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Home My WebLink AboutPart V. Behaviors, Illness, Injury, Hospitalizations, DeathsThe Health of Jefferson County April 2014 The Health of Jefferson County Behaviors, Illness, Injury, Hospitalizations, Deaths Jefferson Healthcare and Jefferson County Public Health Prepared by: Siri Kushner, MPH CPH Presented: April 18, 2014, Revised May 12, 2014 CONTENTS Section A: Deaths 1 Death Rates 2 Death Rates by Gender 3 Death Rates by Age Group 4 Leading Causes of Death 5 Years of Potential Life Lost due to Premature Death 6 Years of Potential Life Lost by Gender 7 Years of Potential Life Lost by Cause 8 Life Expectancy at Birth and by Gender Section B: Hospitalizations 1 Hospitalization Rates 2 Leading Causes of Hospitalization Section C. Chronic Disease 1 Adult physical activity 2 Youth physical activity 3 Adult Daily Fruit and Vegetable Consumption 4 Youth eat at least 5 servings of fruits/vegetables a day 5 Adults at a healthy weight 6 Youth at a healthy weight 7 Youth with asthma 8 Adults with chronic condition 9 Cancer Incidence 10 Cancer Deaths 11 Chronic disease hospitalizations 12 Chronic disease deaths Section D. Tobacco Use 1 Adults who have ever smoked 2 Adults who are current smokers 3 Adult smokers attempting to quit in past 12 months 4 Youth current tobacco use 5 Sales of tobacco to minors Section E. Alcohol and Drug Use 1 Adult binge alcohol drinkers 2 Youth alcohol use The Health of Jefferson County April 2014 The Health of Jefferson County Behaviors, Illness, Injury, Hospitalizations, Deaths Jefferson Healthcare and Jefferson County Public Health Prepared by: Siri Kushner, MPH CPH Presented: April 18, 2014, Revised May 12, 2014 3 Youth binge alcohol use 4 Alcohol-related arrests 5 Alcohol-related hospitalizations 6 Alcohol-related deaths 7 Youth drinking and driving 8 Alcohol-related traffic fatalities Section F. Drug Use 1 Youth current drug use 2 Drug law violations 3 Drug lab clean-ups 4 Syringe Exchange 5 Opiate-related hospitalizations 6 Opiate-related deaths 7 Drug-related hospitalizations 8 Drug-related deaths 9 Alcohol and Drug Deaths as a Proportion of All Deaths 10 State-Funded Alcohol or Drug Service Clients Section G. Mental Health and Suicide 1 Adult average number of poor mental health days 2 Adults report mental distress or depression 3 School Based Health Clinic Mental Health visits 4 Youth report depressive feelings 5 Youth report considering suicide 6 Suicide hospitalization 7 Suicide deaths 8 Mental illness hospitalizations 9 Jefferson Mental Health Clients Section H. Injuries 1 Child Injury and Accident Hospitalizations 2 Adult Women (age 18+) Injury and Accident Hospitalizations 3 Leading Causes of Accident (Unintentional Injury) Deaths 5 Poison Deaths by Age and Gender Section I. Communicable Diseases Communicable Disease rates Sexually Transmitted Infection rates The Health of Jefferson County, April 2014, updated May 2014 Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 CRUDE DEATH RATE AGE-ADJUSTED DEATH RATE # of deaths population crude rate per 100,000 age adj rate per 100,000 # of deaths population crude rate per 100,000 age adj rate per 100,000 1992-94 690 68268 1010.7 792.4 118376 15771203 750.6 857.7 1995-97 763 73665 1035.8 762.6 124390 16701631 744.8 834.6 1998-00 826 77414 1067.0 739.3 130269 17475009 745.5 812.4 2001-03 845 81151 1041.3 690.4 135610 18156531 746.9 793.4 2004-06 891 84941 1049.0 667.0 136595 18927589 721.7 743.3 2007-09 961 88651 1084.0 647.3 143865 19805489 726.4 722.3 2010-12 1014 89972 1127.0 638.3 147421 20260348 727.6 696.3 Washington StateJefferson County Source: Washington State Dept. of Health, Center for Health Statistics, Death Certificate Database. Accessed in: Community Health Assessment Tool (CHAT) A1. Death Rates Definition: The crude death rate is the number of deaths divided by the total population per 1,000 population. Crude rates are used to evaluate the rate of death in one place, they should not be used for comparison as they do not account for differences in demographics that can influence death rates. In 2010-12, there were 338 Jefferson County resident deaths each year on average. Due to differences in the age structure of the population (Jefferson has more older residents), the Jefferson crude death rate has been statistically higher than Washington since 1992-94. Definition: The age adjusted death rate is calculated by applying the age-specific death rates for a place to standardized population counts. The age adjusted rate does not represent the true rate of death in a location but is used for comparing especially when the places being compared have very different age structures. After adjusting for the difference in age structure, the Jefferson death rate is statistically lower than WA from 1995-2012. Since 1992-94 Jefferson and Washington rates have been statistically decreasing. Jefferson County has one of the lowest age-adjusted death rates in Washington State. 1127.0 727.6 0 500 1000 1500 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 cr u d e d e a t h r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n Jefferson County Washington State 638.3 696.3 0 500 1000 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 ag e a d j u s t e d d e a t h ra t e p e r 1 0 0 , 0 0 0 po p u l a t i o n Jefferson County Washington State WA rate statistically improving by 1.2% per year since 1992-4. The Health of Jefferson County, April 2014, updated May 2014 AGE-ADJUSTED DEATH RATE BY WASHINGTON STATE COUNTY, 2010-12 (highest to lowest) # of deaths population age adj rate per 100,000 Grays Harbor 2325 218597 851.9 Ferry 250 22751 829.0 Pend Oreille 425 39001 814.8 Pacific 858 62720 811.4 Lewis 2456 227455 806.8 Cowlitz 3028 307810 800.3 Okanogan 1222 123520 786.0 Stevens 1238 130731 779.6 Wahkiakum 146 11978 778.1 Spokane 12091 1416521 766.7 Mason 1816 182899 765.7 Grant 1963 269320 765.3 Yakima 5443 732631 758.6 Pierce 17075 2399525 757.3 Asotin 692 64923 752.5 Clark 8856 1281363 722.8 Clallam 2730 214608 720.8 Benton 3746 530977 714.3 Lincoln 350 31770 713.6 Skagit 3261 351701 712.3 Skamania 258 33366 711.6 Kitsap 5867 758933 710.6 Columbia 155 12278 708.4 Snohomish 13798 2147335 703.4 Thurston 5758 760464 695.5 Franklin 1059 239163 695.4 Adams 329 56628 683.3 Douglas 885 115731 680.4 Klickitat 528 61318 679.1 Walla Walla 1590 176381 675.8 Chelan 1901 217853 669.5 Whatcom 4405 605340 663.2 Garfield 92 6766 659.4 Kittitas 824 123515 649.3 Jefferson 1014 89972 638.3 Whitman 717 134380 635.0 King 35969 5816449 621.2 Island 1913 236106 599.8 San Juan 388 47569 495.1 The Health of Jefferson County April 2014 Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 JEFFERSON AND WASHINGTON COMPARISON # of female deaths female population crude death rate per 100,000 age adj death rate per 100,000 # of male deaths male population crude death rate per 100,000 age adj death rate per 100,000 1992-94 313 34615 904.2 648.7 700.9 377 33653 1120.3 987.7 1066.9 1995-97 346 37449 923.9 627.4 694.7 417 36216 1151.4 911.5 1021.4 1998-00 388 39489 982.6 634.8 686.7 438 37925 1154.9 853.4 979.7 2001-03 369 41328 892.9 544.2 681.2 476 39823 1195.3 855.5 937.1 2004-06 405 43051 940.7 546.7 641.7 486 41890 1160.2 796.8 870.7 2007-09 467 44739 1043.8 565.7 626.7 494 43912 1125.0 728.5 840.2 2010-12 482 45393 1061.8 542.7 597.2 532 44579 1193.4 739.3 817.7 A2. Death Rates by Gender Jefferson County MALESWA age adj female death rate per 100,000 WA age adj male death rate per 100,000 Source: Washington State Dept. of Health, Center for Health Statistics, Death Certificate Database. Accessed in: Community Health Assessment Tool (CHAT) There were 161 female and 177 male Jefferson County resident deaths each year between 2010 and 2012. Jefferson rates for both males and females are statistically decreasing overtime. Jefferson male rates are statistically higher than Jefferson female rates. Compared to Washington State, Jefferson rates are lower. Jefferson County FEMALES 542.7 597.2 0 200 400 600 800 1992- 94 1995- 97 1998- 00 2001- 03 2004- 06 2007- 09 2010- 12 ag e a d j u s t e d ra t e p e r 1 0 0 , 0 0 0 f e m a l e po p u l a t i o n Jefferson County FEMALES Washington Females Jefferson and WA rates statistically decreasing since 1992-4 739.3 817.7 0 200 400 600 800 1000 1200 1992- 94 1995- 97 1998- 00 2001- 03 2004- 06 2007- 09 2010- 12 ag e a d j u s t e d ra t e p e r 1 0 0 , 0 0 0 m a l e po p u l a t i o n Jefferson County MALES Washington Males Jefferson and WA rates statistically decreasing since 1992-4 542.7 739.3 0 1000 2000 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 ag e a d j u s t e d d e a t h ra t e p e r 1 0 0 , 0 0 0 pe r s o n s Jefferson FEMALE Jefferson MALE Male and Female rates statistically decreasing overtime. Male rate statistically higher than female rate for all years. The Health of Jefferson County April 2014 Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 number of deaths infants age <1 year death rate per 100,000*number of deaths infants aged <1 year death rate per 100,000 1993-97 13 1120 1161.0 2329 411127 566.5 1998-02 2 2189 394032 555.5 2003-07 5 995 502.3 2151 405363 530.6 2008-12 6 991 605.2 2147 433033 495.8 *rate not calculated when number of events less than 5 number of deaths persons aged 1-14 death rate per 100,000*number of deaths persons aged 1-14 death rate per 100,000 1993-97 4 20501 1367 5712659 23.9 1998-02 3 19762 1111 5900926 18.8 2003-07 5 18463 27.1 912 5963739 15.3 2008-12 2 17009 878 6088820 14.4 *rate not calculated when number of events less than 5 A3. Death Rates by Age Group Source: Washington State Dept. of Health, Center for Health Statistics, Death Certificate Database. Accessed in: Community Health Assessment Tool (CHAT) CHILDREN AGE 1-14: Since 1993, on average each year Jefferson County has less than one child death. In 2003-07, the rate of child deaths in Jefferson County is no different than Washington State. The Washington rate has been statistically improving since 1993-7. Jefferson County Washington State Jefferson County Washington State INFANT MORTALITY (age <1 year): Since 2003, on average each year about 1 Jefferson County baby dies before reaching its first birthday. The infant mortality rate in Jefferson County is no different than the rate in Washington State. 14.4 0 20 40 1993-97 1998-02 2003-07 2008-12 ra t e p e r 1 0 0 , 0 0 0 ch i l d r e n a g e 1 -14 Jefferson County Washington State WA rate statistically decreasing 605.2 495.8 0 1000 2000 1993-97 1998-02 2003-07 2008-12 ra t e p e r 1 0 0 , 0 0 0 ba b i e s a g e d < 1 Jefferson County Washington State n<5 therefore rate The Health of Jefferson County April 2014 number of deaths persons aged 15-24 death rate per 100,000 number of deaths persons aged 15-24 death rate per 100,000 1993-97 9 10247 87.8 2924 3656895 80.0 1998-02 7 11679 59.9 2804 4096788 68.4 2003-07 15 12618 118.9 2962 4534229 65.3 2008-12 8 12428 64.4 2696 4641806 58.1 number of deaths persons aged 25-44 death rate per 100,000 number of deaths persons aged 25-44 death rate per 100,000 1993-97 52 30748 169.1 13212 8975116 147.2 1998-02 45 28544 157.7 11175 9075636 123.1 2003-07 55 26896 204.5 10731 9016567 119.0 2008-12 30 25489 117.7 10215 9207067 111.0 number of deaths persons aged 45-64 death rate per 100,000 number of deaths persons aged 45-64 death rate per 100,000 1993-97 176 31917 551.4 31490 5432696 579.6 1998-02 181 42289 428.0 35794 6715661 533.0 2003-07 284 50056 567.4 42487 8074911 526.2 2008-12 290 54709 530.1 47858 9060379 528.2 ADULTS AGE 45-64: On average from 2003 to 2012, there were about 58 deaths of Jefferson residents age 45-64, up from an average of about 36 from 1993 to 2002. The Jefferson rate was lower than Washington in 1998-2002 only, in other years it has been no different than Washington State. YOUNG ADULTS AGED 15-24: On average each year there have been 3 or fewer Jefferson County resident aged 15- 24 deaths. The rate of young adult deaths in Jefferson County is no different than Washington State. The Washington rate has been statistically improving since 1990-4. ADULTS AGE 25-44: On average each year from 2008-12 there were 6 deaths of Jefferson residents age 25-44, down from an average of about 10 in previous years. The Jefferson rate was statistically higher than Washington State in 2003-07. 