mountain Trailblazers is a group of outdoor enthusiasts, whose members enjoy hiking and
backpacking through the natural areas of southwest Missouri and northern Arkansas. The
group offers professional guide services, outdoor education and training, gear and trail reviews
and expedition adventures.
Food and Nutrition Resources in Taney County
Apart from all the normal supermarkets in Taney County, there are many resources which can be
utilized relating to options for less expensive food and healthy choices.
Farmers’ Markets
Branson Farmers’ Market:
The Branson Farmers’ Market is a great option for buying fresh produce and helping to support
local farmers.
o
Saturdays: 7a.m.-12p.m. May 9-October
Front door Farm Market:
Front Door Farm Market is working towards becoming a small scale sustainable farm with all
natural beef, pork, and chickens that have been given no steroids as well as over an acre of
garden. The aim is to supply several families in the area with a healthier and all natural option
for a good portion of their food needs.
Forsyth Farmers’ Market:
Located in the parking lot on Main Street across from the Taney County Judicial Center in
Forsyth. Open every Tuesday, Thursday, and Saturday during season, 7 am until sold out.
Forsyth Farmers’ Market II:
Located at Forsyth Veterans of Foreign Wars Post north of Forsyth on State Highway H just north
of US Highway 160 in Forsyth. Open every Friday and Saturday during season, 7 am until sold
out.
Rockaway Beach Farmers’ Market:
Rockaway Beach Farmers’ Market features a delicious full line of products grown organically
from the region. Open Saturdays from 7a.m.-3p.m, April- October
Food Pantries
Angel Food Ministries
Angel Food Ministries is dedicated to providing food relief and financial support to the
community. Many different food options are available with a different price for each
compilation box of food, with the average price of a box being $24. The food can be ordered
online or in person, and picked up at the host site.
o
A meal box feeds a family of four for about a week; No purchase limit on boxes
48
o
o
o
o
Different menu each month
Absolutely no applications or qualifications necessary to purchase.
Branson United Methodist Church
Beacon of Hope
Christian Action Ministries:
Christian Action Ministries is a non-denominational local
organization dedicated to distributing hundreds of
pounds of food and grocery products in Christ's name to
hungry and needy people in the community. CAM
provides emergency assistance with up to 3 days of
food.
o
Operates solely on donations from individuals,
businesses, churches, clubs, and civic organizations
Loaves and Fishes:
Loaves and Fishes aims to serve the working poor, families, homeless, and seniors during winter
months by providing them with no cost hot meals. Various locations are used as sites for serving
the meals.
My Neighbor’s Pantry:
My Neighbor’s Pantry is a charity food pantry which is committed to fighting hunger in Taney
County. This pantry is a program of Gift of Hope, a charity organization aiming to benefit
children and families in less than ideal circumstances
Food Programs
Boys and Girls Club
The Boys and Girls Club provides after school programs for kids 6-18. Not only do they have
after school programs, but they are also open all day (7:30am
–
6:30pm) during the summer months and offer various
programs for the summer. A hot meal is served each day
during the after school program, and during the summer
months, breakfast, lunch, and a snack are all served.
o
$25 per year, but no child is turned away for financial
reasons.
Free and Reduced Meal Programs
In 2008, 52.7% of students in Taney County schools were enrolled in the Free and Reduced
Breakfast and/or Lunch Program. Children from households with income less than 130% of
poverty are eligible for free lunches, and children from households with income below 185% of
poverty are eligible for reduced price breakfast/lunches. Information regarding the Free and
Reduced meal program is available from area schools.
Jesus Was Homeless:
Jesus Was Homeless is a nonprofit Christian organization which is dedicated to helping people
who are in need. They provide and deliver sack lunches to the weekly stay motels and the
homeless people who live and work in Branson and the surrounding area.
49
Meals on Wheels:
Meals on Wheels is a nationwide food program, but is locally served by the Community Center
to homebound senior citizens who cannot purchase or prepare their own food. Eligibility is
determined by medical need and financial need but overall, ability to pay does not matter.
Snacks in Packs (SIP)
Snack in Packs, sponsored by the Junior Auxiliary of Taney County, is a special food program for
children Kindergarten and 1st grades at Hollister Elementary School. The program was designed
to provide food and snacks for the weekend for eligible children. Each Friday, the child receives
a bag packed with healthy snacks to help meet food needs during weekend.
Summer Food Service Program
The Summer Food Service Program assures that eligible children have access to nutritious meals
during the summer months. Children up to the age of 18 are eligible if their family income is less
than or equal to 185% of the Federal Poverty Guidelines. Adults over the age of 18 are eligible if
they have been determined by the state educational agency to have a disability and participated
in a school-based program for the disabled during the school year.
o
Several different locations in Taney County
o Taneyville R-II: 417-546-5803
o Bradleyville R-1 School: 417-796-2288
o Forsyth Elementary School: 417-546-6384
o Lake Taneycomo Elks: 417-546-6299
o Kirbyville Elementary School: 417-334-2757
o Hollister Elementary School: 417-243-4025
o Branson High School: 417-334-6541
o Branson Primary School: 417-334-6541
o Branson Branch: 417-335-2089
Women, Infants, and Children (WIC):
WIC is a nutrition program which helps mothers and young children eat well and stay healthy.
The program is for women who are pregnant, breast feeding, or who have young children under
the age of 5. It is operated locally through the Taney County Health Department. The WIC
Program provides checks to buy healthy foods, offers health education and personal nutrition
counseling, and referrals to other health programs for the family. Qualifications and other
information can be found at: http://taneycohealth.org/wic.php
o
o
Branson Office: 417 -334 – 4544; 320 Rinehart Road
Forsyth Office: 417 -546 – 4725; 15479 State Highway 160
Breastfeeding Support:
o A Certified Breast feeding educator is available at the Taney County Health Department to
answer all your questions about breast feeding at no cost.
Other Resources
Master Gardeners of the Ozarks:
Master Gardeners of the Ozarks is a gardening enthusiast group which aims to improve the
quality of life and enhance the economy and environment through horticulture education. The
group offers a volunteer program as well as gardening workshops and various gardening events.
50
The volunteer programs consist of involvement in one on one teaching, the speaker’s bureau,
community beautification projects, children’s garden and hosting conferences and workshops
Ozarks Area Community Action Corporation:
Ozarks Area Community Action Corporation is a non-profit agency which works towards
alleviating the causes and conditions of poverty in several counties the Ozarks area, including
Taney County. They offer several programs in order to meet the needs of people in the Ozarks.
o
o
o
Foster Grandparents- For low-income senior citizens, 55 yrs or older. Receive an hourly
stipend for time spent with at-risk children in the community through local agencies such as
public schools, Head Start classes, Youth Community Centers, and Day Care centers.
Neighborhood Centers- Offers Family Support, Emergency Assistance, Targeted Coaching,
School Readiness Fairs, Workshops, and Community Projects. Exists for those in need of
services. Meet with a Family Resource Specialist and discuss the current situation. You will
be referred to specific OACAC community programs for further help.
OACAC Central Office is located in Springfield, Mo.
Older Adult Transportation System (OATS):
o OATS is a nonprofit public transportation system that serves people across Missouri,
including Taney County. It serves to transport people so they can get to work, doctors
appointments, or necessary shopping such as the grocery store or food pantry.
o Approximately $6 Branson to Springfield; within Branson, Hollister, Forsyth area: $1-$3
o Call ahead and schedule a pick up time and route
51
Forces of Change Assessment
The Forces of Change Assessment is one of four assessments conducted during the MAPP process. The
assessment focuses on identification of external forces such as environmental, economic, legal and
other issues that affect the way the community and its public health system operates
During the Forces of Change Assessment, participants answered the following questions: "What is
occurring or might occur that affects the health of our community or the local public health system?"
and "What specific threats or opportunities are generated by these occurrences?" (NACCHO, 2012).
Taney County conducted the Forces of Change Assessment in July 2012. During the Forces of Change
Assessment over 10 Taney County community leaders and members identified trends, factors and
events that impact our community. The Forces of Change Assessment resulted in a list that identifies key
forces and their impacts.
