News Blog Events Pay My Bill Search Jobs My Union Health Portal Find a Provider Find a Location Find Medical Services Patients & Visitors Health Needs Assessment HOME ABOUT US SERVING OUR COMMUNITY HEALTH NEEDS ASSESSMENT PRIORITY INITIATIVES Priority Initiatives Tier 1 Health Priorities Heart (Cardiovascular) Disease Disease of the heart is the #1 leading cause of death in Indiana. Heart disease per 100,000 people rates 23-50% higher than the Healthy People 2020 Goals in Indiana Wabash Valley Counties. Four of the six Indiana Wabash Valley counties fall in the bottom quartile (worst 25%) for Age-Adjusted Death Rate due to Coronary Heart Disease. Five of six of the counties fall in the bottom quartile (worst 25%) for ischemic heart disease in the Medicare population. Five of six of the counties fall in the bottom quartile (worst 25%) for heart failure in the Medicare population. Coronary artery disease begins in childhood. Preventive measures instituted early are thought to have greater lifetime benefits. African Americans are disproportionately impacted by cardiovascular disease. Obesity (Adult and Childhood) Adult obesity rates in all six Indiana Wabash Valley Counties is higher than the Healthy People 2020 Goals. Increasing the number of Hoosiers at a Healthy Weight is a Health Priority within the Indiana State Health Improvement Plan. Being obese is a risk factor for heart disease, cancer, stroke, and diabetes. On average, healthcare costs for obese individuals are approximately $1,400 higher than their normal weight peers. An obese child costs Medicaid $6730, as opposed to $2446 for an average weight child. Obese children are absent from school two more days than normal-weight classmates per year. Obesity is a better predictor of absenteeism than any other factor. The indicators that exacerbate weight gain in the general population (poor access to healthy food, few opportunities for physical activity, and increased consumption of calorie-dense foods) seem to be magnified in lower income, less educated populations. Smoking Smoking rates in Indiana Wabash Valley Counties is double the Healthy by 2020 Goals. Decreasing tobacco usage is a Health Priority within the Indiana State Health Improvement Plan. Tobacco use is the single most preventable cause of death and disease in the United States. Tobacco use is a well-known risk factor for heart disease, cancer, stroke, and diabetes. Five of six of the counties fall in the bottom quartile (worst 25%) for age-adjusted death rate due to lung cancer. The greatest risk factor for lung cancer is duration and quantity of smoking. African Americans have the highest risk of developing lung cancer. Five of six of the counties fall in the bottom quartile (worst 25%) for chronic obstructive pulmonary disease (COPD) in the Medicare population. COPD is most commonly a mix of chronic bronchitis and emphysema, and usually results from tobacco use, although it can also be a result of pollutants in the air, genetic factors, and respiratory infections. For every pack of cigarettes sold in Indiana, Hoosiers spend $15.90 in lost productivity, health care costs, and premature death related to smoking. Significant health disparities persist among racial and ethnic groups as it pertains to smoking and exposure to second-hand smoke. Tier 2 Health Priorities Access to Health Care Access to health care means having "the timely use of personal health services to achieve the best health outcomes". Access to health care can be compromised by poor access to services (i.e. due to geography, a high number of patients per physician, etc.), lack of insurance coverage, and unaffordable costs. Even those with health insurance may have trouble affording co-pays or needed medications. Five of the six Indiana Wabash Counties have an average patient per physician ratio well above the Indiana average of 1,518 patients for every physician: 1,798 patients/physician (Clay), 3,660 patients/physician (Greene), 2,845 patients/physician (Parke), 2,354 patients/physician (Sullivan), and 3,208 patients/physician (Vermillion). Racial and ethnic minorities and people of low socioeconomic status (SES) are disproportionately represented among those with access problems. Low access to health care means absence of recommended care for disease prevention (such as cancer screening, dental care, counseling about diet and exercise, and flu vaccination). Those with low access to health care are also less likely to get recommended care for disease management, such as diabetes care management. 53 Poor access to health care comes at both a personal and societal cost. Those who have problems getting care, are diagnosed at later disease stages, are sicker when hospitalized and more likely to die during their stay Diabetes Diabetes mellitus is the seventh leading cause of death in Indiana. The local adult diabetes rate is similar to both the state and the national median – with Vigo County being below the Indiana average, Clay County being equal to the state average, and Parke, Vermillion, Green, and Sullivan all being above the state average. People with diagnosed diabetes incur average medical expenditures of about $13,700 per year, of which about $7,900 is attributed to diabetes. People with diagnosed diabetes, on average, have medical expenditures approximately 2.3 times higher than what expenditures would be in the absence of diabetes. (national averages) Eating healthy is one of the most important things you can do to lower your risk for type 2 diabetes. Healthy weight maintenance and regular exercise are also important prevention measures for prediabetes, type 2 diabetes, heart disease and stroke. Infant Mortality The Healthy People 2020 national health target is to reduce the proportion of infants born with low birth weight to 7.8%. The proportion of infants born with low birth weight is 10.6% in Sullivan County, 8.4% in Vigo County, and 7.9% in Greene County. Babies born with low birth weight are more likely than babies of normal weight to have health problems and require specialized medical care in the neonatal intensive care unit The Healthy People 2020 national health target is to reduce the proportion of infants born with very low birth weight to 1.4%. Vigo, Vermillion, and Clay counties have higher rates of very low birth weight births than the Healthy People 2020 national targets. Babies born with very low birth weight are at the highest risk of dying in their first year and while there have been many medical advances enabling very low birth weight and premature infants to survive, there is still risk of infant death or long-term complications and disability. The most important things an expectant mother can do to prevent low birth weight and very low birth weight are to seek prenatal care, take prenatal vitamins, stop smoking, and stop drinking alcohol and using drugs. Mental Health & Mental Disorders Vigo County is in the bottom quartile (worst 25%) of the state for depression in the Medicare population (18.9% as of 2012), poor mental health days (4.6 per year), and age-adjusted death due to suicide (19.5 deaths per 100,000 population). Vigo, Clay, and Sullivan counties are all in the bottom quartile (worst 25%) of the state for age-adjusted death due to Alzheimer’s with 44 deaths per 100,000 population (Vigo), 41.6 deaths per 100,000 population (Clay), and 51.6 deaths per 100,000 population (Sullivan) – during 2011-2013 timeframe. According to the National Comorbidity Survey of mental health disorders, people over the age of 60 have lower rates of depression than the general population — 10.7 percent in people over the age of 60 compared to 16.9 percent overall. The Center for Medicare Services estimates 54 that depression in older adults occurs in 25 percent of those with other illnesses, including: arthritis, cancer, cardiovascular disease, chronic lung disease, and stroke. Alzheimer's disease is the most common form of dementia among older people. It is a progressive and irreversible disease that impairs memory and affects thinking and behavior, to the point of eventually interfering with daily tasks. 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