64.4 58.1 0 100 200 1993-97 1998-02 2003-07 2008-12 ra t e p e r 1 0 0 , 0 0 0 pe r s o n s a g e d ag e d 1 5 -24 Jefferson County Washington State WA rate statistically decreasing 117.7 111.0 0 200 400 1993-97 1998-02 2003-07 2008-12 ra t e p e r 1 0 0 , 0 0 0 pe r s o n s ag e d 2 5 -44 Jefferson County Washington State Jefferson rate statistically higher than WA rate in 2003-07 530.1 528.2 0 500 1000 1993-97 1998-02 2003-07 2008-12 ra t e p e r 1 0 0 , 0 0 0 pe r s o n s a g e d 4 5 -64 Jefferson County Washington State The Health of Jefferson County April 2014 number of deaths persons aged 65 and older death rate per 100,000 number of deaths persons aged 65 and older death rate per 100,000 1993-97 995 25163 3954.1 153350 3143164 4878.8 1998-02 1119 27931 4006.4 167001 3321612 5027.7 2003-07 1139 32500 3504.6 170271 3584751 4749.9 2008-12 1341 38753 3460.4 180378 4109647 4389.1 ADULTS AGE 65 and OLDER: On average each year from 2008-12 there were 268 deaths of Jefferson residents aged 65 and older. The Jefferson rate has been statistically lower than the Washington rate since 1993-97. Jefferson County Washington State 3460.4 4389.1 0 5000 10000 1993-97 1998-02 2003-07 2008-12 ra t e p e r 1 0 0 , 0 0 0 pe r s o n s ag e d 6 5 a n d o l d e r Jefferson County Washington State Jefferson rate statistically lower than WA rate in since 1993-97 The Health of Jefferson County April 2014 A4. Leading Causes of Death Jefferson County and Washington State 2010-12 Jefferson County Washington State Primary Cause of Death # of deaths % of all deaths Primary Cause of Death # of deaths % of all deaths Malignant neoplasms (cancer)265 27.6 Malignant neoplasms (cancer)35701 24.8 Diseases of heart 192 20.0 Diseases of heart 31273 21.7 Cerebrovascular diseases 69 7.2 Alzheimer's disease 9378 6.5 Chronic lower respiratory diseases 66 6.9 Chronic lower respiratory diseases 8759 6.1 Accidents 60 6.2 Accidents 7997 5.6 Alzheimer's disease 59 6.1 Cerebrovascular diseases 7596 5.3 Diabetes mellitus 31 3.2 Diabetes mellitus 4752 3.3 Infectious and Parasitic Diseases 26 2.7 Infectious and Parasitic Diseases 3470 2.4 Chronic liver disease and cirrhosis 21 2.2 Suicide 2974 2.1 Other diseases of the respiratory system 16 1.7 Chronic liver disease and cirrhosis 2410 1.7 Top 10 leading causes:805 Top 10 leading causes:114310 All other causes of death 209 21.7 All other causes of death 33111 22.5 Total deaths 1014 Total deaths 147421 2007-09 Jefferson County Washington State Primary Cause of Death # of deaths % of all deaths Primary Cause of Death # of deaths % of all deaths Malignant neoplasms (cancer)263 27.4 Malignant neoplasms (cancer)35021 24.3 Diseases of heart 215 22.4 Diseases of heart 32363 22.5 Accidents 58 6.0 Alzheimer's disease 8795 6.1 Chronic lower respiratory diseases 54 5.6 Chronic lower respiratory diseases 8542 5.9 Cerebrovascular diseases 53 5.5 Cerebrovascular diseases 8030 5.6 Alzheimer's disease 36 3.7 Accidents 7990 5.6 Influenza and pneumonia 19 2.0 Diabetes mellitus 4643 3.2 Diabetes mellitus 17 1.8 Suicide 2656 1.8 Suicide 16 1.7 Influenza and pneumonia 2271 1.6 Chronic liver disease and cirrhosis 15 1.6 Chronic liver disease and cirrhosis 2084 1.4 Top 10 leading causes:746 Top 10 leading causes:112395 All other causes of death 215 22.4 All other causes of death 31470 21.9 Total deaths 961 Total deaths 143865 Source: Washington State Dept. of Health, Center for Health Statistics, Death Certificate Database. Accessed in: Community Health Assessment Tool (CHAT) In 2010-12, the primary cause of more than 1 in 4 Jefferson County deaths was cancer, followed by 1 in 5 deaths due to diseases of the heart. Jefferson and WA ranking differ somewhat but the % of all deaths by cause are similar with one exception although not statistically different, seven percent of Jefferson deaths were from cerebrovascular diseases compared to only five percent in WA, they were the same in 2007-09. Notable changes in Jefferson compared to 2007-09: heart disease deaths decreased from 22.4 to 20%; Alzheimer's deaths increased from 3.7 to 6.1%; cerebrovascular deaths increased from 5.5 to 7.2%: diabetes deaths increased from 1.8 to 3.2%. The Health of Jefferson County April 2014 A5. Years of Potential Life Lost Due to Death Before Age 65 (YPLL-65) Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 years total population YPLL per 1,000 persons years total population YPLL per 1,000 persons 1992-94 2677 54015 49.6 607954 13943249 43.6 1995-97 2731 58128 47.0 612796 14787604 41.4 1998-00 2270 61059 37.2 576600 15501324 37.2 2001-03 2264 63532 35.6 602761 16119924 37.4 2004-06 2924 65473 44.7 607236 16782687 36.2 2007-09 2766 66776 41.4 620052 17476317 35.5 2010-12 2186 66105 33.1 597479 17728705 33.7 Jefferson County Washington State Definition: Years of potential life lost (YPLL) involves estimating the average time a person would have lived had he or she not died prematurely. This measure is used to help quantify social and economic loss owing to premature death, and it has been promoted to emphasize specific causes of death affecting younger age groups (Gardner JW, Sanborn JS, Years of potential life lost (YPLL) -- What does it measure? Epidemiology. 1990 Jul; 1(4): 322-9). Source: Washington State Dept. of Health, Center for Health Statistics, Death Certificate Database. Accessed in: Community Health Assessment Tool (CHAT) In 2010-12 nearly 2,200 person-years were lost due to premature Jefferson County resident deaths (death occurring before age 65). The rates of YPLL in Jefferson County were statistically higher (worse) than Washington from 1992-97 and 2004-09. The Jefferson rates have been statistically unchanged since 1992- 94 while the Washington rates have been statistically decreasing (improving). 33.1 33.7 30 40 50 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 YP L L p e r 1 0 0 0 p e r s o n s Jefferson County Washington State WA rate statistically decreasing since 1992-94 The Health of Jefferson County April 2014 A6. Years of Potential Life Lost by Gender Jefferson County and Washington State JEFFERSON COUNTY years total female population YPLL per 1,000 persons % of total YPLL years total male population YPLL per 1,000 males % of total YPLL 1992-94 1115 27167 41.0 42 1562 26847 58.2 58 1995-97 975 29380 33.2 36 1756 28749 61.1 64 1998-00 879 31054 28.3 39 1391 30005 46.4 61 2001-03 691 32314 21.4 31 1573 31218 50.4 69 2004-06 902 33158 27.2 31 2022 32315 62.6 69 2007-09 979 33683 29.1 35 1787 33093 54.0 65 2010-12 645 33350 19.3 30 1541 32755 47.0 70 WASHINGTON STATE years total female population YPLL per 1,000 females % of total YPLL years total male population YPLL per 1,000 males % of total YPLL 1992-94 202214 6874951 29.4 33 405740 7068298 57.4 67 1995-97 213073 7284250 29.3 35 399593 7503354 53.3 65 1998-00 209537 7635847 27.4 36 367063 7865477 46.7 64 2001-03 221403 7949569 27.9 37 381293 8170354 46.7 63 2004-06 221920 8279943 26.8 37 385316 8502744 45.3 63 2007-09 230041 8625117 26.7 37 390011 8851199 44.1 63 2010-12 221149 8769751 25.2 37 376200 8958954 42.0 63 Jefferson MALEJefferson FEMALE Washington MALEWashington FEMALE Source: Washington State Dept. of Health, Center for Health Statistics, Death Certificate Database. Accessed in: Community Health Assessment Tool (CHAT) In 2010-12 of the nearly 2,200 person-years lost due to premature Jefferson County resident deaths (death occurring before age 65), seventy percent were male-years. Jefferson male YPLL rates are statistically higher than Jefferson female rates. Jefferson female and both WA male and female YPLL rates are statistcially decreasing overtime. Definition: Years of potential life lost (YPLL) involves estimating the average time a person would have lived had he or she not died prematurely. This measure is used to help quantify social and economic loss owing to premature death, and it has been promoted to emphasize specific causes of death affecting younger age groups (Gardner JW, Sanborn JS, Years of potential life lost (YPLL) -- What does it measure? Epidemiology. 1990 Jul; 1(4): 322-9). 19.3 47.0 0 50 100 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 YP L L p e r 1 0 0 0 pe r s o n s Jefferson FEMALE Jefferson MALE 19.3 25.2 0 20 40 60 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 YP L L p e r 1 0 0 0 fe m a l e s Jefferson FEMALE Washington FEMALE 47.0 42.0 0 50 100 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 YP L L p e r 1 0 0 0 m a l e s Jefferson MALE Washington MALE The Health of Jefferson County April 2014 The Health of Jefferson County Public Health April 2014 A7. Years of Potential Life Lost by Cause of Death Jefferson County and Washington State 2010-2012 Jefferson County Washington State Leading Causes of YPLL (primary cause) # of deaths # of YPLL % of all YPLL Leading Causes of YPLL (primary cause)# of YPLL % of all YPLL Cancer 71 532 24.3 Accidents 117241 19.6 Accidents 27 440 20.1 Cancer 107738 18.0 Diseases of heart 25 246 11.3 Diseases of heart 60897 10.2 Chronic liver disease and cirrhosis 13 177 8.1 Suicide 59478 10.0 Conditions originating in the perinatal period 2 130 5.9 Certain conditions originating in the perinatal period 36523 6.1 Suicide 6 111 5.1 Congenital malformations deformations, chromosomal abnormal 27439 4.6 Top leading causes:144 1636 Top leading causes:409316 All other causes of death 48 550 25.2 All other causes of death 188163 31.5 Total (among those under age 65)192 2186 Total (among those under age 65)597479 2007-2009 Jefferson County Washington State Leading Causes of YPLL (primary cause) # of deaths # of YPLL % of all YPLL Leading Causes of YPLL (primary cause) # of deaths # of YPLL % of all YPLL Accidents 35 694 31.7 Accidents 5168 131696 22.0 Cancer 65 601 27.5 Cancer 10594 110356 18.5 Diseases of heart 24 209 9.6 Diseases of heart 5811 63139 10.6 Suicide 7 116 5.3 Suicide 2207 52186 8.7 Chronic liver disease and cirrhosis 11 108 4.9 Certain conditions originating in the perinatal period 583 37666 6.3 Diabetes mellitus 8 107 4.9 Congenital malformations deformations and chromosom 537 26179 4.4 Cerebrovascular diseases 4 94 4.3 Assault (homicide)579 19475 3.3 Congenital malformations deformations and chromosom 3 73 3.3 Chronic liver disease and cirrhosis 1484 18804 3.1 Pregnancy childbirth and the puerperium 1 47 2.2 Diabetes mellitus 1214 12705 2.1 Influenza and pneumonia 2 41 1.9 Cerebrovascular diseases 917 10789 1.8 Assault (homicide)3 41 1.9 Top 10 leading causes:163 2131 Top 10 leading causes:29094 482995 All other causes of death 50 635 29.0 All other causes of death 137057 22.9 Total (among those under age 65)213 2766 Total (among those under age 65)143865 620052 Definition: Years of potential life lost (YPLL) involves estimating the average time a person would have lived had he or she not died prematurely. This measure is used to help quantify social and economic loss owing to premature death, and it has been promoted to emphasize specific causes of death affecting younger age groups (Gardner JW, Sanborn JS, Years of potential life lost (YPLL) -- What does it measure? Epidemiology. 1990 Jul; 1(4): 322-9). In 2010-12, 192 Jefferson County residents died before their 65th birthday. Six causes accounted for three-quarters of those deaths. Reviewing leading causes by YPLL highlights areas for preventing early deaths. Accidents caused 27 deaths (14%) but accounted for 20% of YPLL. The top 3 leading causes of YPLL are the same in Jefferson County and Washington State. Compared to 2007-09, accidents contributed fewer YPLL in 2010-12. Source: Washington State Dept. of Health, Center for Health Statistics, Death Certificate Database. Accessed in: Community Health Assessment Tool (CHAT) The Health of Jefferson County April 2014, updated May 2014 A8. Life Expectancy at Birth Jefferson County and Washington State Jefferson County Washington State difference 1992-94 77.8 77.3 0.6 1995-97 78.3 77.7 0.6 1998-00 79.2 78.2 0.9 2001-03 80.0 78.6 1.4 2004-06 80.1 79.4 0.7 2007-09 80.6 79.7 0.9 2010-12 81.3 80.2 1.1 LIFE EXPECTANCY BY GENDER Female Male difference Female Male difference 1992-94 80.5 75.4 -5.1 80.2 74.2 -6.0 1995-97 81.3 75.4 -6.0 80.4 75.0 -5.4 1998-00 81.3 77.2 -4.1 80.6 75.8 -4.9 2001-03 83.6 76.7 -6.9 80.8 76.3 -4.5 2004-06 82.1 77.2 -4.9 81.5 77.1 -4.4 2007-09 82.9 78.6 -4.3 81.8 77.6 -4.2 2010-12 83.9 78.9 -4.9 82.4 78.0 -4.4 Jefferson County Source: Washington State Dept. of Health, Center for Health Statistics. Accessed in: Community Health Assessment Tool (CHAT) In 2010-12 life expectancy at birth for Jefferson County residents was 81.3 years, 1.1 years longer than in WA. Jefferson life expectancy has been longer than WA since 1992-94. Male life expectancy is about 5 years lower than females, about 4 years in WA State. Life expectancy differs by Jefferson County zip code, the gap between highest (Chimacum and Nordland) and lowest (Brinnon) is 7.4 years. Washington State 81.3 80.2 74.0 76.0 78.0 80.0 82.