Category
Environmental
FORCES OF CHANGE ASSESSMENT FOR TANEY COUNTY
Force
Threats Posed
Opportunities Created
Access to
sidewalks
Climate /
Environmental
changes
Lack of sidewalks limit the
ability to safely travel by
foot or by bicycle and
discourages
physical
activity
Potential increase in the
number or severity of
weather events; potential
health consequences of
deteriorating environment
Recognize the need for more
sidewalks
to
encourage
walkability
Increased
awareness
of
environmental changes on health;
greater understanding of the
connection between environment
and
health;
increased
preparedness for emergencies,
water
conservations,
energy
conservation
Potential for better food safety
regulations
and
consumer
education on safe food handling
/practices; increased education at
an early stage in our schools and
homes; increase public awareness
of related issues
Food Safety
Threats
Increase in the number of
food recalls due to the
contamination of products;
increase
in
foodborne
illness
Recession
Business
closures; Increased efficiencies; reduction
unemployment
and of duplication; collaboration
underemployment; reduced
tax revenue; declining
values of investments;
delay
in
economic
recovery; reduced public
and private capacities;
reduction
of
benefits;
bankruptcies,
home
foreclosures
Economic
52
Category
Force
Threats Posed
Housing
Reduced real estate tax Investment in improving existing
market decline revenues, resulting in more housing; lower tax burden; lower
competition for limited real estate costs; allow for
county resources; instability acquisition of properties to
of neighborhood networks; increase affordable housing stock
overcrowded housing
Budget
Potential for reduction in Development of creative nonreductions at
entitlement programs and governmental
solutions;
local and state
Medicaid; reduced local consolidation
of
programs;
levels
and state funding of social reduction of duplication of
and
health
services programs/services
programs; reduction of
public
employees;
decreased funding for nonprofits
Rising
Increase of insurance co- Healthcare reform; employee
healthcare costs pays,
deductibles
and wellness
programs;
increase
denials; delay in diagnoses attention to prevention; greater
and treatment; employers personal
responsibility
for
reducing health benefits
behaviors impacting health
Job Loss
Violence; increase in crime; Economic stimulus package;
stress and broken families
increase in technical skills;
opportunity to explore new
careers
Legal
Health Care
Reform
Uncertain impact of the
affordable care program;
impact
on
providers;
political resistance; impact
among those not covered
under the Health Care
Reform
Expanded health care coverage;
encourage public health work to
be more population focused;
increase focus on prevention and
wellness
Increasing
senior
population
Increasing
number
of Seniors with disabilities are able
disabilities; increasing costs to continue living in their homes;
of services
increase number of programs and
service models
Increased
demand
for Evaluate
laws;
strengthen
resources
and
support enforcement prevention program
services; greater demand expansion to build personal,
for mental health services; family and community resilience
decreased
community
safety
Mental health problems; Increase awareness and programs
domestic violence
Social
Abuse, neglect
and violence
Substance
abuse
53
Category
Ethical
Force
Threats Posed
Social factors that
affect health
Disparities in health outcomes Systemic approach to
along
racial/ethnic/socio- address causes of health
economic lines
disparities
through
collaboration
among
diverse entities; support
for
population-based
approaches to public
health;
community
involvement
54
Community Themes and Strengths Assessment
As part of the MAPP process, The Community Themes and Strengths Assessment answer the questions:
"What is important to our community?" "How is quality of life perceived in our community?" and "What
assets do we have that can be used to improve community health?" This assessment results in a strong
understanding of community issues and concerns, perceptions about quality of life, and a map of
community assets (NACCHO, 2012).
An assessment on Community Themes and Strengths Assessment was conducted to gather perspectives
from community members and identify problems that could be addressed in the community. Findings
are as follows:
Strengths:
Parks and recreation
Growing hospital
Activities for younger children
Competent fire and emergency personnel
Strong partnerships between agencies
Available networks of support
Access to health care for the
underinsured/uninsured
Increase of restaurants who voluntarily are
smoke free
Weaknesses:
Drug and alcohol abuse
Need more specialized health care services
Chronic diseases
Poor diets
Cancer
Lack of public transportation
Lack of sidewalks
Unemployment
Homelessness
More options for underinsured/uninsured
55
Local Public Health System Assessment
The Taney County public health system was assessed using the national Public Health Performance
Standards Program (NPHPSP) developed by the CDC (2007) with other program partners. The purpose
of this assessment was to identify our public health system strengths and weaknesses and decide upon
improvement. Taney County Health Department is only part of many partners in the public health
system. A one-day session with over 15 community partners completed the public health system
instrument in February 2012. Results are as follows:
INTRODUCTION
The National Public Health Performance Standards Program (NPHPSP) assessments are intended to
help
users
answer
The NPHPSP is a collaborative effort of seven national partners:
questions such as "What
are the activities and
capacities of our public
 Centers for Disease Control and Prevention, Office of Chief of Public
Health Practice (CDC/OCPHP)
health system?" and

American Public Health Association (APHA)
"How well are we
 Association of State and Territorial Health Officials (ASTHO)
providing the Essential
 National Association of County and City Health Officials (NACCHO)
Public Health Services in
 National Association of Local Boards of Health (NALBOH)
our jurisdiction?" The
 National Network of Public Health Institutes (NNPHI)
dialogue that occurs in
 Public Health Foundation (PHF)
answering
these
questions can help to
identify strengths and
weaknesses and determine opportunities for improvement.
The NPHPSP is a partnership effort to improve the practice of public health and the performance of
public health systems. The NPHPSP assessment instruments guide state and local jurisdictions in
evaluating their current performance against a set of optimal standards. Through these
assessments, responding sites consider the activities of all public health system partners, thus
addressing the activities of all public, private and voluntary entities that contribute to public health
within the community.
Three assessment instruments have been designed to assist state and local partners in assessing
and improving their public health systems or boards of health. These instruments are the:



State Public Health System Performance Assessment Instrument,
Local Public Health System Performance Assessment Instrument, and
Local Public Health Governance Performance Assessment Instrument.
This report provides a summary of results from the NPHPSP Local Public Health System Assessment
(OMB Control number 0920-0555, expiration date: August 31, 2013). The report, including the
charts, graphs, and scores, are intended to help sites gain a good understanding of their
performance and move on to the next step in strengthening their public system.
56
Calculating The Scores
The NPHPSP assessment instruments are constructed using the Essential Public Health Services
(EPHS) as a framework. Within the Local Instrument, each EPHS includes between 2-4 model
standards that describe the key aspects of an optimally performing public health system. Each
model standard is followed by assessment questions that serve as measures of performance. Each
site's responses to these questions should indicate how well the model standard - which portrays
the highest level of performance or "gold standard" - is being met.
Sites responded to assessment questions using the following response options below. These same
categories are used in this report to characterize levels of activity for Essential Services and model
standards.
NO ACTIVITY
0% or absolutely no activity.
MINIMAL
ACTIVITY
Greater than zero, but no more than 25% of the activity described
within the question is met.
MODERATE
ACTIVITY
Greater than 25%, but no more than 50% of the activity described
SIGNIFICANT
ACTIVITY
Greater than 50%, but no more than 75% of the activity described
OPTIMAL
ACTIVITY
Greater than 75% of the activity described within the question is
met.
Using the responses to all of the assessment questions, a scoring process generates scores for
each first-tier or "stem" question, model standard, Essential Service, and one overall score. The
scoring methodology is available from CDC or can be accessed on-line at
http://www.cdc.gov/nphpsp/conducting.html.
Understanding data limitations
Respondents to the self-assessment should understand what the performance scores represent
and potential data limitations. All performance scores are a composite; stem question scores
represent a composite of the stem question and sub-question responses; model standard scores
are a composite of the question scores within that area, and so on. The responses to the questions
within the assessment are based upon processes that utilize input from diverse system
participants with different experiences and perspectives. The gathering of these inputs and the
development of a response for each question incorporates an element of subjectivity, which can
be minimized through the use of particular assessment methods. Additionally, while certain
assessment methods are recommended, processes can differ among sites. The assessment
methods are not fully standardized and these differences in administration of the self-assessment
may introduce an element of measurement error. In addition, there are differences in knowledge
57
about the public health system among assessment participants. This may lead to some
interpretation differences and issues for some questions, potentially introducing a degree of
random non-sampling error.
Because of the limitations noted, the results and recommendations associated with these reported
data should be used for quality improvement purposes. More specifically, results should be utilized
for guiding an overall public health infrastructure and performance improvement process for the
public health system. These data represent the collective performance of all organizational
participants in the assessment of the local public health system. The data and results should not be
interpreted to reflect the capacity or performance of any single agency or organization.
Presentation of results
The NPHPSP has attempted to present results - through a variety of figures and tables - in a userfriendly and clear manner. Results are presented in a Microsoft Word document, which allows
users to easily copy and paste or edit the report for their own customized purposes. Original
responses to all questions are also available.
For ease of use, many figures in tables use short titles to refer to Essential Services, model
standards, and questions. If in doubt of the meaning, please refer to the full text in the assessment
instruments.
Sites may choose to complete two optional questionnaires - one which asks about priority of each
model standard and the second which assesses the local health department's contribution to
achieving the model standard. Sites that submit responses for these questionnaires will see the
results included as an additional component of their reports. Recipients of the priority results
section may find that the scatter plot figures include data points that overlap. This is unavoidable
when presenting results that represent similar data; in these cases, sites may find that the table
listing of results will more clearly show the results found in each quadrant.
FINAL REMARKS
The challenge of preventing illness and improving health is ongoing and complex. The ability to
meet this challenge rests on the capacity and performance of public health systems. Through well
equipped, high-performing public health systems, this challenge can be addressed. Public health
performance standards are intended to guide the development of stronger public health systems
capable of improving the health of populations. The development of high-performing public health
systems will increase the likelihood that all citizens have access to a defined optimal level of public
health services. Through periodic assessment guided by model performance standards, public
health leaders can improve collaboration and integration among the many components of a public
health system, and more effectively and efficiently use resources while improving health
intervention services.
58
Performance Assessment Instrument Results
How well did the system perform the ten Essential Public Health Services (EPHS)?
Table 1: Summary of performance scores by Essential Public Health Service (EPHS)
EPHS
1
Monitor Health Status To Identify Community Health Problems
2
Diagnose And Investigate Health Problems and Health Hazards
3
Inform, Educate, And Empower People about Health Issues
4
Mobilize Community Partnerships to Identify and Solve Health Problems
5
Develop Policies and Plans that Support Individual and Community Health Efforts
6
Enforce Laws and Regulations that Protect Health and Ensure Safety
7
Link People to Needed Personal Health Services and Assure the Provision of Health Care
when Otherwise Unavailable
8
Assure a Competent Public and Personal Health Care Workforce
9
Evaluate Effectiveness, Accessibility, and Quality of Personal and Population-Based
Health Services
10
Research for New Insights and Innovative Solutions to Health Problems
Overall Performance Score
Score
68
96
87
85
94
99
66
92
78
80
85
Table 1 (above) provides a quick overview of the system's performance in each of the 10 Essential Public
Health Services (EPHS). Each EPHS score is a composite value determined by the scores given to those activities
that contribute to each Essential Service. These scores range from a minimum value of 0% (no activity is
performed pursuant to the standards) to a maximum of 100% (all activities associated with the standards are
performed at optimal levels).
Figure 1 (below) displays performance scores for each Essential Service along with an overall score that
indicates the average performance level across all 10 Essential Services. The range bars show the minimum
and maximum values of responses within the Essential Service and an overall score.
59
Figure 1: Summary of EPHS performance scores and overall score (with range)
60
Appendix A
Policy Changes
61
2012 Community Health Assessment:
Public Policy Changes
Year
20052006
2006
Agency
Schools
Rule Change
Model School Wellness Program required by Missouri State Law
Schools
2006
Schools
2006
Taney County
Health
Department
Schools
Requires school districts to grant authorization to pupils for the
possession and self-administration of medications for the
treatment of asthma and anaphylaxis.
Allows school nurses to keep on hand and administer
epinephrine auto syringes to students who the nurse believes is
having an anaphylactic reaction.
County Food Code Ordinance Enacted
2007
2006
Ongoing
2007
2008
City of Branson
Park Board
TCHD
Skaggs
City of Branson
Park Board
City of Forsyth
TCHD
TCHD
2007
2008
Missouri
City of Branson
Annually
MO DHSS
Taney County
Park Board
2008
2006
Ongoing
Beginning July 1, 2008, every child enrolled in kindergarten or
first grade shall receive comprehensive vision examinations by a
state licensed optometrist or physician and before the
completion of first and third grade, school districts must conduct
and eye screen for each student.
Rec-Plex Facility opened.
Tobacco Free Campus Policy Implemented
Tobacco Free Campus
Walking Trails constructed for the community
Walking Trails constructed for the community.
Ordinance for adoption of 1999 Food Code
Integration of Environmental Health Services and TCHD
Approved
MC+ changes to Missouri Health Net approved to begin in 2008
Liquor Law Ordinance Changes for City of Branson to tighten sale
and consumption of alcohol beverages in Branson
Communicable Disease Reporting Rule Changes
Taney County Park Board Established
62
Appendix B
Taney County Tobacco Use Assessment
63
2011 Tobacco Use Assessment
Introduction
Taney County consists of 632.14 square miles of land and 19.12 square miles of water and is located in
the southwest corner of Missouri in the heart of Ozark country. Taney County was organized on January
6, 1837 and was named after a Chief Justice of the United States Supreme Court, Roger B. Taney (Taney
County Missouri, 2011).
Total resident population is approximately 51,675 according to the 2010 census which has increased
30.2% since 2000 (U.S. Census Bureau, 2011). The population diversity is approximately 93.6% white,
0.9% Black, 4.8% Hispanic and the remaining 0.7% consists of other ethnic groups. The population is
young with a median age of 21.9 years for both males and females. There are a larger number of
females compared to males in Taney County, 51.5% and 48.5%, respectively (U.S. Census Bureau, 2011).
The 2009 median income for a household in Taney County according to the 2010 US Census was
$37,319. The per capita income for the county in the past 12 months (2005-2009) was $20,855 and
about 15.8% of the population is living below the poverty level (U.S. Census Bureau, 2011).
Of adults 25 years of age and older in Taney County, 86.2% possesses a high school diploma or higher
while 20.4% holds a bachelor's degree or higher as their highest educational attainment (U.S. Census
Bureau, 2011).
Background
Tobacco use is the leading cause of death in the Unites States with an estimated 443,000 deaths each
year which includes approximately 49,000 non-smokers exposed to secondhand smoke. Smoking
tobacco has been associated with an increased risk of stroke, heart disease, chronic obstructive
pulmonary disease, and several other forms of cancer. Smokeless tobacco has also been associated with
an increased risk of oral cancer, pancreatic cancer, and cardiovascular disease (CDC, 2011).
The economic costs of smoking are staggering. It is estimated that smoking is related to over one-tenth
of the total hospital and medical expenses in the United States, with the combined cost of smokingrelated sickness and decreased productivity (lost work output and absenteeism) raising this total into
the billions of dollars. In addition, the health risk to nonsmokers (e.g., passive smoking) may also be
significant, especially if there is a preexisting cardiovascular or pulmonary condition (CDC, 2011).
The Taney County Health Department’s (TCHD) primary focus has always been to increase awareness
and educate the community on the harmful effects of tobacco use and second-hand smoke. In 2006, the
department received a Maternal and Child Health Grant from the Missouri Department of Health and
Senior Services (DHSS) which allowed the health department the ability to hire a health educator to
teach tobacco awareness in schools. Through student lead anti-tobacco groups in Branson and Forsyth
Junior High Schools, the DreamOn (BJHS) and TATU (FJHS) clubs empower local youth to take action to
reduce tobacco use and exposure to secondhand smoke. For the last 5 years, members of these clubs
have worked to educate themselves , their peers and community about tobacco use. They have
participated in Red Ribbon Week, the Great American Smoke-out, and Kick Butts Day as well as
participating in Relay for Life. These students have also participated in radio interviews and developed
PSA’s.
64
In 2007, the department initiated the Breathe Easy Coalition. This coalition began with representatives
from TCHD’s board, Skaggs Regional Medical Center, the American Heart Association, American Lung
Association, American Cancer Society, and community leaders from Branson, Forsyth and Hollister. In
2009, the coalition changed its name to Smoke-free Taney County and has recently joined the Alcohol
and Drug Abuse Prevention Team(ADAPT) as a subcommittee.
Since Taney County has the highest rate of smoking (36.5%) according to 2007 Missouri County Level
Study of having the tobacco users within the state of Missouri, we decided to conduct a tobacco use
survey to assess the prevalence of smokers, age distribution, education obtained among smokers and if
they would like to receive education on tobacco cessation.
County Level Study 2007
A Missouri county level study (CLS) was conducted on tobacco use in 2007. The Missouri Foundation for
Health (MFH) contracted with the University of Missouri-Columbia Health and Behavioral Risk Research
Center (UMC HBRRC) to conduct interviews with 400 adults in 112 counties and 800 adults each in
Jackson and St. Louis Counties and the City of St. Louis. A total of 47,200 Missouri adults were randomly
called on landline telephones and an additional 5,000 were called on cell telephones. The 2007 CLS
involved interviews with 49,513 Missouri adults and was supported by a grant from MFH. The 2003 CLS
involved interviews with approximately 15,000 adults. Because of the lower number of responses in
smaller counties, the 2003 study combined data from two or three counties. UMC HBBRC conducted the
interviews in 2003 and 2007. Macro International conducted the primary data analysis in 2007 and a
special comparison analysis of the 2003 and 2007 studies (Missouri County-Level Study, 2007).
Currently a 2011 study is being conducted. Calls began in January 2011 and will continue through
December 2011. MFH contracted with Macro International to conduct the primary data analysis.
Missouri Department of Health and Senior Services (DHSS) staff was responsible for the study design
and will monitor data quality and consult with MFH on interpreting and reporting results. The 2011 CLS
results will be posted on the DHSS Community Data Profiles web site where 2007 results and a
comparison analysis of 2003 and 2007 may be found (Missouri County-Level Study, 2007).
Results from the 2007 County Level Study:
Taney County 381 interviewed
36.5% currently smoked
2.9% used smokeless tobacco
22.5% were former smokers
Missouri, 49,019 interviewed
23.2% currently smoked
3.9% used smokeless tobacco
25.1 were former smokers
Limitations to the 2007 study:
The findings of the 2007 study are subject to at least three limitations. First, the CLS did not collect
information from institutionalized persons, thereby excluding persons residing in nursing homes, long65
term care, and correctional facilities. Second, as a self-report survey, the CLS is subject to recall bias.
Third, the CLS did not include persons residing in households without telephones and those households
that use cell phones only.
August 2011, Taney County Health Department developed and implemented an anonymous online
survey of residents of Taney County for three consecutive weeks using websites of the City of Branson,
the Taney County Health Department, and Community Partnership of the Ozarks.
66
Methodology
Study Design
A cross-sectional, anonymous questionnaire survey
Assessment of Tobacco Use among Taney County Residents
Needs assessments are conducted during the planning phase of any program to isolate the target
population, determine what variables are contributing to increased tobacco use compared to other
counties in Missouri, and to determine what actions can be implemented to decrease tobacco use in our
community. The information collected from the tobacco use assessment has driven a needs assessment
for the population in the community, and helped establish which course should be taken to maximize
efficacy.
An important step in addressing tobacco use and dependence is by screening residents of Taney County
for tobacco use. A questionnaire was developed by Taney County Health Department to collect and
analyze data on the tobacco prevalence and also to find out if the respondents were aware of second
and third hand smoke. The anonymous questionnaire about tobacco use was uploaded to the Taney
County Health Department, the City of Branson, and Community Partnership of the Ozarks websites for
a period of three weeks. Only residents of Taney County were asked to respond to the survey. Mass
emails went out to community partners for participation in the survey and to forward onto others to
increase participation. The goal was to have at least 1000 responses to the survey; however, at the
close of the survey, we received a total of 282 responses. Any respondents who did not reside in Taney
County were excluded from the results making the total of viable responses to 270.
Purpose and Scope:
The purpose and scope of the needs assessment is to gather data from residents
in the local community to determine their opinions and comprehension of tobacco use. Demographic
and behavioral statistics were collected from self-report surveys and used to determine individual and
community knowledge and actions as it pertains to tobacco use.
Overall goal of the assessment:
Prevalence of tobacco use in Taney County
Age distribution of current tobacco users
Education obtained from tobacco users
Assess respondents’ knowledge of second and third hand smoke
Gathering Data: Primary data was collected from residents in the community via survey administration
and asked residents to complete an original self-report online questionnaire. Considerable effort was
made to ensure accurate reporting; however, self-reporting respondents may have provided inaccurate
information because the respondent was unaware of relevant information or did not wish to reveal
information that was requested.