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 ye a r s o f l i f e e x p e c t e d at b i r t h Jefferson County Washington State 83.9 82.4 70 75 80 85 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 li f e e x p e c t a n c y a t b i r t h Jefferson FEMALE Washington FEMALE 78.9 78.0 65 70 75 80 85 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 li f e e x p e c t a n c y a t b i r t h Jefferson MALE Washington MALE The Health of Jefferson County April 2014, updated May 2014 LIFE EXPECTANCY BY ZIPCODE 98320 Brinnon 98325 Chimacum 98339 Port Hadlock 98358 Nordland 98365 Port Ludlow 98368 Port Townsend 98376 Quilcene 1992-94 79.7 76.4 77.7 78.9 78.6 77.3 81.6 1995-97 75.2 75.3 76.2 77.6 78.8 79.8 72.5 1998-00 77.2 79.0 79.9 84.7 79.7 79.1 74.3 2001-03 80.7 76.7 79.0 87.9 82.1 80.5 77.7 2004-06 74.6 79.8 76.8 84.2 82.9 80.3 84.1 2007-09 70.9 82.2 80.7 89.5 83.5 80.3 76.3 2010-12 79.6 87.0 79.9 87.0 83.5 82.0 79.8 LIFE EXPECTANCY AND MEDIAN HOUSEHOLD INCOME BY CENSUS TRACT, 2010-12 Census Tract Life Expectancy Median Household Income # Households 9507.02 79.2 $36,847 875 9506.01 81.5 $37,543 3297 9502.02 81.5 $50,899 797 9504 85.1 $35,912 1880 9506.02 86.3 $47,151 1387 9505 86.6 $50,313 3124 9503 87.2 $66,993 2821 79.6 87.0 79.9 87.0 83.5 82.0 79.8 74.0 76.0 78.0 80.0 82.0 84.0 86.0 88.0 98320 Brinnon 98325 Chimacum 98339 Port Hadlock 98358 Nordland 98365 Port Ludlow 98368 Port Townsend 98376 Quilcene 2010-12 79.2 81.5 81.5 85.1 86.3 86.6 87.2 $0 $20,000 $40,000 $60,000 $80,000 74.0 76.0 78.0 80.0 82.0 84.0 86.0 88.0 9507.02 9506.01 9502.02 9504 9506.02 9505 9503 Higher Income, Longer Life The Health of Jefferson County April 2014 Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 AGE-ADJUSTED RATE #population crude rate per 100,000 age adj rate per 100,000 #population crude rate per 100,000 age adj rate per 100,000 1992-94 8224 65105 12631.9 11594.9 1548854 15771202 750.6 9981.8 1995-97 8438 70067 12042.8 10933.6 1527608 16701630 744.8 9393.6 1998-00 8838 73740 11985.4 10856.4 1606669 17475008 745.5 9495.7 2001-03 8758 77372 11319.3 9960.2 1693611 18156531 746.9 9599.5 2004-06 8686 81120 10707.6 9175.0 1783183 18927589 721.7 9608.7 2007-09 9670 84795 11404.0 9365.2 1883865 19805489 726.4 9544.5 2010-12 8109 86152 9412.4 7782.4 1875899 20260344 727.6 9122.0 Jefferson County Washington State Source: Washington State Dept. of Health, Center for Health Statistics, Comprehensive Hospital Abstract Reporting System. Accessed in: Community Health Assessment Tool (CHAT) B1. Hospitalization Rates Definition: The age adjusted rate is calculated by applying the age-specific rates for a place to standardized population counts. The age adjusted rate does not represent the true rate in a location but is used for comparing especially when the places being compared have very different age structures. After adjusting for the difference in age structure, the Jefferson hospitalization rate is statistically lower than WA in 2010-12 and 2004-06; it was statistically higher from 1992-2003. Since 1992-94 the Jefferson rate has been statistically decreasing. 7782.4 9122.0 0 5000 10000 15000 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 ag e a d j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n Jefferson County Washington State Jefferson rate statistically decreasing since 1992-4. The Health of Jefferson County April 2014 B2. Leading Causes of Hospitalization Jefferson County and Washington State 2010-12 Jefferson County Washington State Primary Cause of Hospitalization # of hospitaliz ations % of all hospitaliz ations Primary Cause of Hospitalization # of hospitaliza tions % of all hospitaliz ations Diseases of the circulatory system 1369 17%Complications of pregnancy; childbirth; and the puerperium 252104 13% Diseases of the digestive system 938 12%Diseases of the circulatory system 244794 13% Diseases of the musculoskeletal system and connective tissue 880 11%Certain conditions originating in the perinatal period 242437 13% Injury and poisoning 859 11%Diseases of the digestive system 175125 9% Diseases of the respiratory system 684 8%Injury and poisoning 154143 8% Neoplasms (cancers)571 7%Diseases of the respiratory system 140863 8% Complications of pregnancy; childbirth; and the puerperium 523 6%Diseases of the musculoskeletal system and connective tissue 133194 7% Certain conditions originating in the perinatal period 493 6%Mental Illness 92336 5% Diseases of the genitourinary system 442 5%Neoplasms (cancers)85808 5% Mental Illness 272 3%Diseases of the genitourinary system 84382 4% Top 10 leading causes:7031 87%Top 10 leading causes:1605186 All other causes of hospitalization 1078 All other causes of hospitalization 270649 12.7 Total hospitalizations 8109 Total hospitalizations 1875835 2007-09 Jefferson County Washington State Primary Cause of Hospitalization # of hospitaliz ations % of all hospitaliz ations Primary Cause of Hospitalization # of hospitaliza tions % of all hospitaliz ations Diseases of the circulatory system 1790 18.5 Complications of pregnancy; childbirth; and the puerperium 266405 14.1 Diseases of the digestive system 1067 11.0 Certain conditions originating in the perinatal period 256161 13.6 Injury and poisoning 1000 10.3 Diseases of the circulatory system 255081 13.5 Diseases of the musculoskeletal system and connective tissue 960 9.9 Diseases of the digestive system 170807 9.1 Neoplasms (cancers)790 8.2 Injury and poisoning 155284 8.2 Diseases of the respiratory system 758 7.8 Diseases of the respiratory system 147148 7.8 Diseases of the genitourinary system 662 6.8 Diseases of the musculoskeletal system and connective tissue 123897 6.6 Complications of pregnancy; childbirth; and the puerperium 612 6.3 Neoplasms (cancers)96978 5.1 Source: Washington State Dept. of Health, Center for Health Statistics, Comprehensive Hospital Abstract Reporting System. Accessed in: Community Health Assessment Tool (CHAT) In 2010-12, the primary cause of about 1 in 6 Jefferson County resident hospitalizations was related to the circulatory system (hypertension, heart disease, cerebrovascular disease), followed by about 1 in 8 for diseases of the digestive system (gastrointestinal disorders, liver disease, pancreatic disorders), about 1 in 9 each for diseases of the musculoskeletal system (arthritis, joint disorders, osteoporosis) and injury/poisoning. Compared to WA, Jefferson has lower rates of all but injury/poisoning, cancers and perinatal period conditions. Compared to 2007-09, the number of hospitalizations for the leading causes decreased but the proportions were relatively unchanged. The Health of Jefferson County April 2014 Certain conditions originating in the perinatal period 545 5.6 Diseases of the genitourinary system 89736 4.8 Mental Illness 269 2.8 Mental Illness 82128 4.4 Top 10 leading causes:8453 Top 10 leading causes:1643625 All other causes of hospitalization 1213 12.5 All other causes of hospitalization 240158 12.7 Total hospitalizations 9666 Total hospitalizations 1883783 The Health of Jefferson County April 2014 Jefferson County, Washington State Source: Behavioral Risk Factor Surveillance System Note: Starting with 2011, BRFSS results cannot be compared historically due to changes in the survey methodology. 2003-05 (WA 05) 2007-09 (WA09)2011-12 Jefferson County 87%84%83% Washington State 83%81%80% gender male 79% female 86% age group 18-34 n<30 35-64 83% 65+78% education level high school or less 70% more than high school 88% income level $50,000 or less 74% more than $50,000 94% C1. Adult Physical Activity Question: During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise? More than 8 in 10 Jefferson County adults report getting some physical activity for exercise. Rates are higher among females, adults with more education, and adults with higher incomes. 83% 80% 0% 20% 40% 60% 80% 100% 2003-05 (WA 05) 2007-09 (WA09) 2011-12 Jefferson County Washington State The Health of Jefferson County March 2014 C2. Youth Physical Activity Jefferson County and Washington State Source: Healthy Youth Survey, askhys.net 8th grade 10th grade 12th grade 8th grade 10th grade 12th grade 2006 53%47%42%47%42%39% 2008 59%57%43%46%43%40% 2010 73%42%62%57%51%46% 2012 56%56%49%56%51%47% DID NOT PARTICIPATE IN DAILY PE CLASSES AT SCHOOL 8th grade 10th grade 12th grade 8th grade 10th grade 12th grade 2002 76%83%50%49%65%76% 2004 76%94%87%45%69%76% 2006 64%91%89%51%65%71% 2008 79%88%87%51%68%75% 2010 90%96%90%39%71%76% 2012 86%88%91%51%72%77% Over half of 8th and 10th graders and about half of 12th graders Jefferson County and Washington State report getting the recommended level of daily physical activity. Rates are better over time. Note: Participation in the Healthy Youth Survey is voluntary. Data are not reported when the grade-level response rate is less than 40%. Results represent students participating in the survey and likely represent all students in the grade level. YOUTH REPORT GETTING AT LEAST 60 MINUTES OF PHYSICAL ACTIVITY DAILY In Jefferson County, about 90% of 8th, 10th and 12th graders report NOT having daily physical education classes, worse than WA for all grades. Jefferson rates have worsened over time while the State has stayed about the same. 0% 20% 40% 60% 80% 100% Washington State 8th grade 10th grade 12th grade 0% 20% 40% 60% 80% 100% Jefferson County 8th grade 10th grade 12th grade 0% 20% 40% 60% 80% 100% Washington State 8th grade 10th grade 12th grade 0% 20% 40% 60% 80% 100% Jefferson County 8th grade 10th grade 12th grade The Health of Jefferson County March 2014 3 OR MORE HOURS OF SCREEN TIME DAILY 6th grade 8th grade 10th grade 12th grade 6th grade 8th grade 10th grade 12th grade 2002 27%45%37%33%29%51%44%38% 2004 27%55%47%33%29%49%47%39% 2006 26%38%49%42%31%52%53%46% 2008 18%52%46%49%27%51%53%47% 2010 38%48%46%52%50%51% 2012 21%47%48%47%15%51%50%47% Note: No 6th grade data in 2010 In Jefferson County, about half of 8th, 10th and 12th graders and 1 in 5 sixth graders report 3 or more hours of screen time daily, about the same as WA for all grades. Jefferson and WA 10th and 12th grade rates have worsened over time, Jefferson and WA 8th grade rates have been up and down but in 2012 are about what they were in 2002, Jefferson and WA 6th grade rates have improved. 0% 20% 40% 60% 80% 100% Washington State 6th grade 8th grade 10th grade 12th grade 0% 20% 40% 60% 80% 100% Jefferson County 6th grade 8th grade 10th grade 12th grade The Health of Jefferson County April 2014 Jefferson County, Washington State At least 5 fruits/veggies a day:At least 1 serving a day: 2003-05 (WA 05) 2007-09 (WA09)2011 Fruit 2011 Veg Jefferson County 28%29% Washington State 25%25%65%81% About 3 in 10 Jefferson adults reported eating at least five fruits and veggies per day, slightly above WA State. A new question was developed for the 2011 BRFSS survey and Jefferson data are not available. WA data indicate that about 2/3rds of adults get at least 1 serving of fruits and 2 in 5 get at least one vegetable serving. Note: Starting with 2011, BRFSS results cannot be compared historically due to changes in the survey question and methodology. C3. Adult daily fruit and vegetable consumption no data Source: Behavioral Risk Factor Surveillance System; 2011 WA: http://www.cdc.gov/nutrition/downloads/State-Indicator- Report-Fruits-Vegetables-2013.pdf 0% 20% 40% 60% 80% 100% 2003-05 (WA 05) 2007-09 (WA09) Jefferson County Washington State 0% 20% 40% 60% 80% 100% 2011 Fruit 2011 Veg Jefferson County Washington State The Health of Jefferson County April 2014 C4. Youth eat at least 5 servings of fruits/vegetables Jefferson County and Washington State Source: Healthy Youth Survey 8th grade 10th grade 12th grade 8th grade 10th grade 12th grade 2002 30%19%30%27%22%20% 2004 17%28%19%26%23%21% 2006 31%25%36%30%25%22% 2008 33%29%19%28%25%22% 2010 2012 33%34%31%26%24%24% Note: Question not asked in 2010 Note: Participation in the Healthy Youth Survey is voluntary. Data are not reported when the grade-level response rate is less than 40%. Results represent students participating in the survey and likely represent all students in the grade level. Youth self-reporting servings of fruits and vegetables. Not asked in 2010. About 1 in 3 Jefferson youth report eating 5 or more servings of fruits and vegetables daily, better than WA state. Rates have not changed much over time and hardly differ by grade. 0% 20% 40% 60% 80% 100% Washington State 8th grade 10th grade 12th grade 0% 20% 40% 60% 80% 100% Jefferson County 8th grade 10th grade 12th grade The Health of Jefferson County April 2014 Jefferson County, Washington State Source: Behavioral Risk Factor Surveillance System Note: Starting with 2011, BRFSS results cannot be compared historically due to changes in the survey methodology. 2003-05 (WA 05) 2007-09 (WA09)2011-12 Jefferson County 41%46%45% Washington State 43%40%40% gender male 37% female 51% age group 18-34 n<30 35-64 36% 65+32% education level high school or less n<30 more than high school 43% income level $50,000 or less 46% more than $50,000 45% C5. Adults at a healthy weight Self-reported height and weight translated into Body Mass Index, healthy weight = BMI 18.5-24.9 Not quite half of Jefferson adults are at a healthy weight, slightly above the WA rate. Rates are lower (worse) for males and older adults. 45% 40% 0% 20% 40% 60% 80% 100% 2003-05 (WA 05) 2007-09 (WA09) 2011-12 Jefferson County Washington State The Health of Jefferson County April 2014 C6. Youth at a healthy weight Jefferson County and Washington State Source: Healthy Youth Survey 8th grade 10th grade 12th grade 8th grade 10th grade 12th grade 2002 82%80%80%74%78%79% 2004 76%74%81%75%78%76% 2006 76%74%86%75%75%75% 2008 84%76%83%74%75%75% 2010 79%82%64%73%76%75% 2012 71%84%85%75%77%77% Note: Participation in the Healthy Youth Survey is voluntary. Data are not reported when the grade-level response rate is less than 40%. Results represent students participating in the survey and likely represent all students in the grade level. Youth self-reported height and weight used to calculate Body Mass Index (BMI) percentile for age and gender. About 7 in 10 eighth graders and more than 8 in 10 tenth and twelfth graders report being at a healthy weight. Jefferson rates are better than the WA rates for 10th and 12th graders. Among Jefferson 8th graders, the rate is lower, about 7 in 10, lower than previous years and for the first time, below the WA rate. 0% 20% 40% 60% 80% 100% Washington State 8th grade 10th grade 12th grade 0% 20% 40% 60% 80% 100% Jefferson County 8th grade 10th grade 12th grade The Health of Jefferson County April 2014 C7. Youth with asthma Jefferson County and Washington State Source: Healthy Youth Survey Have you ever been told by a doctor or other health professional that you had asthma? 6th grade 8th grade 10th grade 12th grade 6th grade 8th grade 10th grade 12th grade 2002 11%18%30%26%13%18%19%19% 2004 13%21%13%38%14%17%20%19% 2006 11%11%18%27%15%17%19%21% 2008 7%14%24%32%15%18%21%21% 2010 11%17%22%12%14%19%19%19% 2012 15%18%24%27%16%19%22%22% Still have asthma 2012 6%10%11%10%8%9%9%10% ER visit for asthma 2012 n/a 2%4%9%n/a 4%5%5% Asthma attack in past year 2012 n/a 8%11%11% n/a 10%11%11% Used rescue asthma medication 2012 n/a 5%6%15%n/a 8%9%10% Note: Participation in the Healthy Youth Survey is voluntary. Data are not reported when the grade-level response rate is less than 40%. Results represent students participating in the survey and likely represent all students in the grade level. Asthma rates increase by grade - over 1 in 4 twelfth graders compared to 1 in 7 sixth graders report ever being told they have asthma. Jefferson rates are about the same as WA. About 1 in 10 kids report still having asthma; ER visits for asthma and using rescue meds are highest among 12th graders. 0% 10% 20% 30% 40% 50% Washington State 6th grade 8th grade 10th grade 12th grade 0% 10% 20% 30% 40% 50% Jefferson County 6th grade 8th grade 10th grade 12th grade The Health of Jefferson County April 2014 Jefferson County, Washington State Source: Behavioral Risk Factor Surveillance System Note: Starting with 2011, BRFSS results cannot be compared historically due to changes in the survey methodology. 2010 2011-12 Jefferson County 23%23% Washington State 20%22% gender male n<30 female 24% age group 18-34 n<30 35-64 24% 65+33% education level high school or less n<30 more than high school 21% income level $50,000 or less 27% more than $50,000 n<30 C8. Adults with at least one chronic condition Calculated variable of adults reporting having been told by doctor, nurse or other health professional that they have at least one of the following: heart attack, angina or coronary heart disease, stroke, asthma, diabetes. Between 1 in 4 and 1 in 5 Jefferson and Washington State adults has ever been told by a health care provider that they have had a heart attack, angina, heart disease, stroke, asthma or diabetes. 23% 22% 0% 20% 40% 60% 80% 100% 2010 2011-12 Jefferson County Washington State The Health of Jefferson County April 2014, updated May 2014 C9. Cancer Incidence Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 # new cases population crude rate per 100,000 aa rate per 100,000 # new cases population crude rate per 100,000 aa rate per 100,000 1994-1996 572 71847 796.1 554.8 79319 16402206 483.6 530.8 1997-1999 606 76231 795.0 541.3 88138 17244631 511.1 552.5 2000-2002 772 80107 963.7 618.8 94562 17923788 527.6 557.2 2003-2005 796 83437 954.0 587.8 99834 18634216 535.8 547.3 2006-2008 860 87725 980.3 567.8 105034 19553588 537.2 531.6 2009-2011 924 89695 1030.2 536.6 112989 20164603 560.3 529.7 Top 5 Types of New Cancers: 2009-11 RANK # cases crude rate per 100,000 aa rate per 100,000 RANK # cases crude rate per 100,000 age adj rate per 100,000 prostate*1 164 369 180 3 14345 143 137 breast 2 141 312 159 1 19481 193 172 skin^*3 135 151 79 5 10326 51 48 digestive system 4 123 137 73 2 17695 88 83 respiratory system 5 107 119 59 4 13750 68 66 *age-adjusted rate statistically higher than Washington ^excludes Basal and Squamous Source: Washington State Dept. of Health, Center for Health Statistics, Cancer Registry. Accessed in: Community Health Assessment Tool (CHAT) Jefferson County Washington State Jefferson County Washington State There were about 300 new cancer diagnoses each year between 2009 and 2011 among Jefferson County residents. The Jefferson and Washington rates were only statistically different in 2000-02 and the rates in both places are not statistically changed overtime. The crude rates differ dramatically from the age-adjusted rates in Jefferson County because the proportion of older adults is so high. The most common new cancers during 2009-11 among Jefferson County residents were prostate cancer, approximately 55 cases per year, followed by breast cancer, approximately 47 cases per year. The most common new cancers in WA are breast followed by digestive system. The age-adjusted prostate and skin cancer incidence rates are statistically higher than WA state. The crude rates differ dramatically from the age-adjusted rates in Jefferson County because the proportion of older adults is so high. 536.6 529.7 450 500 550 600 650 1994-1996 1997-1999 2000-2002 2003-2005 2006-2008 2009-2011 ag e a d j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n Jefferson County Washington State The Health of Jefferson County April 2014, updated May 2014 CANCER INCIDENCE BY GENDER MALES # new cases population crude rate per 100,000 aa rate per 100,000 # new cases population crude rate per 100,000 aa rate per 100,000 1994-1996 313 35357 885.3 610.4 39484 8159541 483.9 600.0 1997-1999 328 37401 877.0 600.6 43505 8588702 506.5 618.5 2000-2002 450 39239 1146.8 726.9 46848 8926742 524.8 620.8 2003-2005 436 41084 1061.2 643.4 49574 9290123 533.6 604.7 2006-2008 455 43389 1048.7 589.6 52778 9757390 540.9 584.9 2009-2011 520 44460 1169.6 603.3 55493 10052100 552.1 562.0 FEMALES # new cases population crude rate per 100,000 aa rate per 100,000 # new cases population crude rate per 100,000 aa rate per 100,000 1994-1996 259 36490 709.8 503.2 39830 8242665 483.2 489.9 1997-1999 278 38830 715.9 489.7 44633 8655929 515.6 514.3 2000-2002 322 40868 787.9 523.5 47707 8997046 530.3 517.5 2003-2005 360 42353 850.0 536.3 50251 9344094 537.8 510.9 2006-2008 405 44336 913.5 548.1 52250 9796198 533.4 496.6 2009-2011 404 45235 893.1 467.2 57490 10112503 568.5 511.2 CANCER INCIDENCE BY AGE GROUP Jefferson County cancer incidence rates for residents age 0-34 have been lower than Washington since 2000-02; rates for residents age 35-64 are higher than Washington; and rates for older adults are similar to WA. Rates are highest in both Jefferson and Washington State for older adults. Jefferson and Washington rates are unchanged overtime except the rates for Washington adults age 35-64 is statistically increasing. Jefferson County Washington State Jefferson County Washington State Jefferson County and Washington State age-adjusted cancer incidence rates for males and females are similar. Male rates are higher than female rates in both Jefferson and Washington State. Jefferson and Washington rates are unchanged overtime. 603.3 562.0 0 500 1000 1994-1996 1997-1999 2000-2002 2003-2005 2006-2008 2009-2011 ag e a d j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n MALES Jefferson County Washington State 467.2 511.2 0 500 1000 1994-1996 1997-1999 2000-2002 2003-2005 2006-2008 2009-2011 ag e a d j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n FEMALES Jefferson County Washington State 31.9 44.4 0 50 1994-1996 1997-1999 2000-2002 2003-2005 2006-2008 2009-2011 ra t e p e r 1 0 0 , 0 0 0 po p u l a t i o n AGE 0-34 Jefferson County Washington State 787.1 612.8 0 1000 1994-1996 1997-1999 2000-2002 2003-2005 2006-2008 2009-2011 ra t e p e r 1 0 0 , 0 0 0 po p u l a t i o n AGE 35-64 Washington rate statistically increasing overtime Jefferson County Washington State The Health of Jefferson County April 2014, updated May 2014 AGE 0-34 # new cases population rate per 100,000 # new cases population rate per 100,000 1994-1996 8 26084 30.7 3531 8484479 41.6 1997-1999 11 25921 42.4 3454 8683028 39.8 2000-2002 9 25478 35.3 3771 8814404 42.8 2003-2005 10 25528 39.2 3897 9004833 43.3 2006-2008 7 25679 27.3 3812 9321798 40.9 2009-2011 8 25100 31.9 4218 9494877 44.4 AGE 35-64 # new cases population rate per 100,000 # new cases population rate per 100,000 1994-1996 206 30644 672.2 29964 6029577 497.0 1997-1999 211 34205 616.9 35144 6604806 532.1 2000-2002 258 37503 687.9 39231 7099316 552.6 2003-2005 324 39133 827.9 43331 7527134 575.7 2006-2008 356 41012 868.0 46745 7973040 586.3 2009-2011 324 41165 787.1 50182 8188311 612.8 AGE 65+# new cases population rate per 100,000 # new cases population rate per 100,000 1994-1996 358 15119 2367.9 45824 1888150 2426.9 1997-1999 384 16105 2384.4 49540 1956797 2531.7 2000-2002 505 17126 2948.7 51560 2010068 2565.1 2003-2005 462 18776 2460.6 52606 2102249 2502.4 2006-2008 497 21034 2362.8 54477 2258751 2411.8 2009-2011 592 23430 2526.7 58589 2481415 2361.1 CANCER INCIDENCE BY AGE GROUP AND GENDER FEMALE AGE 0-34 # new cases population rate per 100,000 # new cases population rate per 100,000 1994-1996 0 12922 1938 4133930 46.9 1997-1999 6 12850 46.7 1941 4223969 46.0 2000-2002 7 12618 55.5 2195 4293062 51.1 2003-2005 3 12509 2279 4388482 51.9 2006-2008 5 12465 40.1 2194 4547958 48.2 2009-2011 4 12059 2397 4634455 51.7 AGE 35-64 # new cases population rate per 100,000 # new cases population rate per 100,000 1994-1996 111 15700 707.0 29964 6029577 497.0 1997-1999 116 17649 657.3 35144 6604806 532.1 2000-2002 132 19469 678.0 39231 7099316 552.6 Jefferson County Washington State Jefferson County Washington State Both female and male age 35-64 rates are statistically higher in Jefferson County in most years compared to WA; the top cancers are breast and prostate. 2526.7 2361.1 0 2000 4000 1994-1996 1997-1999 2000-2002 2003-2005 2006-2008 2009-2011 ra t e p e r 1 0 0 , 0 0 0 po p u l a t i o n AGE 65+ Jefferson County Washington State The Health of Jefferson County April 2014, updated May 2014 2003-2005 177 20281 872.7 43331 7527134 575.7 2006-2008 189 21227 890.4 46745 7973040 586.3 2009-2011 168 21346 787.0 50182 8188311 612.8 AGE 65+# new cases population rate per 100,000 # new cases population rate per 100,000 1994-1996 148 7869 1880.9 21451 1091281 1965.7 1997-1999 156 8331 1872.5 23071 1128275 2044.8 2000-2002 183 8781 2084.1 24057 1150012 2091.9 2003-2005 180 9563 1882.3 24408 1188997 2052.8 2006-2008 211 10644 1982.3 25000 1261396 1981.9 2009-2011 232 11830 1961.2 27729 1371687 2021.5 MALE AGE 0-34 # new cases population rate per 100,000 # new cases population rate per 100,000 1994-1996 8 13162 60.8 1590 4350549 36.6 1997-1999 5 13070 38.3 1513 4459059 33.9 2000-2002 2 12860 1576 4521342 34.9 2003-2005 7 13019 53.8 1618 4616351 35.1 2006-2008 2 13214 1617 4773840 33.9 2009-2011 4 13041 1821 4860422 37.5 AGE 35-64 # new cases population rate per 100,000 # new cases population rate per 100,000 1994-1996 95 14944 635.7 13522 3012123 448.9 1997-1999 95 16557 573.8 15523 3301121 470.2 2000-2002 126 18034 698.7 17772 3545344 501.3 2003-2005 147 18852 779.8 19763 3760520 525.5 2006-2008 167 19785 844.1 21685 3986196 544.0 2009-2011 156 19819 787.1 22814 4081949 558.9 AGE 65+# new cases population rate per 100,000 # new cases population rate per 100,000 1994-1996 210 7251 2896.4 24372 796869 3058.5 1997-1999 228 7774 2933.0 26469 828522 3194.7 2000-2002 322 8345 3858.6 27500 860056 3197.5 2003-2005 282 9213 3060.9 28193 913252 3087.1 2006-2008 286 10390 2752.7 29476 997354 2955.4 2009-2011 360 11601 3103.2 30858 1109728 2780.7 Jefferson County Washington State The Health of Jefferson County April 2014 C10. Cancer Deaths Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 # deaths population crude rate per 100,000 aa rate per 100,000 # deaths population crude rate per 100,000 aa rate per 100,000 1992-1994 219 68268 320.8 227.6 29261 15771203 185.5 208.9 1995-1997 234 73665 317.7 215.4 30248 16701631 181.1 201.4 1998-2000 230 77414 297.1 192.9 31566 17475009 180.6 196.8 2001-2003 228 81151 281.0 171.9 32669 18156531 179.9 191.5 2004-2006 243 84941 286.1 167.3 32989 18927589 174.3 180.0 2007-2009 263 88651 296.7 165.0 35021 19805489 176.8 176.3 2010-2012 265 89972 294.5 153.5 35701 20260348 176.2 168.1 TOP 5 TYPES OF CANCER (PRIMARY CAUSE): 2010-12 RANK # deaths crude rate per 100,000 age adjusted rate per 100,000 RANK*# deaths crude rate per 100,000 age adjusted rate per 100,000 trachea bronchus and lung 