Analyzing Data:
This full-report will be made available to all stakeholders in the community in the public domain via the
Taney County Health Department website upon compilation of the primary data.
67
Identifying the Intervention Focus:
Based on the primary and secondary data collected and analyzed, by providing community education to
Taney County residents the primary goal will be to educate them on the dangers of tobacco use and
offer different ideas and methods to safely and effectively quit smoking or using smokeless tobacco.
Area to focus on: Behavioral changes and health education in addition to providing resources to assist
the community in their process which will enable individuals to change their habits, decrease possible
health issues and live a longer life.
Results
Tobacco Use Prevalence
•
•
10% of the participants surveyed regularly use tobacco products, 27% were regular users at one
time but have quit, and 63% never used regularly. Missouri data from the 2010 Behavioral Risk
Factor Surveillance Survey (BRFSS) estimate that the smoking rate among Missouri residents is
around 21.1% (BRFSS, 2010).
Although rates of tobacco use are low overall, significantly more females use regularly than
males (85% vs.15%).
The overall adult smoking prevalence was significantly higher among adults ages 46-55 than
among adults ages 65 and older. 42% of the participants that use tobacco have an education of
at least an associate’s degree.
18% of non-smokers shared a household with a family member who currently smokes and 37%
of smokers live with other family members that smoke besides themselves.
Survey findings indicate that 50% of smokers and 82% of non-smokers supported laws making
restaurants smoke-free.
The smoking prevalence among adults decreased with increasing education level. Adults who
had some post secondary education have the highest smoking prevalence (40%) among all
educational attainment groups.
Starting age of Taney County smokers who responded to the survey:
o
o
o
o
63% under the age of 18,
26% between the ages of 18-21,
7% between the ages of 31-44 and
4% between the ages 45-60.
The Need for Intervention
Cessation of tobacco use can greatly improve the physical health consequences of tobacco use, help
reduce the financial burden from the purchase of tobacco, increase self-esteem, and reduce tobacco
user’s feelings of stigma.
•
According to the survey, 48% of Taney County residents who regularly use tobacco would either
like to quit, maybe would quit or are unsure they would quit within the next 12 months.
•
79% of current tobacco users indicated that they tried to quit in the past but were unsuccessful.
65% of current users tried to quit “Cold Turkey”, with nicotine replacement therapy used far less
often. 44% of tobacco users surveyed that they have tried to quit tobacco “more than three
times.
68
Limitations
The study had some limitations: smoking status was by anonymous self-report and the survey was
cross-sectional. Therefore, some Taney County residents may have under reported their tobacco use.
Because the study was carried out on three website locations with a press release that was conveyed
along with mass emails to our community partners to disseminate to their staff, residents were not
interviewed personally. Taney County Health Department did not collect information from
institutionalized persons, thereby excluding persons residing in nursing homes, long-term care, and
correctional facilities. Taney County Health Department did not include persons residing in households
without internet access.
Conclusion
Tobacco use in any form (smoking or smokeless) is prevalent among Taney County Residents. Cigarette
smoking was the most popular form of tobacco use. Female Taney County residents were more likely to
use tobacco. Targeted adult intervention strategies by counseling and education are necessary.
Enforcement of regulations on sale and advertisements of tobacco products may also be useful.
Legislations on use of tobacco products need to be enforced to decrease availability, accessibility and
affordability of tobacco products by instituting a no smoking policy in public places. Policies to bring
about changes in acceptability of tobacco use (social norms) among adults may also help to curb the
tobacco use among Taney County residents. A reassessment of the county will need to be conducted
after the intervention of health education and policy change to compare results and see if there has
been a decrease related to policy change.
69
Appendix C
Health Care Services-Taney County
70
Introduction
Health care service providers in Taney County are regional resources for residents in surrounding
counties in Missouri and Arkansas. Because of this, and Taney County’s increasing population, it is
important to identify the capacity of the delivery of current health care services. Hospital capacity,
skilled nursing, and physician characteristics will be examined to develop a profile of the resources
available in Taney County.
Nursing
The number of nurses by type of license in Taney County is presented in Table 1 for 2011.
Table 1
Nurses by License Type-Taney County, 2011
2006
2011
%
Change
Acute Care Nurse Practitioner
2
3
50
Adult Nurse Practitioner
1
1
0
Adult Psych/Mental Health CNS
1
2
100
Family Nurse Practitioner
10
13
30
Nurse Anesthetist
5
7
40
Pediatric Nurse Practitioner
1
1
0
Women's Health Nurse Practitioner
1
1
0
LPN
155
171
10.3
RN
223
345
54.7
Total
399
544
36.3
Source: Missouri Division of Professional Registration, 2011
Hospital Services
Skaggs Regional Medical Center reported having 160 licensed beds in 2010 (Table 2). Table 3 also
provides the occupancy rate and average length of stay for Skaggs Regional Medical Center in Branson.
71
Table 2
Skaggs Regional Medical Center
Rooms by Type, 2008 and 2010
2008
160
2010
160
Licensed Beds
Occupancy Rate
160
66%
Average Length of Stay
(Days)
3.5
4.2
Open Heart Surgery
Rooms
1
1
Other Operating
Rooms
6
6
Number of Airborne
Infection Isolation
Rooms
8
8
Number of Isolation
Rooms
8
8
Delivery Rooms
3
3
Licensed Beds
Source: Skaggs Regional Medical Center, 2011
Table 3
Skaggs Regional Medical Center Beds by Type, 2011
Licensed
Staffed
Occupancy
Average
Length*
Inpatient Service
Area
Beds
Beds
Rate
of Stay
Medical Surgical
(Includes Swing)
32
28
85%
5 Days
Obstetric
14
14
40%
2 Days
Intensive Care
(Mixed)
14
14
75%
--
Other Special Care Type: STEPDOWN
28
25
75%
4 Days
-
-
-
--
160
120
66%
4.2 Days
Alcohol/Chemical
Total Hospital
72
Table 4
Utilization Statistics- Skaggs Regional Medical Center, 2010
Payroll Expenses
$53,400,000
Number of Open Heart
Surgeries - Adult
94
Non-Payroll Expenses
$130,100,000 Number of Open Heart
Surgeries - Ped
0
Total Expenses
$183,500,000 Number of Cardiac Caths
Procedures
Angioplasties
Outpatient Total
133,241
CT Scans Procedures
763
374
14,278
ESWL Totals (Lithotripsies)
31
Excimer Laser Procedures
73
Gamma Knife Procedures
0
4,291
Hemodialysis Treatments
530
Inpatient
1,581
PET Procedures
326
Outpatient
2,710
Radiation Therapies
4,023
MRI Procedures
2,602
Emergency Visits
Surgery Total
41,019
Open Heart Surgery Rooms
1
Births
Other Operating Rooms
6
OB Level
Number of Isolation Rooms
15
Newborn Days
2,014
Number of Airborne Infection
Isolation Rooms
Negative Pressure Room (Air
exchange 12 times/hour
Negative Pressure Room (Air
exchange 6 times/hours
7
Delivery Rooms
3
All
LDRP Rooms
0
High Risk Infant Clinic
0
High Risk Prenatal Clinic
0
12-Jun
616
2
73
Table 5
Health Care-Associated Infection Reporting-Skaggs Regional Medical Center
Number of
Hospital
Infections
Hospital
Infection
Rate
Medical/Surgical
0
0
Rate for
Similar
Sized
Hospital
0.9
Surgical Site Infections
(Low Risk Group)
0
0
(Medium Risk Group)
0
(High Risk Groups)
0
Statewide
Rate
National
Rate
0.9
1.7
0.7
0.6
0.7
0
1.7
1.4
1.4
0
3.8
3
2.4
Source: Missouri Department of Health, Health Care-Associated Infection Reporting, 2011
The US Department of Health and Human Services, Health Resources and Services
Administration have designated Taney County as a Health Professional Shortage area in regard
to Low Income access to healthcare and Mental Health Services.
Table 6
Health Promotion Services-Skaggs Regional
Medical Center, 2010
Diabetes Screening
Yes
Diabetes Education
Yes
Arthritis Education
Yes
Weight Management
PSA Screening
Yes
Cholesterol Screening
Yes
Heart Health Education
Yes
Fitness/Exercise Program
Yes
Smoking Cessation Program
Yes
Osteoporosis Screening
Yes
Osteoporosis Education
Yes
Source: Missouri Department of Health and Senior Services, Community Data Profiles,
74
Table 7
Utilization Statistics-Skaggs Regional Medical
Center, 2009
2007
2008
2009
Licensed Beds
177
165
165
Inpatient Days
28,668
26,777
24,200
Discharges
6,514
6,483
6,503
Average
Length of Stay
4.4
4.1
3.7
Occupancy
44.4
44.5
40.2
Source: Missouri Department of Health and Senior Services, Community Data Profiles, 2011
75
Physicians
The number of total Active/Associate and Board Certified physicians by specialty at Skaggs Regional
Medical Center for the year 2010 are listed in Table 8.
Table 8
Physician Staffing By Specialty, Skaggs Regional Medical
Center, 2010
Physician Staffing
Active/Associate
41
Board Certified
37
General Internal Medicine
10
8
Pediatrics
2
2
Cardiology
5
5
Gastroenterology
0
0
Oncology
2
2
Neurology
5
5
Other Med Specialties
0
0
Obstetrics/Gynecology
4
4
Ophthalmology
2
2
Orthopedic Surgery
4
4
Plastic Surgery
0
0
General Surgery
4
4
Thoracic Surgery
1
1
Other Surgical Specialties
2
2
Anesthesiology
4
4
Emergency Medicine
27
27
Nuclear Medicine
0
0
Pathology
5
5
Psychiatry
1
1
Physical Med & Rehab
1
1
Radiology
3
3
Other Specialties
0
0
Dental Specialties
0
0
Podiatric Specialties
3
3
126
120
General Practice
Total
76
Emergency Room Utilization
Table 9 provides information regarding Emergency Room utilization by condition for Taney County
residents. A comparison with state averages is also provided.