1 88 98 49 1 9475 47 45 lymphoid 2 28 31 18 2 3535 17 17 prostate 3 22 49 30 6 1812 18 21 pancreas 4 17 19 9 4 2407 12 11 colon rectum 5 15 17 9 3 3017 15 14 *WA 5th ranking cancer type is breast Jefferson County Washington State Source: Washington State Dept. of Health, Center for Health Statistics, Death Certificate Database. Accessed in: Community Health Assessment Tool (CHAT). Groupings based on NCHS113 There were about 88 cancer (underlying or primary cause) deaths each year between 2010 and 2012 among Jefferson County residents. The Jefferson and Washington are similar and both are statistically decreasing overtime. The crude rates differ from the age-adjusted rates in Jefferson County because the proportion of older adults is so high. These data do not include anyone with cancer that contributed to their death but that was not listed as the underlying or primary cause of death on the death certificate. Jefferson County Washington State The most common underlying cause cancer death during 2010-12 among Jefferson County residents were trachea/bronchus/lung, approximately 29 deaths per year, followed by lymphoid, approximately 9 deaths per year, these were the top 2 cancer types in Washington as well. The age-adjusted cancer death rates are not statistically different than WA state. The crude rates differ dramatically from the age-adjusted rates in Jefferson County because the proportion of older adults is so high. 153.5 168.1 0 100 200 300 1992-1994 1995-1997 1998-2000 2001-2003 2004-2006 2007-2009 2010-2012 ag e a d j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n Jefferson County Washington State Jefferson and Washington rates statistically decreasing since 1992-94 The Health of Jefferson County April 2014 CANCER DEATHS (PRIMARY CAUSE) BY GENDER MALES # new cases population crude rate per 100,000 aa rate per 100,000 # new cases population crude rate per 100,000 aa rate per 100,000 1992-1994 117 33653 347.7 271.7 15357 7838038 195.9 259.5 1995-1997 134 36216 370.0 259.6 15566 8312147 187.3 244.6 1998-2000 127 37925 334.9 223.8 16323 8703089 187.6 239.0 2001-2003 133 39823 334.0 211.5 16779 9046035 185.5 229.0 2004-2006 137 41890 327.0 198.2 16856 9439442 178.6 212.0 2007-2009 137 43912 312.0 177.8 18153 9885214 183.6 208.0 2010-2012 145 44579 325.3 181.6 18809 10093011 186.4 200.3 FEMALES # new cases population crude rate per 100,000 aa rate per 100,000 # new cases population crude rate per 100,000 aa rate per 100,000 1992-1994 102 34615 294.7 199.6 13904 7933165 175.3 176.1 1995-1997 100 37449 267.0 178.1 14682 8389484 175.0 173.7 1998-2000 103 39489 260.8 165.6 15243 8771920 173.8 168.8 2001-2003 95 41328 229.9 137.6 15889 9110497 174.4 166.2 2004-2006 106 43051 246.2 139.7 16133 9488147 170.0 158.1 2007-2009 126 44739 281.6 153.3 16868 9920275 170.0 153.7 2010-2012 120 45393 264.4 127.9 16892 10167337 166.1 144.8 CANCER DEATHS (PRIMARY CAUSE) BY AGE GROUP Jefferson County and Washington State age-adjusted cancer death rates for males and females are similar. Washington male rates are higher than female rates, in Jefferson they are not statistically different. Jefferson and Washington rates for males and females are statistically decreasing overtime. Jefferson County Washington State Jefferson County Washington State Jefferson County has only had 3 cancer deaths among residents age 0-34 since 1992-94. Each year from 2010-12, Jefferson had 24 cancer deaths among adults 35-64 and 65 per year among adults age 65 and older. Among adults age 35-64, Jefferson rates were higher from 1995-2000 and in 2010-12 compared to WA. Among adults age 65 and older, Jefferson rates are lower than WA in 2010-12, not different in previous years. Rates are highest in both Jefferson and Washington for older adults. Jefferson and Washington rates are statistically decreasing overtime for adults age 65 and older, also statistically decreasing for Washington adults age 35-64 and those under age 35. 181.6 200.3 0 200 400 1992-1994 1995-1997 1998-2000 2001-2003 2004-2006 2007-2009 2010-2012 ag e a d j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n MALES Jefferson County Washington State Jefferson and Washington rates statistically decreasing since 1992-94 127.9 144.8 0 200 400 1992-1994 1995-1997 1998-2000 2001-2003 2004-2006 2007-2009 2010-2012 ag e a d j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n FEMALES Jefferson County Washington State Jefferson and Washington rates statistically decreasing since 1992-94 4.2 0 10 1992- 1994 1995- 1997 1998- 2000 2001- 2003 2004- 2006 2007- 2009 2010- 2012 ra t e p e r 1 0 0 , 0 0 0 po p u l a t i o n AGE 0-34 Washington rate statistically decreasing overtime Jefferson County Washington State 172.1 126.2 0 200 1992- 1994 1995- 1997 1998- 2000 2001- 2003 2004- 2006 2007- 2009 2010- 2012 ra t e p e r 1 0 0 , 0 0 0 po p u l a t i o n AGE 35-64 Washington rate statistically decreasing overtime Jefferson County Washington State The Health of Jefferson County April 2014 AGE 0-34 # deaths population rate per 100,000 # deaths population rate per 100,000 1992-1994 1 25766 468 8303874 5.6 1995-1997 0 26193 494 8561662 5.8 1998-2000 1 25674 413 8718440 4.7 2001-2003 0 25457 473 8879596 5.3 2004-2006 0 25601 412 9094197 4.5 2007-2009 1 25627 401 9416384 4.3 2010-2012 0 24860 402 9497609 4.2 AGE 35-64 # deaths population rate per 100,000 # deaths population rate per 100,000 1992-1994 47 28249 166.4 7997 5639375 141.8 1995-1997 60 31935 187.9 8282 6225942 133.0 1998-2000 64 35386 180.9 8656 6782884 127.6 2001-2003 42 38075 110.3 9050 7240328 125.0 2004-2006 64 39872 160.5 9472 7688491 123.2 2007-2009 64 41149 155.5 10193 8059932 126.5 2010-2012 71 41245 172.1 10386 8231096 126.2 AGE 65+# deaths population rate per 100,000 # deaths population rate per 100,000 1992-1994 171 14253 1199.7 20796 1827954 1137.7 1995-1997 174 15537 1119.9 21472 1914027 1121.8 1998-2000 165 16355 1008.9 22497 1973685 1139.8 2001-2003 186 17619 1055.7 23146 2036608 1136.5 2004-2006 179 19468 919.5 23105 2144902 1077.2 2007-2009 198 21875 905.1 24427 2329173 1048.7 2010-2012 194 23867 812.8 24913 2531643 984.1 Jefferson County Washington State 812.8 984.1 0 2000 1992- 1994 1995- 1997 1998- 2000 2001- 2003 2004- 2006 2007- 2009 2010- 2012 ra t e p e r 1 0 0 , 0 0 0 po p u l a t i o n AGE 65+ Jefferson and WA rates statistically decreasing overtime Jefferson County Washington State C11. Chronic Disease Hospitalizations Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Diseases of the Circulatory System # hosp population crude rate per 100,000 aa rate per 100,000 # hosp population crude rate per 100,000 aarate per 100,000 1992-94 1693 65105 2600.4 1855.5 227094 15771202 1439.9 1614.5 1995-97 1878 70067 2680.3 1814.9 233365 16701630 1397.3 1543.9 1998-00 2026 73740 2747.5 1780.8 242271 17475008 1386.4 1498.1 2001-03 1868 77372 2414.3 1503.3 249609 18156531 1374.8 1447.2 2004-06 1704 81120 2100.6 1246.4 253302 18927589 1338.3 1366.3 2007-09 1790 84795 2111.0 1191.3 255081 19805489 1287.9 1273.5 2010-12 1369 86152 1589.1 857.5 244794 20260344 1208.2 1150.1 TREND OVER TIME #% Total Comparison Jefferson Washington HYPERTENSION 22 2%Jeff < WA Jefferson and WA unchanged DISEASES OF THE HEART 886 65%Jeff < WA Jefferson and WA statistically decreasing CEREBROVASCULAR 287 21%Jeff < WA Jefferson and WA statistically decreasing Diabetes-related (this includes diabetes as primary or other reason for the hospitalization) Source: Washington State Dept. of Health, Center for Health Statistics, Comprehensive Hospital Abstract Reporting System. Accessed in: Community Health Assessment Tool (CHAT) There were about 450 Jefferson resident circulatory system disease hospitalizations each year between 2010 and 2012. The Jefferson and WA rates are statistically decreasing overtime. The Jefferson rate was statistically higher than WA from 1992-2000 and statistically lower from 2004-2012. About two-thirds of circulatory system hospitalizations are related to diseases of the heart. Jefferson County Washington State 2010-12 From 2010-12, the leading cause of hospitalizations among Jefferson residents were diseases of the circulatory system. In addition to these, chronic diseases presented below are diabetes, asthma and COPD. There were about 400 Jefferson resident diabetes-related hospitalizations each year between 2010 and 2012. The Jefferson rate is unchanged overtime while the WA rate is statistically increasing. The Jefferson rate was statistically lower than WA in 1995-7 and from 2001-2012. 865.8 1230.4 0 1000 2000 ag e a d j u s t e d r a t e pe r 1 0 0 , 0 0 0 po p u l a t i o n Jefferson County Washington State WA rates statistically increasing overtime. 857.5 1150.1 0 1000 2000 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12ag e a d j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n Jefferson County Washington State Jefferson and WA rates statistically decreasing overtime The Health of Jefferson County April 2014 # hosp population crude rate per 100,000 aarate per 100,000 # hosp population crude rate per 100,000 aarate per 100,000 1992-94 692 65105 1062.9 764.2 108245 15771202 686.3 754.3 1995-97 865 70067 1234.5 818.3 138612 16701630 829.9 906.1 1998-00 1085 73740 1471.4 995.0 166310 17475008 951.7 1020.7 2001-03 1179 77372 1523.8 993.7 201513 18156531 1109.9 1159.4 2004-06 1313 81120 1618.6 1014.1 231822 18927589 1224.8 1241.2 2007-09 1562 84795 1842.1 1091.2 257229 19805489 1298.8 1276.1 2010-12 1242 86152 1441.6 865.8 263028 20260344 1298.2 1230.4 Primary-Diabetes with or without complications # hosp population crude rate per 100,000 aa rate per 100,000 # hosp population crude rate per 100,000 aarate per 100,000 1992-94 65 65105 99.8 76.8 12775 15771202 81.0 85.3 1995-97 49 70067 69.9 54.3 13277 16701630 79.5 83.1 1998-00 87 73740 118.0 107.5 14847 17475008 85.0 87.5 2001-03 63 77372 81.4 75.3 17154 18156531 94.5 95.4 2004-06 69 81120 85.1 86.4 18678 18927589 98.7 98.3 2007-09 88 84795 103.8 100.0 21335 19805489 107.7 106.3 2010-12 61 86152 70.8 75.1 23300 20260344 115.0 112.3 Asthma # hosp population crude rate per 100,000 aa rate per 100,000 # hosp population crude rate per 100,000 aarate per 100,000 1992-94 75 65105 115.2 113.7 15949 15771202 101.1 101.4 There were about 12 Jefferson resident asthma hospitalizations each year between 2010 and 2012. The Jefferson and WA rates are statistically decreasing overtime. The Jefferson rate was statistically higher than WA from 1995- 2000 and statistically lower from 2010-2012. Jefferson County Washington State There were about 20 Jefferson resident diabetes as a primary cause hospitalizations each year between 2010 and 2012. The Jefferson rate is unchanged overtime while the WA rate is statistically increasing overtime. The Jefferson rate was statistically lower than WA from 1995-97 and from 2010-2012. Jefferson County Washington State Jefferson County Washington State 75.1 112.3 0 50 100 150 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12ag e a d j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n Jefferson County Washington State WA rates statistically increasing overtime 0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 ag e a d j u s t e d r a t e 41.567.4 0 100 200 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12ag e a d j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n Jefferson County Washington State Jefferson and WA rates statistically decreasing overtime The Health of Jefferson County April 2014 1995-97 100 70067 142.7 143.0 16332 16701630 97.8 98.1 1998-00 104 73740 141.0 143.9 15424 17475008 88.3 89.3 2001-03 66 77372 85.3 93.6 15619 18156531 86.0 87.7 2004-06 61 81120 75.2 80.1 14274 18927589 75.4 76.8 2007-09 57 84795 67.2 74.2 14371 19805489 72.6 73.4 2010-12 35 86152 40.6 41.5 13533 20260344 66.8 67.4 Chronic obstructive pulmonary disease and bronchiectasis # hosp population crude rate per 100,000 aa rate per 100,000 # hosp population crude rate per 100,000 aarate per 100,000 1992-94 86 65105 132.1 86.9 15419 15771202 97.8 108.7 1995-97 85 70067 121.3 83.7 16726 16701630 100.1 110.7 1998-00 139 73740 188.5 119.6 19784 17475008 113.2 123.3 2001-03 130 77372 168.0 98.3 19580 18156531 107.8 114.7 2004-06 177 81120 218.2 124.4 19728 18927589 104.2 107.4 2007-09 137 84795 161.6 83.4 23095 19805489 116.6 115.4 2010-12 137 86152 159.0 81.0 23790 20260344 117.4 110.6 There were about 46 Jefferson resident COPD and bronchiectasis hospitalizations each year between 2010 and 2012. The Jefferson and WA rates are unchanged overtime. The Jefferson rate was statistically lower than WA in 1995-97 and from 2007-2012. Jefferson County Washington State 81.0 110.6 0 50 100 150 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12ag e a d j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n Jefferson County Washington State The Health of Jefferson County April 2014 C12. Chronic Disease Deaths Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Diseases of the heart # deaths population