Table 9
Emergency Room Visit Profile for Taney County Residents-2010
Taney
County
Numbers
AgeAdjusted
Rate
Significantly
Different
AgeAdjusted
State
Rate
16,919
405.8
H
356.8
189
4.6
L
8.2
139
3.4
L
5.9
Neoplasms (Cancer and Other
Growths)
27
0.6
N/S
0.6
Nutritional/Metabolic/Immunity
204
4.6
N/S
4.2
103
2.4
H
1.6
34
0.8
L
1.3
24
0.5
L
1
638
15.5
H
10
Alcohol- and SubstanceRelated Mental Disorders
249
6.1
H
2.4
Anxiety-Related Disorders
140
3.4
H
2.7
1,794
43.8
H
34.4
Headache/Migraine
687
17
H
10.5
Otitis Media and Related
Conditions
412
10.4
H
9.2
897
19.5
H
17
Hypertension
105
2.3
H
1.8
Heart Disease
662
14.5
H
12.8
Stroke/Other
Cerebrovascular Disease
40
0.8
N/S
0.8
2,263
54.9
L
56.4
Chronic Obstructive
Pulmonary Disease
(COPD)
360
8.4
H
5.5
Asthma
110
2.7
L
5.2
All Diseases/Conditions
Infection
Viral Infections
Diabetes Mellitus
Blood and Blood-Forming
Anemia
Mental Disorders
Brain/Spinal Cord/Eyes/Ears
Heart and Circulation
Respiratory (Throat and Lung)
77
196
4.7
N/S
4.7
1,314
31.5
H
24.3
547
13.5
H
7
854
20.1
H
18.8
Urinary Tract Infections
291
6.8
L
7.4
Pelvic Inflammatory
Disorders (PID)
45
1.1
N/S
1.3
209
5
L
6.9
156
3.7
L
5.5
630
15.5
H
11.7
1,501
36.3
H
22.7
Arthritis and Related Joint
Disorders
361
8.7
H
5
Back Problems
733
17.8
H
10.6
4,224
102.7
H
99.9
Fractures
436
10.4
L
11.9
Open Wounds
888
21.6
L
22.5
Sprains and Strains
958
23.7
N/S
23
Burns
93
2.3
H
1.7
Pneumonia and Influenza
Digestive System
Teeth and Jaw Disorders
Kidneys/Bladder/Genitalia
Pregnancy/Childbirth/Reproduction
Pregnancy Complications
Skin
Bone/Connective Tissue/Muscle
Injury and Poisoning
147
3.6
H
2.7
Poisoning
All rates are per year per 1,000 population and are age-adjusted to the U.S. 2000 standard population. * Fewer than 20 events in
numerator; rate is unstable. Trends are available only if each 3-year period of the moving average has an average of 20 or more
events.
Long-Term Care Facilities
Characteristics of long-term care facilities in Taney County are shown in the following tables. In 2010,
there were seven licensed nursing homes in the county with 519 licensed beds. There are four levels of
care provided by nursing homes in the state of Missouri, three levels are provided by nursing homes in
Taney County.
o
o
o
o
Residential Care Facility I (RCF I): provides shelter, board and protective oversight; this may
include keeping and distributing medications and providing care during short-term illnesses
or recuperation.
Residential Care Facility II (RCF II): provides additional services including supervision of diets
and providing care during short-term illnesses or recuperation.
Intermediate Care Facility (ICF): provides personal care, basic health and nursing care
services under the daily supervision of a licensed nurse and under the direction of a licensed
physician.
Skilled Nursing Facility (SNF): provides, skilled nursing care and treatment services
commonly performed by or under the supervision of a registered professional nurse.
78
Individuals living in an SNF require twenty-four hour care and other nursing functions
requiring specialized judgment and skill.
Missouri Guide for Seniors, Choosing a Long-Term Care Facility
Table 10 presents the number of licensed beds and days of care for the year 2010. The average
occupancy rate and the number of Medicare/Medicaid beds for the year 2010 are also shown.
Table 10
Characteristics of Long Term Care Facilities- Taney County,
2010
Licensed Medicare Medicaid
Beds
Beds
Beds
Total
Skilled Nursing
Facility
3
350
Yes
Yes
Residential Care
Facility I
2
47
No
No
Residential Care
Facility II
2
122
No
No
Total
7
519
Table 11
Characteristics of Long Term Care Facilities- Taney County, 2010
Alzheimer’s Ventilator
Total
Unit
Care
Skilled
Nursing
Facility
Residential
Care Facility I
Adult
Day
Care
FT
Staff
PT
Staff
Average
Average
Minimum Maximum
Charges
Charges
3
1
1
0
2
247
16
$3,145.33
2
0
0
0
0
0*
5*
$783*
Residential
Care Facility II
2
0
0
0
0
11
11
$1,020.50
Total
7
1
1
0
2
258
32
$2,043.33
79
Table 11 lists the number of Alzheimer’s Units, Ventilator Care and Adult Day Care available in long-term
care facilities in Taney County. It also provides the number of staff and average charges for these
facilities.
Medicaid and Other Pay Sources
Table 12 presents the number of people in Taney County enrolled in the Medicaid program as of July 1,
2010. It indicates that 8,817 residents of Taney County under the age of 65 and 633 over the age of 65
were receiving Medicaid services. Approximately 20.07% of the population under age 65 in Taney
County was receiving Medicaid services in 2010.
Table 12
Medicaid Participation By Age for Taney County, 2010
2006
Medicaid
Participants
371
2010
Medicaid
Participants
509
Percent
Change
37.2
Total Under 19
4,698
5,966
27
Total Under 65
6,808
8,817
29.5
625
633
1.3
7,433
9,450
27.1
18.47%
20.07%
Age Groups
Under 1
65 and Over
TOTAL
Percent of
Population* Under
65 receiving
Medicaid services
"Medicaid Participation" in these tables refers to people with a Medicaid card.
This is an unduplicated count of those participating in Medicaid as of July 1,
2010.
80
Table 13
Medicaid Participation By Age and Race For Taney County, 2010
Number
White
AfricanAmerican
509
463
7
1,548
1,472
25
5
326
311
4
6
301
286
5
7 to 9
868
820
6
10 to 14
1,090
1,317
18
15 to 17
725
690
7
18
214
199
5
5,581
5,558
77
19
85
81
1
20
89
84
2
21
104
98
1
22 to 24
326
318
2
25 to 34
828
782
9
35 to 44
535
508
3
45 to 54
554
527
7
55 to 64
415
394
2
8,517
8,350
104
633
619
1
1
1
9,150
8,969
Age Groups
Under 1
1 to 4
Total Under 19
Total Under 65
65 and Over
Unknown
TOTAL
Percent of Population* Under 65
105
20.07%
"Medicaid Participation" in these tables refers to people with a Medicaid card. This is an
unduplicated count of those participating in Medicaid as of July 1, 2010.
Table 13 provides a more detailed description of the age groups and racial categories receiving Medicaid
services. Approximately 20.07% of the population that is under 65 years of age in Taney County was
enrolled in Medicaid in 2010.
Days of care by pay source is illustrated in Table 14 with a slight total increase of all pay sources for care.
81
Table 14
Days of Care By Pay Source-Taney County in 2008 and
2009
Percent Change
2008
2009
2008-2009
Medicare
16,325
14,690
-11.1
Medicaid
5,373
6,507
21.1
Other
Government
110
161
46.4
Workers Comp
92
93
1.1
Self pay/No
Charge
2,128
2,100
-1.3
Commercial
4,000
4,611
15.3
Other
186
98
-50
Unknown
27
24
-11.1
28,249
28,284
0.1
All Pay Sources
Source: Missouri Department of Health and Senior Services; Rate per 10,000; Age Adjustment Uses 2000 Standard
Population.
82
References
BRFSS. (2010). BRFSS. Retrieved from Missouri Department of Health and Senior Services:
http://health.mo.gov/data/brfss/2010datareport.pdf
CDC. (2011, March 8). Smoking & Tobacco Use. Retrieved from Center for Disease Control and
Prevention: http://www.cdc.gov/tobacco/data_statistics/fact_sheets/index.htm
MICA. (2007). Tobacco Cessation for Missouri Adults. Retrieved from Missouri Department of
Health and Senior Services:
http://health.mo.gov/data/mica/County_level_study/header.php?cnty=929&profile_ty
pe=3&chkBox=C
Missouri County-Level Study. (2007). Missouri County-Level Study. Retrieved October 24, 2011,
from Missouri Department of Health and Senior Services:
http://health.mo.gov/data/cls/index.php
Taney County Missouri. (2011). History of Taney County. Retrieved from Taney County,
Missouri: http://www.co.taney.mo.us/cgi-bin/County/index.cgi?section=history
U.S. Census Bureau. (2012, June 3). State & County QuickFacts. Retrieved from U.S. Census
Bureau: http://quickfacts.census.gov/qfd/states/29/29213.html
83
Contact: Jean Mueller
320 Rinehart Road
Phone: (417) 334-4544 ext. 224
Cell:
(417) 230-0725
Email: [email protected]
FOR IMMEDIATE RELEASE
February 4, 2013
Health Focus for February is Good Oral Hygiene
To help kick-off National Children’s Dental Health Month, the Taney County Health
Department is addressing the most common chronic disease of children by encouraging
enrollment in the Children’s Dental Clinic. Preventative and emergency dental care are
available to Taney County children ages 18 and under with active Medicaid and women in
Taney County with active Medicaid for pregnant women.
Dr. Chyrelle Blount is the Division Dentist at the Taney County Health Department
Children’s Dental Clinic. “Untreated tooth decay can cause pain, and possible infections
which could lead to problems with eating, speaking, and learning,” Dr. Blount said.
“Children who start good habits at an early age learn the importance of taking care of their
teeth and gums.”
The Centers for Disease Control and Prevention reports that, although tooth decay is largely
preventable, it remains the most common chronic disease of children aged 6 to 11 years at
25 percent, and adolescents aged 12 to 19 years at 59 percent.
Tooth decay is four times more common than asthma among adolescents aged 14 to 17
years at an average of 15 percent.
Parents and caregivers can help encourage good oral health by:

Encouraging a well-balanced diet that limits sugar and starchy foods. If these foods
are included in the daily diet, eating them with a meal and not as a snack produces
extra saliva to help rinse the food out of the mouth.

Using fluoride toothpaste protects children’s teeth (for children less than seven years
old, use only a pea-sized amount on their toothbrush).

Asking a dentist or doctor about how to protect child's teeth with dental sealants and
fluoridated drinking water.

Brushing teeth twice daily. Parents may need to help younger children with this.

Flossing teeth daily. You'll need to floss for your children until they are around four
years old.

Scheduling regular dental checkups every six months.
The Children’s Dental Division of the Taney County Health Department provides preventive
dental care which includes exams, cleanings, x-rays, sealants, and a fluoride varnish. As
well as restoration, space maintainers, stainless steel crowns, root canals, and extractions.
Recent original research released from the Centers for Disease Control and Prevention has
led to an increasing awareness of the overall health effects of poor dental hygiene.
Particular attention has been paid to the possible role of gum diseases in coronary heart
disease. The study suggests that improving dental health may reduce the risk of heart
disease, a finding which has significant public health implications because of the high rate
this disease.
“The first step in preventing bacteria buildup and infection is to know the meaning of good
oral hygiene,” Dr. Blount said. “Good oral hygiene results in a mouth that looks and smells
healthy. This means your teeth are clean and free of debris, gums are pink and do not hurt
or bleed when you brush or floss, and bad breath is not a constant problem.”
To learn more, visit the Taney County Health Department website at
www.taneycohealth.org . Please contact a staff member at (417) 546-4725 ext. 311 or
[email protected] for more information or to schedule an appointment.
###
320 Rinehart Road
Phone: (417) 334-4544 ext. 224
Cell:
(417) 230-0725
February 27, 2013
ASPCA Grant Funding Provides Care for Animals During Disasters
Branson, MO—The Taney County Health Department is a recent recipient of a $12,100 grant from the
American Society for the Prevention of Cruelty of Animals (ASPCA). The grant funds will allow for the
expansion of animal control emergency response efforts.
“The Taney County Health Department Animal Control Division is honored to be working with ASPCA to
develop a local and regional animal emergency response program,” said Eric Hansen, Animal Control
Officer. Hansen said, “Following the 2012 Leap Day tornado that struck Branson and neighboring
communities, it became apparent that coordination of services among emergency response partners
was needed to ensure the care and safety of animals.”
When a disaster occurs, pets are often separated from their owners resulting in a stressful situation for
both the owner and pet. In response to the Leap Day tornado, the ASPCA collaborated with Pet Smart
Charities and donated animal care kits to the community. The kits included dog crates, pet cages,
feeding bowls, leashes, cat litter boxes and food. Taney County Health Department Animal Control
Officers coordinated distribution of over 175 care kits to area residents following the tornado disaster.
The kits allowed families the option of keeping their pets with them and provided shelter and care
needed during their transition.
The amount of storage needed for the remaining animal care kits in stock after the recovery efforts
ended was significant. As a result, grant funding was sought through ASPCA to resolve this issue and
develop a plan for assisting future local and regional emergency response activities. The funding will
allow for the purchase of a 28 ft. enclosed trailer for equipment storage and immediate deployment in
response to a disaster. “Developing strong partnerships that have planned and trained for response to
a large scale disaster involving animals is important,” said Hansen. “The ASPCA grant will provide the
necessary resources to begin the process that will ensure the safety and care of animals during a
disaster.”
For more information about the ASPCA visit their website at www.aspca.org or the Taney County Health
Department website at www.taneycohealth.org or call Eric Hansen at (417) 334-4544 ext. 230.
###
320 Rinehart Road
Phone: (417) 334-4544 ext. 224
Cell:
(417) 230-0725
For Immediate Release
May 14, 2013
Animal Shelter Staff Attend Workshop
Pefinder an online database for adoptable pets recently conducted a one-day workshop in
Branson. Darcy Potter and Ashlee Sanchez represented the Taney County Health Department
Animal Control Shelter at the training sponsored by PETCO and hosted by the Shepherd of the
Hills Humane Society.
The workshop provided information to improve adoption rates for shelter animals including,
on-line marketing, networking with other adoption programs and training dogs for adoptability.
Petfinder.com is the largest online, searchable database of animals that need permanent
homes, with over 375,000 animals listed. Visit Petfinder.com to view animals that are
available for adoption at the Taney County Animal Control Shelter.
The Taney County Animal Control Shelter located at 255 Critter Trail, Hollister, Missouri and is
open to the public Monday through Saturday 10:00 am to 2:00 pm.
For more information about pet adoptions visit the Taney County Health Department website
at taneycohealth.org or call (417) 332-0172.
###
320 Rinehart Road, Branson, MO
Phone: (417) 334-4544 ext. 224
Cell:
(417) 230-0725
May 16, 2013
Dog Safety: National Dog Bite Prevention Week
The Taney County Health Department continues its tradition of calling attention to one of the nation's
most commonly reported public health problems: dog attacks and bites. Dog bites can range from a
relatively painless nip to a fatal mauling. A public service campaign known as National Dog Bite
Prevention Week® takes place May 19-25 and offers safety tips for pet owners to responsibly reduce the
more than 4.7 million dog bite injuries that occur each year.
“The Taney County Health Department urges all families to start early in educating children about safety
around dogs, even if you don't own a dog,“ Jeff McRoy, Animal Control Officer says."Any animal can
bite if it is frightened or feels threatened, even the family pet. Unfortunately, children are the most
common victims," says McRoy.
Each year, an estimated 4.7 million people are victims of a dog bites, and more than half are children
younger than 14 years old, according to the American Academy of Pediatrics.
Dog bites are a largely preventable public health problem, and adults and children can learn to reduce
their chances of being bitten. Before you bring a dog into your household:
Learn what breed of dogs is the best fit for your household and spend time with a dog before
buying or adopting it.
If a child seems frightened by dogs, wait before bringing the dog home.
If you decide to bring a dog into your home:
Never leave infants or young children alone with a dog.
Avoid highly excitable games like wrestling or tug-of-war.
Immediately seek professional advice from veterinarians or animal control officers if the dog
develops aggressive behaviors.
To help prevent children from being bitten by dogs, teach the following basic safety tips and review
them regularly:
Do not approach an unfamiliar dog.
Do not run from a dog or scream.
Remain motionless, "be still like a tree," when approached by an unfamiliar dog.
Avoid direct eye contact with a dog.
Do not disturb a dog that is sleeping, eating, chewing on a toy, or caring for puppies.
If a dog or other animal bites you:
Try not to panic.
Immediately wash the wound thoroughly with soap and water.
Contact your physician for additional care and advice.
Report the bite to your local law enforcement agency. Be prepared to tell the animal control
officer everything you know about the animal, including the owner's name and address.
If you do not know the animal’s owner try to get the following information; a description of
the animal including color, size, or breed, where the incident occurred, have you seen the.
animal before, and if you know where the animal is located now.
Visit the Taney County Health Department website at taneycohealth.org or call either location at (417)
334-4544 or (417) 546-4725 for more information about dog bite prevention.
###
Contact: Kara Miller
ADAPT Coalition
Phone: (417) 334-4544 ext. 225
May 16, 2013
ADAPT Coalition and IMAX Sponsor After-Prom Event
The Taney County Alcohol and Drug Abuse Prevention Team (ADAPT), along with the Branson IMAX
Theater, recently sponsored an after-prom event for all Taney County high schools. Students and prom
attendees from Bradleyville, Branson, Forsyth, and Hollister attended this alcohol-free and drug-free
event where they were treated to snacks and a movie at the Branson IMAX Theater, on Shepherd of the
Hills Expressway, in Branson. Approximately 407 students enjoyed these four separate events, one for
each school’s prom.
The Taney County ADAPT coalition was formed in 2008 with the mission to reduce and prevent youth
substance abuse in our community. The Branson IMAX Theater and ADAPT have proudly collaborated
for the last five years to sponsor the after-prom event and plan to continue to work together to promote
a safe and fun, substance-free event for the students of Taney County.
For more information about the ADAPT coalition please visit the Taney County Health Department
website at taneycohealth.org/Community Health/Community Coalitions.
###
320 Rinehart Road, Branson, MO 65616
Phone: (417) 334-4544 ext. 224
Cell:
(417) 230-0725
May 21, 2013
Health Department Offers Shingles Vaccine
The Taney County Health Department will conduct a special clinic for Shingles vaccine on
Monday, June 3, from 8:00 am to noon at both Taney County Health Department locations
Branson-320 Rinehart Road and Forsyth- 15479 US Highway 160. The Taney County Senior
Citizen’s Service Fund allocated funds to offer free Shingles (Zostavax) vaccine to Taney
County residents 60 years of age and older.
According to the Centers for Disease Control (CDC), an estimated one million cases of Shingles
occurs each year in the United States. One in three people will get Shingles during their lifetime.
Shingles is a painful localized skin rash that often has blisters caused by the varicella zoster virus
(VZV), the same virus that causes chickenpox. Anyone who has had chickenpox can develop
Shingles. In many cases, it causes pain that has been described as sharp, shooting and throbbing.