crude rate per 100,000 aa rate per 100,000 # deaths population crude rate per 100,000 aarate per 100,000 1992-94 186 68268 272.5 210.3 34240 15771203 217.1 254.1 1995-97 201 73665 272.9 193.9 34226 16701631 204.9 233.8 1998-00 236 77414 304.9 200.4 34298 17475009 196.3 215.8 2001-03 232 81151 285.9 182.5 33500 18156531 184.5 197.0 2004-06 200 84941 235.5 144.3 32090 18927589 169.5 174.9 2007-09 215 88651 242.5 137.5 32360 19805489 163.4 161.5 2010-12 192 89972 213.4 119.6 31273 20260348 154.4 146.5 Cerebrovascular diseases # deaths population crude rate per 100,000 aa rate per 100,000 # deaths population crude rate per 100,000 aarate per 100,000 1992-94 68 68268 99.6 82.7 9272 15771203 58.8 70.2 1995-97 64 73665 86.9 63.9 10181 16701631 61.0 70.3 There were about 23 Jefferson resident cerebrovascular disease deaths each year between 2010 and 2012. The Jefferson and WA rates are statistically decreasing overtime. The Jefferson and WA rates were statistically no different. Jefferson County Washington State Source: Washington State Dept. of Health, Center for Health Statistics, Death Certificate Database. Accessed in: Community Health Assessment Tool (CHAT) From 2010-12, the leading cause of deaths among Jefferson residents were cancer followed by diseases of the heart, cerebrovascular and chronic lower respiratory diseases. In addition to these, hypertension and diabetes are presented below. There were about 64 Jefferson resident heart disease deaths each year between 2010 and 2012. The Jefferson and WA rates are statistically decreasing overtime. The Jefferson rate was statistically lower than WA in all years except 1998-2003. Jefferson County Washington State 119.6146.5 0 100 200 300 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12ag e a d j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n Jefferson County Washington State Jefferson and WA rates statistically decreasing overtime 42.336.1 0 50 100 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12ag e a d j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n Jefferson County Washington State Jefferson and WA rates statistically decreasing overtime The Health of Jefferson County April 2014 1998-00 74 77414 95.6 66.2 10819 17475009 61.9 68.4 2001-03 85 81151 104.7 68.0 11105 18156531 61.2 65.6 2004-06 74 84941 87.1 51.2 8832 18927589 46.7 48.6 2007-09 53 88651 59.8 35.5 8030 19805489 40.5 40.7 2010-12 69 89972 76.7 42.3 7596 20260348 37.5 36.1 Essential (primary) hypertension and hypertensive renal disease # deaths population crude rate per 100,000 aa rate per 100,000 # deaths population crude rate per 100,000 aarate per 100,000 1992-94 1 68268 596 15771203 3.8 4.5 1995-97 2 73665 639 16701631 3.8 4.4 1998-00 3 77414 793 17475009 4.5 5.0 2001-03 2 81151 934 18156531 5.1 5.5 2004-06 4 84941 1286 18927589 6.8 7.1 2007-09 13 88651 14.7 8.2 1514 19805489 7.6 7.6 2010-12 4 89972 1617 20260348 8.0 7.5 Chronic lower respiratory diseases # deaths population crude rate per 100,000 aa rate per 100,000 # deaths population crude rate per 100,000 aarate per 100,000 1992-94 42 68268 61.5 46.3 6632 15771203 42.1 47.9 1995-97 37 73665 50.2 33.7 6787 16701631 40.6 45.8 1998-00 52 77414 67.2 44.5 7747 17475009 44.3 49.1 2001-03 39 81151 48.1 28.7 8004 18156531 44.1 47.8 2004-06 58 84941 68.3 39.9 7882 18927589 41.6 44.1 2007-09 54 88651 60.9 34.1 8542 19805489 43.1 44.2 2010-12 66 89972 73.4 39.5 8759 20260348 43.2 42.5 There were about 22 Jefferson resident chronic lower respiratory disease deaths each year between 2010 and 2012. The Jefferson rate is unchanged while the WA rate is statistically decreasing overtime. The Jefferson rate not statistically different than WA except in 2001-03 when it was lower. Jefferson County Washington State There are very few Jefferson resident hypertension deaths each year however in Washington, the rate is statistically increasing overtime. Jefferson County Washington State 7.5 0 5 10 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12ag e a d j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n Jefferson County Washington State WA rate statistically increasing overtime 39.542.5 0 20 40 60 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12ag e a d j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n Jefferson County Washington State WA rate statistically decreasing overtime The Health of Jefferson County April 2014 Primary Diabetes # deaths population crude rate per 100,000 aa rate per 100,000 # deaths population crude rate per 100,000 aarate per 100,000 1992-94 9 68268 13.2 9.3 2840 15771203 18.0 20.4 1995-97 19 73665 25.8 18.2 3381 16701631 20.2 22.6 1998-00 18 77414 23.3 15.1 3848 17475009 22.0 24.1 2001-03 25 81151 30.8 19.9 4413 18156531 24.3 26.0 2004-06 32 84941 37.7 24.3 4594 18927589 24.3 25.1 2007-09 17 88651 19.2 12.7 4643 19805489 23.4 23.4 2010-12 31 89972 34.5 18.8 4752 20260348 23.5 22.5 Diabetes-related (this includes diabetes as primary or contributing cause of death) # deaths population crude rate per 100,000 aarate per 100,000 # deaths population crude rate per 100,000 aarate per 100,000 1992-94 45 68268 65.9 48.9 8670 15771203 55.0 62.7 1995-97 54 73665 73.3 50.1 10034 16701631 60.1 67.6 1998-00 74 77414 95.6 60.2 11319 17475009 64.8 71.2 2001-03 66 81151 81.3 51.2 12854 18156531 70.8 76.0 2004-06 81 84941 95.4 61.0 14413 18927589 76.1 79.2 2007-09 117 88651 132.0 76.2 15469 19805489 78.1 78.7 2010-12 113 89972 125.6 68.5 16335 20260348 80.6 77.9 There were about 38 Jefferson resident diabetes-related deaths each year between 2010 and 2012. The Jefferson rate and WA rates are statistically increasing overtime. The Jefferson rate was statistically lower than WA in 2001- 3, otherwise the rates are not different. Jefferson County Washington State There were about 10 Jefferson resident diabetes as a primary cause deaths each year between 2010 and 2012. The Jefferson and WA rates are unchanged overtime. The Jefferson and WA rates are not statistically different. Jefferson County Washington State 18.822.5 0 10 20 30 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12ag e a d j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n Jefferson County Washington State 68.577.9 0 50 100 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 ag e a d j u s t e d r a t e pe r 1 0 0 , 0 0 0 po p u l a t i o n Jefferson County Washington State Jefferson and WA rates statistically increasing overtime. The Health of Jefferson County April 2014 The Health of Jefferson County April 2014 Jefferson County, Washington State Source: Behavioral Risk Factor Surveillance System Question: Have you smoked at least 100 cigarettes in your entire life? Note: Starting with 2011, BRFSS results cannot be compared historically due to changes in the survey methodology. 2001 2003-05 (WA 05) 2007-09 (WA09)2011-12 Jefferson County 55%52%53%41% Washington State 50%45%41%44% gender male 49% female 43% age group 18-34 n<30 35-64 43% 65+51% education level high school or less 50% more than high school 37% income level $50,000 or less 46% more than $50,000 33% D1. Adults Who Have Ever Smoked About 4 in 10 Jefferson County and WA State adults report having ever smoked 100 cigarettes in their lifetime. Jefferson rates with the previous BRFSS methods were higher, over half, and unchanged since 2001. In Washington State, with the previous methods, the rate dropped from 50% in 2001 to 41% in 2009. In 2011-12, the rate is higher among males, older adults and adults with lower education levels and lower incomes. 41% 44% 0% 25% 50% 75% 100% 2001 2003-05 (WA 05) 2007-09 (WA09) 2011-12 Jefferson County Washington State The Health of Jefferson County April 2014 D2. Adult Current Smokers Jefferson County, Washington State Source: Behavioral Risk Factor Surveillance System Note: Starting with 2011, BRFSS results cannot be compared historically due to changes in the survey methodology. 2001 2003-05 (WA 05) 2007-09 (WA09)2011-12 Jefferson County 21%17%19%12% Washington State 23%18%15%17% 2011-12 n too small for sub-group analyses. 2007-09 2009 Jefferson WA State gender male 20%16%higher among males female 16%14% age group 18-34 *19% 35-64 17%15%higher among younger adults 65+*7% education level high school or less 36%24% some college 19%17%higher among lower-educated adults 4+ years college *6% * number of respondents less than 30 therefore data cannot be Computed from two questions: Adults reporting having smoked at least 100 cigarettes in their entire life and now smoking every day or some days Adult smoking rates for Jefferson County are quite low - 12%! Previously, nearly 20% of Jefferson County adults reported having ever smoked 100 cigarettes in their lifetime and having smoked every day or some days in the past 30 days. In 2007-09, the rate was higher among males, younger adults and adults with lower education levels. 12% 17% 0% 10% 20% 30% 2001 2003-05 (WA 05) 2007-09 (WA09) 2011-12 Jefferson County Washington State The Health of Jefferson County April 2014, updated May 2014 Jefferson County and Washington State Note: Starting with 2011, BRFSS results cannot be compared historically due to changes in the survey methodology. 2001 2003-05 (WA 05) 2007-09 (WA09)2011-12 Jefferson County 72%59%56%62% Washington State 64%54%57%59% Quit Line Calls from Jefferson Residents # calls 2007 67 2008 110 2009 143 2010 133 7/1/12-6/30/13 104 7/1/13-12/31/13 21 D3. Adult Smokers Attempting to Quit in the Past 12 Months More than half of Jefferson County and Washington State adult smokers report having made a quit attempt in the past 12 months. Updated QuitLine data were not available yet. In 2009, 143 Jefferson residents called the Quit Line, up from 110 in 2008 and 67 in 2007. Since the Quit Line began in 2000, about 700 Jefferson residents have called. Questions: During the past 12 months, have you stopped smoking for one day or longer because you were trying to quit smoking? Source: Quit Attempts: Behavioral Risk Factor Surveillance System; Quit Line Calls: WA State Dept. of Health The number of calls dropped dramaticlly during the second half of 2013 when free nicotine replacement therapy was no longer offered. 62% 59% 0% 25% 50% 75% 100% 2001 2003-05 (WA 05) 2007-09 (WA09) 2011-12 Jefferson County Washington State 67 110 143 133 104 21 0 50 100 150 The Health of Jefferson County April 2014 D4. Youth current tobacco use Jefferson County and Washington State Source: Healthy Youth Survey Question: During the past 30 days, on how many days did you: Smoke cigarettes? CIGARETTES 8th grade 10th grade 12th grade 8th grade 10th grade 12th grade 2002 13%22%36%9%15%23% 2004 12%23%22%8%13%20% 2006 10%24%32%6%15%20% 2008 8%14%22%7%14%20% 2010 8%14%21%7%13%20% 2012 5%15%26%5%10%16% Other types of tobacco use by grade, 2012: Cigars 2%16%13%3%7%14% Smokeless tobacco 1%7%8%3%5%8% Candy-flavored tobacco 3%14%26%4%9%16% Hookah 1%9%31%4%9%17% E-cigs 1%2%11%2%4%7% Dissolvables 0%0%4%1%1%1% Note: Participation in the Healthy Youth Survey is voluntary. Data are not reported when the grade-level response rate is less than 40%. Results represent students participating in the survey and likely represent all students in the grade level. About 1 in 20 8th graders, 1 in 7 10th graders and 1 in 4 12th graders reports using cigarettes in the past month. The 8th grade rate has been decreasing over time, a trend for WA rates in all three grades. Jefferson 10th and 12th grade rates dropped in 2008; 10th grade rates have remained the same; 12th grade rates went back up in 2012. Jefferson 10th and 12th grade rates are higher than WA State. 0% 20% 40% 60% 80% 100% Washington State 8th grade 10th grade 12th grade 0% 20% 40% 60% 80% 100% Jefferson County 8th grade 10th grade 12th grade 2% 1% 3% 1% 1% 0% Jefferson County Washington State 8th grade 16% 7% 14% 9% 2% 0% Jefferson County Washington State 10th grade 13% 8% 26% 31% 11% 4% Jefferson Washington 12th grade The Health of Jefferson County April 2014 Jefferson County and Washington State Source: Washington State Department of Health, Synar Compliance Check Database Jefferson County Washington State # attempts % of sales to minors % of sales to minors 2003 17 6%11% 2004 22 36%12% 2005 22 14%10% 2006 20 10%5% 2007 30 3%9% 2008 20 15%15% 2009 22 9%9% 2010 24 17%10% 2011 26 4%11% 2012 25 4%16% 2013 22 5%15% D5. Sales of Tobacco to Minors In 2013, 5% of attempts to sell tobacco to minors were successful in Jefferson compared to 15% in Washington State. The Jefferson rate has been low the past 3 years. There are 57 retailers licensed to sell tobacco in Jefferson County. 5% 15% 0% 5% 10% 15% 20% 25% 30% 35% 40% 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Jefferson County Washington State The Health of Jefferson County April 2014 Jefferson County, Washington State Source: Behavioral Risk Factor Surveillance System Adults who report consuming 5 or more alcoholic drinks on an occasion in the past 30 days Note: Starting with 2011, BRFSS results cannot be compared historically due to changes in the survey methodology. 