The CDC recommends the one-time vaccination to reduce the risk of Shingles and its associated
pain in people 60 years of age or older.
The Taney County Senior Citizen’s Service Fund allocated $16,000 to the Taney County Health
Department to purchase and administer the vaccine. Due to the cost of the vaccine there is a
very limited supply available and will be offered on a first come, first serve basis.
Those interested in getting the Shingles vaccine will need to follow these guidelines:



60 years of age or older
Provide proof of Taney County residency
Provide a doctor’s order ( people with some medical conditions should not get the
vaccine)
For more information about the upcoming clinic please contact the Taney County Health
Department at either location, Branson (417) 334-4544 ext. 590, Forsyth (417) 546-4725 ext.
690 or visit our website at taneycohealth.org.
###
Phone: (417) 334-4544 ext. 224
Cell:
(417) 230-0725
July 11, 2013
Health Department Offers Free Tdap Vaccinations
The Taney County Health Department (TCHD) will offer free Tdap (tetanus, diphtheria, and pertussis)
vaccinations during a mass vaccination clinic in partnership with the Missouri Department of Health and
Senior Services. The clinic will be held Tuesday, July 30 from 8:00 am to 4:00 pm at the Branson and
Forsyth health department locations. Children 11 years old or older and adults are eligible to receive a
Tdap vaccination.
The Missouri Department of Health and Senior Services is providing Tdap vaccine on a one-time basis to
local health departments to train staff and educate the public how a mass vaccination clinic would work
in the event of an emergency. The Taney County Health Department will have 500 doses of Tdap
vaccine to offer the community at no cost, regardless of insurance coverage. No appointments are
required for this clinic and vaccine will be available on a first come, first serve basis. “We encourage
everyone, children and adults, to take advantage of this one- time event to receive a Tdap vaccination at
no cost,” says clinical director Pam Priest.
The Tdap vaccination protects against tetanus, diphtheria, and pertussis. Tetanus, commonly called
lockjaw, is present in the soil and enters the body through cuts, scratches, or wounds. Adults should
receive a booster dose of tetanus every five years. Pertussis, also known as whooping cough, is a
contagious disease that causes severe coughing spells and difficulty breathing. It is a very serious illness
for children under one year of age. The Centers for Disease Control (CDC) recommends a booster dose
of Tdap for everyone 11 years old through adulthood especially those who are in close contact with
young children. This includes parents, siblings, grandparents, childcare providers and anyone who needs
a booster shot.
For information, contact the Taney County Health Department at (417) 334-4544 Branson (320 Rinehart
Road), (417) 546-4725 Forsyth (15479 State Hwy 160) or visit the TCHD website at
www.taneycohealth.org .
###
Phone: (417) 334-4544 ext. 224
Cell:
(417) 230-0725
July 19, 2013
Taney County Health Department Celebrates World Breastfeeding Week
BREASTFEEDING SUPPORT: CLOSE TO MOTHERS
Even when mothers are able to get off to a good start with breastfeeding, all too often in the
weeks or months after delivery there is a sharp decline in breastfeeding rates. This is a time
when a community support system for nursing mothers is essential.
The week of August 1-7 is designated as World Breastfeeding Week (WBW). Breastfeeding
advocates in over 174 countries worldwide will be celebrating the WBW theme
'BREASTFEEDING SUPPORT: CLOSE TO MOTHERS’, highlighting breastfeeding peer counselors.
Peer counselors provide support through personal experience and training with a focus on
education and encouragement to nursing mothers.
The Taney County Health Department, Women’s, Infant, and Children (WIC) program, has
participated in the Breastfeeding Peer Counselor program for 15 years and currently has two
peer counselors on staff. “We consider the peer counseling program an important part of the
success for mothers who choose to breastfeed their children,” says Tammy Drake, WIC Division
Manager. “The counselors have personal experience and training to encourage mothers to
reach and maintain their breastfeeding goals.”
To celebrate World Breastfeeding Week, the Taney County Health Department will be hosting a
family event at Stockstill Park to raise awareness about the benefits of breastfeeding. The
event will include a walk around the park on August 8 from 6:00-7:30 pm with activities and
refreshments.
For information about breastfeeding peer counseling and support groups visit our website at
www.taneycohealth.org or call the Taney County Health Department at (417) 334-4544
(Branson) or (417)-546-4725 (Forsyth).
###
Phone: (417) 334-4544 ext. 224
Cell:
(417) 230-0725
July 30, 2013
Branson, MO—The Missouri Department of Health and Senior Services released information July 26, 2013
regarding a confirmed case of Cyclospora in Taney County and Kansas City. Nationwide, the Centers for Disease
Control (CDC) has been notified of over 350 cases of this illness.
“The case identified in Taney County is most likely connected to out of state travel based on local investigation
findings and not from any local source. There haven’t been any reports of illness from Cyclospora linked to a
Taney County source,” said Kim Foster, Taney County Health Department epidemiologist. Foster stated, “The
best way to prevent this type of illness is to thoroughly wash fruits and vegetables before eating and always wash
your hands before preparing food or eating.”
Cyclospora is a parasite that causes intestinal infection called cyclosporiasis; sometimes referred to as a stomach
illness. The most likely way a person will become ill with Cyclospora is through contaminated food or water.
Cyclospora needs time (days to weeks) after being passed in a bowel movement to become infectious to another
person. Therefore, it is unlikely that Cyclospora is passed directly from one person to another.
The CDC has yet to narrow down which specific food item is spreading the illness; however, the parasite is
commonly found in fresh produce. The Missouri Department of Health and Senior Services is currently working
with the CDC and other agencies to investigate whether or not the two cases reported in Missouri are linked to
cases in other states.
Symptoms for Cyclospora include diarrhea, loss of appetite, stomach cramps, bloating, nausea, and fatigue.
Symptoms usually begin about one week after becoming infected and last from a few days to a month or longer.
Sometimes the symptoms may go away and return one or more times. If you have symptoms, contact your health
care provider.
At this time, the source of illness has not been confirmed. Individuals are encouraged to follow good hand
washing techniques and contact their healthcare provider if they become ill with any symptoms related to this
illness.
For more information about Cyclospora please visit the Taney County Health Department website at
www.taneycohealth.org and click on the CDC link or call the Branson location at (417) 334-4544 or Forsyth location
at (417) 546-4725.
###
Phone: (417) 334-4544 ext. 224
Cell:
(417) 230-0725
August 15, 2013
Tetanus shots available for individuals assisting in flood cleanup
The Taney County Health Department will continue to offer tetanus shots for those affected by
the recent flood.
Individuals who live in the flood area, those assisting with cleanup, or volunteers are eligible for
a tetanus shot at no cost. Shots are available at either Taney County Health Department
location during normal business hours --8:00 am to 4:00 pm Monday through Friday, no
appointments necessary.
Office locations:
 Branson—320 Rinehart Road (417) 334-4544
 Forsyth – 15479 US Hwy 160 (417) 546-4725
Children under age 18 must be accompanied by an adult.
Special arrangements could be made to provide tetanus shots at your location for groups of 10
or more individuals assisting with flood cleanup. For more information about arranging an
onsite clinic, please contact Jean Mueller at 334-4544 ext 224.
###
Phone: (417) 334-4544 ext. 224
Cell:
(417) 230-0725
August 30, 2013
Protect Yourself from Tick and Mosquito Bites
Due to the heavier than normal rainfall in the last several weeks, mosquitoes and ticks are on the rise in
the area.
“The increase in ticks and mosquitoes in our area is not a serious health concern, but we want everyone
to take the necessary precautions to prevent bites,” said Kim Foster, Taney County Health Department
epidemiologist. Using an insect repellent is a simple way to prevent insect bites. “There are several
types of repellents available, the most important step is to choose one and use it,” said Foster.
Repel ticks by using an insect repellent that contains DEET or permethrin. Products containing
permethrin should be only be used to treat clothing or gear, such as boots, pants, socks or tents. Use
repellents that contain at least 20% DEET, but not more than 30% for children, on exposed skin.
Wearing light colored clothing, long sleeve shirts, long pants and socks while outdoors can help prevent
both tick and mosquito bites.
Ticks can be carried into the house on clothing and pets, so both should be checked carefully to
eliminate ticks. Conduct a body check after being outdoors in a potentially tick-infested area by
searching your entire body for ticks. Use a hand-held or full-length mirror to view all parts of your body.
Carefully remove any ticks you find on your body. To remove an attached tick, use fine-tipped tweezers
to grasp the tick as close to the skin’s surface as possible. Pull upward with steady, even pressure; do
not twist or jerk the tick. After removing the tick, thoroughly clean the bite area and your hands with
rubbing alcohol, an iodine scrub, or soap and water. Mark the date you removed the tick on a calendar.
If you develop a rash or fever within several weeks of removing the tick, see your doctor. Be sure to
inform the doctor about the recent tick bite and the date it was removed.
Mosquito bites occur more often at peak hours between dusk and dawn, use extra care during this time
of time or stay indoors. Help reduce the number of mosquitoes around your home by emptying
standing water from flowerpots, gutters, buckets, pool covers, pet water dishes, discarded tires, and
birdbaths on a regular basis.
Visit the Taney County Health Department website at taneycohealth.org for more information or call
(417) 334-4544 or (417) 546-4725.
###
Phone: (417) 334-4544 ext. 224
Cell:
(417) 230-0725
September 19, 2013
Flu Vaccination Clinic Scheduled
The Taney County Health Department will host community flu clinics on October 1, 2013 for individuals
who are in the following categories over age 65, Medicare recipients, or have a chronic illness. Flu
season can start as early as October, which is why health agencies recommend getting the vaccine as
early as possible.