2001 2003-05 (WA 05) 2007-09 (WA09)2011-12 Jefferson County 12%14%14%n<30 Washington State 15%14%15%17% E1. Adult Binge Alcohol Drinkers About 1 in 7 Jefferson County and Washington State adults reported binge drinking in the past month. 17% 0% 10% 20% 30% 40% 50% 2001 2003-05 (WA 05) 2007-09 (WA09) 2011-12 Jefferson County Washington State The Health of Jefferson County April 2014 E2. Youth alcohol use Jefferson County and Washington State Source: Healthy Youth Survey Question: On how many days in the past month did you: Drink a glass, can, or bottle of alcohol (beer, wine, wine coolers, hard liquor)? CURRENT USE 6th grade 8th grade 10th grade 12th grade 6th grade 8th grade 10th grade 12th grade 2002 6%38%49%72%4%18%29%43% 2004 3%39%44%54%4%18%33%43% 2006 6%17%44%53%4%15%33%42% 2008 1%20%33%45%4%16%32%41% 2010 3%16%37%49%4%14%28%40% 2012 1%12%27%57%3%12%23%36% EVER USED ALCOHOL 6th grade 8th grade 10th grade 12th grade 6th grade 8th grade 10th grade 12th grade 2002 36%59%72%88%33%44%60%75% 2004 37%54%65%83%30%42%60%73% 2006 36%43%74%83%31%38%61%72% 2008 28%43%70%79%29%39%61%72% 2010 26%41%69%78%26%39%57%71% 2012 28%43%65%82%23%35%52%68% Note: Participation in the Healthy Youth Survey is voluntary. Data are not reported when the grade-level response rate is less than 40%. Results represent students participating in the survey and likely represent all students in the grade level. In 2012, more than 1 in 2 twelfth graders; more than 1 in 4 tenth graders; 1 in 8 eighth graders and only 1% of sixth graders reported using alcohol in the past month. Jefferson youth alcohol use rates are about the same as WA State except for the 12th grade rate. Jefferson 8th and 10th grade rates appear to be decreasing. In 2012, more than 4 in 5 twelfth graders; more than 2 in 3 tenth graders; 2 in 5 eighth graders and more than 1 in 4 sixth graders reported ever having using alcohol. Jefferson youth lifetime alcohol use rates are above WA State rates. Compared to 2002, rates in all grades are lower. 0% 20% 40% 60% 80% 100% Washington State 6th grade 8th grade 10th grade 12th grade 0% 20% 40% 60% 80% 100% Jefferson County 6th grade 8th grade 10th grade 12th grade 0% 20% 40% 60% 80% 100% Washington State 6th grade 8th grade 10th grade 12th grade 0% 20% 40% 60% 80% 100% Jefferson County 6th grade 8th grade 10th grade 12th grade The Health of Jefferson County April 2014 Source for alcohol:Jefferson County Washington State 2012 8th grade 10th grade 12th grade 8th grade 10th grade 12th grade Bought at store 7%20%15%6%7%7% Older sibling 14%7%15%9%11%9% Friends/party 50%73%58%39%52%60% Gave $ to someone 14%20%35%9%19%27% At home 36%20%27%39%32%26% At family celebration 36%20%15%12%10%10% Other way 29%27%4%17%16%14% In 2012, most youth got their alcohol from friends or at parties. More than 1 in 3 eighth graders report getting it from home with or without permission, about the same as WA. More than 1 in 3 Jefferson 8th graders report getting alcohol at a family celebration compared only 1 in 9 in WA State. Rates of purchasing alcohol at a store are higher for Jefferson 10th and 12th graders compared to WA. 7% 14% 50% 14% 36% 36% 29% Jefferson Washington 8th grade 20% 7% 73% 20% 20% 20% 27% Jefferson Washington 10th grade 15% 15% 58% 35% 27% 15% 4% Jefferson Washington 12th grade The Health of Jefferson County April 2014 E3. Youth binge alcohol use Jefferson County and Washington State Source: Healthy Youth Survey 8th grade 10th grade 12th grade 8th grade 10th grade 12th grade 2002 17%28%52%10%19%27% 2004 20%26%35%10%19%26% 2006 8%27%36%9%20%26% 2008 13%20%31%9%18%26% 2010 9%21%36%8%16%25% 2012 10%20%45%7%14%22% Note: Participation in the Healthy Youth Survey is voluntary. Data are not reported when the grade-level response rate is less than 40%. Results represent students participating in the survey and likely represent all students in the grade level. In 2012, about 1 in 10 eighth graders; 1 in 5 tenth graders and nearly half of twelfth graders report binge drinking in the past two weeks, all rates are above WA State. Jefferson 12th grade rates have been up the past two surveys while WA rate trends are going down for all grades. Question: Think back over the last 2 weeks. How many times have you had five or more drinks in a row? (A drink is a glass of wine, a bottle of beer, a shot glass of liquor, or a mixed drink.) 0% 20% 40% 60% 80% 100% Washington State 8th grade 10th grade 12th grade 0% 20% 40% 60% 80% 100% Jefferson County 8th grade 10th grade 12th grade The Health of Jefferson County April 2014 E4. Alcohol Arrests Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Adults age 18+ Washington State Adult Number Rate per 1,000 Population Rate per 1,000 1994-96 586 10.5 55611 12.0 1997-99 726 12.1 59848 11.5 2000-02 611 9.6 63481 10.5 2003-05 521 7.9 65675 11.4 2006-08 480 6.9 69828 10.3 2009-11 346 4.6 75440 9.6 Youth age 10-17 Source: DSHS Risk and Protection Profile for Substance Abuse Prevention in Jefferson County Note: Alcohol violations include all crimes involving driving under the influence, liquor law violations, and drunkenness. Washington State Patrol DUI's are included as part of the state rate but not county rate since arrests are not assigned to counties. There were about 115 Jefferson County resident adult alcohol violation arrests annually during the period 2009-11. With the exception of 1997-99, the Jefferson rate has been below the Washington State rate. The Jefferson and Washington rates have been statistically decreasing. Jefferson County In Jefferson County there were about 45 youth (age 10-17) alcohol related arrests each year between 2006 and 2008, only 20 arrests per year from 2009-11. The Jefferson rate has been above the Washington rate. The Jefferson and Washington rates are statistically decreasing overtime. 4.6 9.6 0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 1994-96 1997-99 2000-02 2003-05 2006-08 2009-11 ar r e s t r a t e p e r 1 , 0 0 0 a d u l t s ag e 1 8 + Jefferson County Washington State 9.0 4.8 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 1994-96 1997-99 2000-02 2003-05 2006-08 2009-11 Ar r e s t r a t e p e r 1 , 0 0 0 y o u t h a g e 10 -17 Jefferson County Washington State The Health of Jefferson County April 2014 Washington State Number Rate per 1,000 Population Rate per 1,000 1994-96 230 31.0 7426 7.8 1997-99 184 23.5 7819 9.4 2000-02 185 23.5 7869 8.3 2003-05 111 14.2 7814 7.2 2006-08 136 17.2 7926 7.3 2009-11 60 9.0 6649 4.8 Alcohol or Drug Related Arrests, Youth age 10-14 Washington State Number Rate per 1,000 Population Rate per 1,000 1994-96 70 14.7 4746 3.4 1997-99 65 13.5 4813 3.7 2000-02 30 6.2 4805 3.8 2003-05 28 6.0 4686 3.8 2006-08 23 5.4 4295 2.6 2009-11 27 6.7 4034 2.7 Jefferson County Jefferson County Note: Alcohol violations include all crimes involving driving under the influence, liquor law violations (minor in possession), and drunkenness. Drug violations include all crimes involving sale, manufacturing, and possession of drugs. In Jefferson County there were 9 youth (age 10-14) arrests related to alcohol or drugs each year between 2009 and 2011. The Jefferson rate dropped dramatically between 1997-99 and 2000-02. The Jefferson rate has been above the Washington rate since 1994-96. 6.7 2.7 0.0 5.0 10.0 15.0 1994-96 1997-99 2000-02 2003-05 2006-08 2009-11 Ar r e s t r a t e p e r 1 , 0 0 0 y o u t h a g e 10 -14 Jefferson County Washington State The Health of Jefferson County April 2014, updated May 2014 E5. Alcohol Related Hospitalization Rate Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Age Adjusted Alcohol Related Hospitalization Rate per 100,000 Population number Jefferson County Washington State 1992-94 126 164.2 127.9 1995-97 133 153.2 147.0 1998-00 134 138.7 148.3 2001-03 170 178.7 150.4 2004-06 158 143.5 156.9 2007-09 207 181.8 173.9 2010-12 183 167.3 187.2 Unadjusted Alcohol Related Hospitalization Rate per 100,000 Population number population Jefferson County Washington State 1992-94 126 65105 193.5 122.2 1995-97 133 70067 189.8 142.5 1998-00 134 73726 181.8 146.4 2001-03 170 75919 223.9 151.7 2004-06 158 79033 199.9 162.2 2007-09 207 82622 250.5 183.2 2010-12 183 86152 212.4 201.8 ICD-9 CM CODES: 291 Alcohol induced mental disorders (291.0 Alcohol withdrawal delirium, 291.1 Alcohol induced persisting amnestic disorder, 291.2 Alcohol induced persisting dementia, 291.3 Alcohol induced psychotic disorder with hallucinations, 291.4 Idiosyncratic alcohol intoxication, 291.5 Alcohol induced psychotic disorder with delusions, 291.8 Other specified alcohol induced mental disorders (291.81 Alcohol withdrawal, 291.82 Alcohol induced sleep disorders, 291.89 Other), 291.9 Unspecified alcohol induced mental disorders), 303 Alcohol dependence syndrome (303.0 Acute alcoholic intoxication, 303.9 Other and unspecified alcohol dependence), 305.0 Alcohol abuse, 357.5 Alcoholic polyneuropathy, 425.5 Alcoholic cardiomyopathy, 535.3 Alcoholic gastritis, 571 Chronic liver disease and cirrhosis (571.0 Alcoholic fatty liver, 571.1 Acute alcoholic hepatitis, 571.2 Alcoholic cirrhosis of liver, 571.3 Alcoholic liver damage, unspecified), 790.3 Excessive blood level of alcohol, 980 Toxic effect of alcohol (980.0 Ethyl alcohol), E860 Accidental poisoning by alcohol, not elsewhere classified (E860.0 Alcoholic beverages, E860.1 Other and unspecified ethyl alcohol and its products). Source: Washington State Dept. of Health Center for Health Statistics, Comprehensive Hospital Abstract Reporting System, Accessed in CHAT. There were on average 61 Jefferson County resident alcohol-related hospitalizations per year from 2010-12. Rates are higher among males and adults age 34-65. More than half of the alcohol-related hospitalizations are males and adults age 35-64. The Jefferson County age adjusted rate is not statistically different from the Washington State rate and the Jefferson rate is unchanged overtime while the WA rate is statistically increasing. 167.3 187.2 0.0 50.0 100.0 150.0 200.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Age Adjusted Rate per 100,000 population Jefferson County Washington State WA rate statistically increasing since 1992-94 0.0 50.0 100.0 150.0 200.0 250.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Unadjusted Rate per 100,000 population Jefferson County Washington State WA rate statistically increasing since 1992-94 The Health of Jefferson County April 2014, updated May 2014 Age Adjusted Alcohol Related Hospitalization Rates per 100,000 by Gender male femalenumberratenumberrate% male rate rate 1992-94 96 253.3 30 82.1 76%178.8 81.3 1995-97 97 238.1 36 74.6 73%206.4 92.0 1998-00 74 160.3 60 119.4 55%206.8 94.8 2001-03 111 243.2 59 117.7 65%207.7 96.2 2004-06 107 203.9 51 83.6 68%212.0 103.2 2007-09 142 268.7 65 95.7 69%233.1 116.0 2010-12 125 224.7 58 114.8 68%254.3 123.1 Alcohol Hospitalization Rates by Age Group per 100,000 population 0-34 35-64 65+ number rate number rate number rate rate rate rate 1992-94 12 49.7 63 232.8 51 367.2 33.7 215.2 237.7 1995-97 10 40.9 75 246.0 48 317.1 33.7 254.7 263.7 1998-00 4 79 233.7 51 319.7 30.6 261.3 262.6 2001-03 11 46.4 122 337.9 37 229.7 25.6 278.9 248.6 2004-06 4 113 292.7 41 245.7 25.6 297.9 252.0 2007-09 7 29.0 137 337.7 63 352.6 31.3 343.1 243.2 2010-12 14 60.1 127 321.1 42 180.1 40.2 376.7 239.6 Jefferson County Washington State age 0-34 age 35-64 age 65+ Jefferson County Washington State male female 0.0 100.0 200.0 300.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Male Rate per 100,000 population Jefferson County Washington State 0.0 100.0 200.0 300.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Female Rate per 100,000 population Jefferson County Washington State 0.0 100.0 200.0 300.0 400.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Adult age 35-64 rate per 100,000 population Jefferson County Washington State 0.0 25.0 50.0 75.0 100.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Adult age 0-34 rate per 100,000 population Jefferson County Washington State 0.0 100.0 200.0 300.0 400.