The walk-in clinics will be held at both Taney County Health Department locations on Tuesday, October
1 from 8:30 a.m to 4:00 p.m. The offices are located at 15479 US Hwy 160, Forsyth and 320 Rinehart
Road, Branson.
The health department will offer the Fluzone High-Dose vaccine to adults 65 years and older. The highdose flu vaccine generates a stronger immune response and offers greater protection for those most at
risk for complications from influenza. There is no out- of- pocket expense to Medicare recipients.
The Centers for Disease Control (CDC) recommend an annual flu shot for anyone age 6 months and
older. It is especially important for people of all ages with a chronic disease, such as diabetes, heart
disease, or asthma, to get a flu shot. Protection against the flu begins about two weeks after
vaccination making it important to take action as soon as possible.
“The health department will have flu vaccine available for individuals who do not have Medicare,
including children age 6 months and older, “said Pam Priest, Taney County Health Department Clinical
Division Manager. “This year we have the option to provide vaccine to children and adults with private
insurance.”
Contact the Taney County Health Department at (417) 546-4725 Forsyth location or (417) 334-4544
Branson location for more information about fees and vaccine availability or visit our website at
www.taneycohealth.org .
###
Phone: (417) 334-4544 ext. 224
Cell:
(417) 230-0725
October 2, 2013
Health Department Director Honored
Jim Berry, Taney County Health Department Director, received the W. Scott Johnson Award at the 2013
Missouri Public Health Association Annual Conference recently held in Columbia, Missouri.
The W. Scott Johnson Award is the most prestigious award presented by the Missouri Public Health
Association and given to an individual for distinguished service to public health in Missouri. The award is
in commemoration of the skills, integrity, leadership, and devotion to duty, which characterized the life
of W. Scott Johnson.
Berry joined the Taney County Health Department as director in 1996 following more than 30 years of
hospital management. During his 17 years of service and leadership, he has developed the Taney
County Health Department to be one of the most professional and successful public health departments
in the state of Missouri.
He is a recognized leader in the state of Missouri having served as a member of the Missouri Board of
Health, Missouri Institute for Community Health, Missouri Public Health Association, Missouri Hospital
Association, and Missouri Association of Local Public Health Agencies. Berry currently serves on the Cox
Medical Center Branson Board of Trustees and Faith Community Health Board of Directors.
Jim Berry will retire in December 2013 after a successful career in healthcare and public health spanning
51 years.
###
Bert Malone, Missouri Public Health Association Board of Directors, & Jim Berry, TCHD Director
Phone: (417) 334-4544 ext. 224
Cell:
(417) 230-0725
October 3, 2013
WIC Services Continue in Taney County
Regardless of the ongoing federal government shutdown, the Taney County Women’s, Infants, and
Children (WIC) program is operating as normal. WIC services are continuing as usual and issued checks
can be used at local grocery stores. WIC clinics at both Taney County Health Department locations are
open for business and no appointments have been cancelled.
WIC is a federally funded program administered by state and local health departments. The Missouri
Department of Health & Senior Services has informed local public health departments funding is
available to continue operations through the month of October.
WIC participants should check for any program changes and updates at the Taney County Health
Department website and Facebook page.
For more information, contact the Taney County Health Department at Branson (417) 334-4544 ext. 590
or Forsyth (417) 546-4725 ext. 321 or visit our website at www.taneycohealth.org.
###
Phone: (417) 334-4544 ext. 224
Cell:
(417) 230-0725
October 11, 2013
Free Dog Adoption Event
Did you know that black dogs are generally the last to be adopted? A black dog is more often passed
over for adoption in favor of other dogs. Those involved in animal welfare refer to this as “Black Dog
Syndrome”.
It is a mystery why dark-colored dogs are adopted less frequently. Shelters everywhere say it is real, but
since there is no practical problem with black fur, such as a link to poor health, they can only guess at
the reasons, such as:
 Black dogs are difficult to see in their crates at the shelter.

Black dogs do not photograph as well as those with lighter coats and their facial expressions are
not shown as well.

Many larger dog breeds have dark-colored coats and few owners select larger breeds.
In order to educate the community about this issue, during the month of October, the Taney County
Animal Control Shelter is offering free adoptions for all black dogs. The waived adoption fee includes
microchipping, spay or neuter, heartworm test, and preventative and selected vaccinations including
rabies.
"When people are considering adoption, they shouldn't just look at what the dog looks like or the color,”
says Sherry Simpson Animal Control supervisor."They should find the best personality match for their
family." Black dogs make great pets and are as loyal and lovable as any other dog in the shelter.
Visit the Taney County Animal Control Center at 255 Critter Trail in Hollister between the hours of 10:00
and 2:00 p.m. Monday through Saturday.
To learn more, visit the Taney County Health Department website at www.taneycohealth.org Animal
Control and Adoption tab or call the Center at (417) 332-0172 ext. 401.
###
Phone: (417) 334-4544 ext. 224
Cell:
(417) 230-0725
October 17, 2013
Taney County Health Department Director Selected
The Taney County Health Department Board of Trustees selected Robert Niezgoda as health department director,
effective December 28, 2013. He will be replacing Jim Berry who has held this position for the last 17 years.
Niezgoda has served as health department assistant director since 2009. He joined the department in 2004 as the
epidemiology specialist and served as the emergency response planner since 2006.
Niezgoda received his master’s degree in public health from Southwest Missouri State University in 2004. He currently
serves as a Missouri Public Health Association and Missouri Institute for Community Health board member and a
member of the Missouri State University, Masters of Public Health Program Professional Advisory Committee.
“We had several quality candidates whom we interviewed but Robert demonstrated extensive experience in a variety of
the emerging public health focus areas as well as a vision for where the Taney County Health Department needs to
develop in the future. The Board is confident in Robert Niezgoda’s leadership abilities to move us in that direction,” said
Sonya Hayter, chair of the Taney County Health Department search committee.
Niezgoda resides in Forsyth with his wife Selina.
Robert Niezgoda
Phone: (417) 334-4544 ext. 224
Cell:
(417) 230-0725
December 4, 2013
Home for the Holidays Pet Adoption and Fostering Event
In an effort to reduce the number of animals that will be homeless for the holidays, the Taney County
Animal Control Shelter is offering a reduced adoption fee that will run through December 31.
The reduced adoption fee for a dog or cat is $40. The fee includes spay/neutering, routine vaccinations,
microchip and heartworm test for adults dogs.
“We are hoping that people considering adding a furry family member to their household during the
holidays will consider adopting a shelter animal,” said Sherry Simpson, TCHD Animal Control Division
Manager. “Supporting the Home for the Holidays adoption program is a win-win for everyone.”
Another way to support the Home for the Holidays event is to become a foster home for pets during the
holidays. “We would like to find temporary homes for adoptable pets during the holiday season,” said
Simpson. The goal would be for animals to be placed in foster homes beginning on December 21.
The shelter’s own holiday wish list includes donations of blankets, towels, treats, and dog and cat toys.
People interested in making this Christmas a happy holiday for a pet in need or who want more
information about becoming a foster home should contact the Taney County Animal Control Shelter.
The shelter is located at 255 Critter Trail in Hollister and open to the public Monday-Saturday 10:00 am
to 2:00 pm. To view animals available for adoption or for more information, go to
http://taneycohealth.org/animal_adoptions.php or call (417) 332-0172.
###
Phone: (417) 334-4544 ext. 224
Cell:
(417) 230-0725
December 20, 2013
Women, Infants and Children (WIC) Contract Renewed
The Taney County Health Department has signed a contract to continue providing WIC (Women, Infants
and Children) services for the fiscal year 2014 with the Missouri Department of Health and Senior
Services. The purpose of this contract is to provide funds to support the delivery of services and
benefits of the WIC Program to eligible participants.
Under terms of the contract, the Taney County Health Department can serve 1,994 people who are
eligible for WIC services every month. During the 2013 contract year, approximately 1,955 participants
received WIC benefits each month in Taney County.
WIC, a supplemental food program , provides at no cost to the participant, nutrition education,
breastfeeding support, referrals to other health and social services, and checks for nutritious
supplemental foods to pregnant, breastfeeding and postpartum women, infants and children up to age
five. WIC participants are those who meet income guidelines and are determined by health
professionals to be at nutritional risk.
WIC supplemental food packages are specifically chosen to provide foods high in protein, iron, calcium,
and Vitamins A and C. Eligible women and children receive fortified milk, eggs, cereal, whole wheat
bread, tortillas or brown rice, fruits and vegetables and canned or dried beans or peanut butter.
Although WIC recommends breastfeeding, infants receive supplemental iron fortified formula when
needed, and infant cereal and baby food at the appropriate age. Participants are issued checks to buy
these foods at authorized local retail stores.
The Taney County Health Department receives $18,656 additional funding to provide the Breastfeeding
Peer Counseling Program. Peer Counselors are available to educate women about the advantages of
breastfeeding, and to offer support and encouragement. The Taney County WIC program has been
recognized as a “Breastfeeding Friendly WIC Clinic” for the second consecutive year. With this
designation comes a $23,000 grant that covers the cost of staff time to provide breastfeeding support
and education.
“The goal of the WIC program is to improve the health and nutrition of those who are eligible for the
service by providing quality nutrition education and supplemental nutritious foods,” said Tammy Drake,
WIC Division Manager.
WIC services are provided at both Taney County Health Department locations. Those interested in
applying for WIC or in need of more information should contact the Taney County Health Department at
the Forsyth location at (417) 546-4725 ext. 321 or at the Branson location at (417) 334-4544 ext. 214 or
visit our website at www.taneycohealth.org.
"This institution is an equal opportunity provider."
###

A Community of Partners - Taney County Health Department

Transcription

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