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Adult age 65+ rate per 100,000 population Jefferson County Washington State The Health of Jefferson County April 2014, updated May 2014 E6. Alcohol Related Death Rate Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Alcohol Related Death Rate per 100,000 Population Age Adjusted Rate number Jefferson County Washington State 1992-94 3 9.7 1995-97 9 9.3 10.7 1998-00 4 9.7 2001-03 8 7.0 10.0 2004-06 23 17.3 9.6 2007-09 19 13.2 10.7 2010-12 19 14.4 11.6 Crude Rate number population Jefferson County Washington State 1992-94 3 68268 8.9 1995-97 9 73665 12.2 10.0 1998-00 4 77414 9.3 2001-03 8 81151 9.9 10.0 2004-06 23 84941 27.1 10.0 2007-09 19 88651 21.4 11.4 2010-12 19 89972 21.1 13.0 ICD10 CODES: E24.4 Alcohol-induced pseudo-Cushing's syndrome; F10 Mental and behavioral disorders due to use of alcohol (F10.0 Acute intoxication, F10.1 Harmful use, F10.2 Dependence syndrome, F10.3 Withdrawal state, F10.4 Withdrawal state with delirium, F10.5 Psychotic disorder, F10.6 Amnesic syndrome, F10.7 Residual and late-onset psychotic disorder, F10.8 Other mental and behavioral disorders, F10.9 Unspecified mental and behavioral disorder), G31.2 Degeneration of nervous system due to alcohol, G62.1 Alcoholic polyneuropathy, G72.1 Alcoholic myopathy, I42.6 Alcoholic cardiomyopathy, K29.2 Alcoholic gastritis, K70 Alcoholic liver disease(K70.0 Alcoholic fatty liver, K70.1 Alcoholic hepatitis, K70.2 Alcoholic fibrosis and sclerosis of liver, K70.3 Alcoholic cirrhosis of liver, K70.4 Alcoholic hepatic failure, K70.9 Alcoholic liver disease, unspecified), K86.0 Alcohol-induced chronic pancreatitis, R78.0 Finding of alcohol in blood, X45 Accidental poisoning by and exposure to alcohol, X65 Intentional self-poisoning by and exposure to alcohol, Y15 Poisoning by and exposure to alcohol, undetermined intent. Source: Washington State Dept. of Health Center for Health Statistics, Death Certificate Database. Accessed in CHAT. Between 2007 and 2012 there were about 6 Jefferson County resident alcohol-related deaths per year. In 2004-06 the Jefferson rate increased dramatically; the state rate has been relatively unchanged overtime. The majority of deaths are among males and while the rates are similar, more deaths are among adults age 35-64 than among older adults. 14.4 11.6 0.0 5.0 10.0 15.0 20.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Age Adjusted Rate per 100,000 population Jefferson County Washington State 21.1 13.0 0.0 5.0 10.0 15.0 20.0 25.0 30.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Crude Rate per 100,000 population Jefferson County Washington State The Health of Jefferson County April 2014, updated May 2014 Alcohol Related Death Rates per 100,000 by Gender male female number rate number rate %male rate rate 1992-94 3 0 100%14.3 5.8 1995-97 9 19.1 0 100%15.7 6.2 1998-00 3 1 75%14.3 5.5 2001-03 4 4 50%14.4 6.1 2004-06 14 22.7 9 12.3 61%13.6 6.0 2007-09 10 15.7 9 10.9 53%15.0 6.6 2010-12 14 19.0 5 10.1 74%16.4 7.2 Alcohol Death Rates by Age Group 0-34 35-64 65+ number rate number rate number rate rate rate rate 1992-94 0 2 1 0.5 15.1 27.3 1995-97 0 7 21.9 2 0.6 17.2 28.3 1998-00 0 1 3 0.6 15.8 25.3 2001-03 1 3 4 0.4 17.6 25.1 2004-06 0 12 30.1 11 56.5 0.6 17.4 23.5 2007-09 0 13 31.6 6 27.4 0.6 20.4 24.2 2010-12 1 11 26.7 7 29.3 0.8 23.4 25.3 age 0-34 age 35-64 age 65+ Jefferson County male female Jefferson County Washington State Washington State 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Male Rate per 100,000 population Jefferson County Washington State 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Female Rate per 100,000 population Jefferson County Washington State 0.0 10.0 20.0 30.0 40.0 50.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Adult age 35-64 rate per 100,000 population Jefferson County Washington State 0.0 10.0 20.0 30.0 40.0 50.0 60.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Adult age 65+ rate per 100,000 population Jefferson County Washington State The Health of Jefferson County April 2014 E7. Youth drinking and driving Jefferson County and Washington State Source: Healthy Youth Survey Questions:During the past 30 days, how many times did you ride in a car or other vehicle driven by someone who had been drinking alcohol? During the past 30 days, how many times did you drive a car or other vehicle when you had been drinking alcohol? RODE WITH DRINKING DRIVER 8th grade 10th grade 12th grade 8th grade 10th grade 12th grade 2002 23%33%38%20%24%25% 2004 27%30%27%18%24%24% 2006 21%39%33%17%25%24% 2008 18%22%22%19%24%23% 2010 23%22%24%18%22%23% 2012 15%22%23%17%19%21% DROVE AFTER DRINKING 2012 3%9%11%4%5%11% Note: Participation in the Healthy Youth Survey is voluntary. Data are not reported when the grade-level response rate is less than 40%. Results represent students participating in the survey and likely represent all students in the grade level. More than 1 in 5 tenth and twelfth graders report riding in a car with someone who had been drinking alcohol in the past month, 1 in 7 eighth graders - all rates are about the same as the State. Rates for all grades in Jefferson and WA appear to be decreasing. About 1 in 10 Jefferson 10th and 12th graders report driving after drinking; the 10th grade rate is higher than the WA rate. 0% 10% 20% 30% 40% 50% Washington State 8th grade 10th grade 12th grade 0% 10% 20% 30% 40% 50% Jefferson County 8th grade 10th grade 12th grade 3% 9% 11% 0% 20% 8th grade 10th grade 12th grade Jefferson County Washington State The Health of Jefferson County April 2014 E8. Alcohol-Related Traffic Fatalities Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 alcohol- related traffic fatalities total traffic fatalities Rate (%) Washington State Rate (%) 1994-96 11 20 55.0 47.5 1997-99 7 25 28.0 40.3 2000-02 5 16 31.3 38.9 2003-05 7 21 33.3 38.7 2006-08 7 19 36.8 41.3 2009-11 1 9 11.1 43.4 Source: DSHS Risk and Protection Profile for Substance Abuse Prevention in Jefferson County Annual number of alcohol-related traffic fatalities, per 100 traffic fatalities. "Alcohol-related" means that the officer on the scene determined that at least one driver involved in the accident "had been drinking." "Alcohol-related" includes but is not limited to the legal definition of driving under the influence. In 2009-11, only 1 of the 9 Jefferson County traffic fatalities was determined to have been alcohol-related, down from previous years. The Jefferson rate has been below the Washington rate since 1997-99. Jefferson County 11.1 43.4 0.0 10.0 20.0 30.0 40.0 50.0 60.0 1994-96 1997-99 2000-02 2003-05 2006-08 2009-11 ra t e p e r 1 0 0 ( % ) Jefferson County Washington State The Health of Jefferson County April 2014 F1. Youth current drug use Jefferson County and Washington State Source: Healthy Youth Survey Question: During the past 30 days, on how many days did you: (insert drug name)? MARIJUANA 8th grade 10th grade 12th grade 8th grade 10th grade 12th grade 2002 16%36%52%10%18%25% 2004 19%28%29%9%17%19% 2006 10%30%30%7%18%22% 2008 11%21%33%8%19%23% 2010 13%34%37%9%20%26% 2012 12%30%35%9%19%27% OTHER TYPES OF DRUG USE BY GRADE, 2012: Other illegal drugs 3%13%8%3%5%7% Hyperactivity drugs 4%4%4%2%3%5% Prescription pain killers 4%10%8%3%6%7% Note: Participation in the Healthy Youth Survey is voluntary. Data are not reported when the grade-level response rate is less than 40%. Results represent students participating in the survey and likely represent all students in the grade level. About 1 in 8 eighth graders, 3 in 10 tenth graders and more than 1 in 3 twelfth graders reports using marijuana in the past month. Rates are lower for Washington State in all grades. Jefferson and Washington rates are relatively unchanged overtime. Other illegal drug and prescription pain killer use as reported by Jefferson 10th graders is about twice the rates reported by Washington 10th graders; 8th and 12th grade rates are about the same as Washington. 9% 19% 27% 0% 20% 40% 60% 80% 100% Washington State 8th grade 10th grade 12th grade 12% 30% 35% 0% 20% 40% 60% 80% 100% Jefferson County 8th grade 10th grade 12th grade 3% 4% 4% Other illegal drugs Hyperactivity drugs Prescription pain killers Jefferson County Washington State 8th grade 13% 4% 10% Other illegal drugs Hyperactivity drugs Prescription pain killers Jefferson County Washington State 10th grade 8% 4% 8% Other illegal drugs Hyperactivity drugs Prescription pain killers Jefferson Washington 12th grade The Health of Jefferson County April 2014 F2. Drug Law Violations Jefferson County and Washington State Source: DSHS Risk and Protection Profile for Substance Abuse Prevention in Jefferson County Note: Drug law violations include all crimes involving sale, manufacturing, and possession of drugs. Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Adults age 18+ Adult Number Rate per 1,000 Population Washington State LB UB 1994-96 120 2.2 55620 4.9 1.79 2.58 1997-99 261 4.4 59848 5.5 3.85 4.93 2000-02 312 4.9 63481 5.7 4.39 5.49 2003-05 246 3.7 66495 5.5 3.25 4.19 2006-08 397 5.5 72668 5.9 4.94 6.03 2009-11 262 3.5 75440 5.3 3.07 3.92 Youth ages 10-17 Youth Number Rate per 1,000 Population Washington State Rate 1994-96 53 7.1 7426 4.4 5.35 9.34 1997-99 50 6.4 7819 5.0 4.75 8.44 2000-02 50 6.3 7878 5.1 4.71 8.37 2003-05 34 4.4 7692 4.5 3.06 6.18 2006-08 52 7.3 7155 4.5 5.43 9.54 2009-11 51 7.7 6649 4.8 5.72 10.09 Jefferson County Jefferson County There were about 90 adult drug law violations in Jefferson County each year from 2009-11. The rate of drug law violations in Jefferson County has been statistically below the Washington State rate except in 2004-06 when the rates were the same. The Jefferson and Washington rates are statistically unchanged overtime. The number of drug law violation arrests of youth age 10-17 in Jefferson County has been relatively unchanged since 1994. Except for 2003-05, on average each year, there have been about 17 drug law violation arrests. The Jefferson rate has been statistically higher than the Washington rate with the exception of 2003-05 when the rates were about the same. The Jefferson and Washington rates are unchanged overtime. 3.5 5.3 0.0 2.0 4.0 6.0 8.0 10.0 1994-96 1997-99 2000-02 2003-05 2006-08 2009-11 Ar r e s t r a t e p e r 1 , 0 0 0 ad u l t s a g e 1 8 + Jefferson County Washington State 7.7 4.8 0.0 2.0 4.0 6.0 8.0 10.0 1994-96 1997-99 2000-02 2003-05 2006-08 2009-11 Ar r e s t r a t e p e r 1 , 0 0 0 y o u t h ag e 1 0 -1 7 Jefferson County Washington State The Health of Jefferson County April 2014 F3. Drug Lab and Dump Site Clean-Up Jefferson County and Washington State Source: Washington State Department of Ecology http://www.ecy.wa.gov/programs/spills/response/drug_labs/CountyTable1990%20to2012.pdf Jefferson County Washington State 1997 1 203 1998 2 349 1999 5 789 2000 1 1454 2001 5 1890 2002 5 1693 2003 12 1480 2004 2 1341 2005 1 809 2006 5 390 2007 0 237 2008 1 184 2009 1 186 2010 0 95 2011 0 46 2012 1 84 The number of drug labs requiring clean-up peaked in 2003 in Jefferson County; 2001 in Washington State. Since 2007 there have only been 3 clean-ups in Jefferson County. Decreased drug lab clean-ups indicate increased enforcement and alternate procurement methods. 1 2 5 1 5 5 12 2 1 5 0 1 1 0 0 1 0 500 1,000 1,500 2,000 0 2 4 6 8 10 12 14 16 18 20 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Nu m b e r o f D r u g L a b C l e a n -Up s , Wa s h i n g t o n S t a t e Nu m b e r o f D r u g L a b C l e a n -up s , Je f f e r s o n C o u n t y Jefferson County Washington State The Health of Jefferson County April 2014 Jefferson County Source: Jefferson County Public Health Syringes exchanged IDU prevention materials HIV tests offered new clients returning client visits secondary exchangers 2000 506 11 3 7 3 2001 2,076 3 6 9 5 2002 4,206 1,026 11 29 25 2003 9,222 1,424 9 55 53 2004 18,060 7,265 12 48 45 2005 13,716 7,611 0 6 30 29 2006 17,905 9,000 3 8 50 49 2007 24,585 9,988 22 9 56 58 2008 21,330 7,941 27 6 64 67 2009 14,044 7,098 31 12 53 35 2010 9,156 11,024 36 13 68 40 2011 17,726 16,512 41 19 123 110 2012 17,405 11,535 49 18 132 96 2013 24,596 15,984 90 28 157 126 F4. Materials Distributed by Jefferson County Syringe Exchange Program Nearly 25,000 syringes were exchanged at the Jefferson County Syringe Exchange Program in 2013. The decrease in 2009 and 2010 is likely explained by a drop in secondary exchange. The numbers of new, returning and secondary exchangers were highest ever in 2013. Materials Distributed Client Demographics n o t o f f e r e d 24,596 0 5,000 10,000 15,000 20,000 25,000 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Syringes exchanged The Health of Jefferson County April 2014, updated May 2014 F5. Opiate Related Hospitalization Rate Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Age Adjusted Opiate Related Hospitalization Rate per 100,000 Population number Jefferson County Washington State 1992-94 3 5.7 1995-97 8 13.0 6.9 1998-00 9 12.1 8.4 2001-03 14 15.7 12.3 2004-06 11 10.1 16.0 2007-09 26 26.4 20.8 2010-12 18 13.1 23.2 Unadjusted Opiate Related Hospitalization Rate per 100,000 Population number population Jefferson County Washington State 1992-94 3 65105 5.7 1995-97 8 70067 11.4 7.0 1998-00 9 73726 12.2 8.5 2001-03 14 75919 18.4 12.5 2004-06 11 79033 13.9 16.5 2007-09 26 82622 31.5 21.5 2010-12 18 86152 20.9 24.3 ICD-9 CODES: 304.0 Opioid type dependence, 304.7 Drug dependence - Combinations of opioid type drug with any other, 305.5 Opioid abuse, 965.0 Poisoning by Opiates and related narcotics (965.00 Opium (alkaloids), unspecified, 965.01 Heroin, 965.02 Methadone, 965.09 Other), E850.0 Unintentional poisoning – heroin, E850.1 Unintentional poisoning – methadone, E850.2 Unintentional poisoning - other opiates & related narcotics Source: Washington State Dept. of Health Center for Health Statistics, Comprehensive Hospital Abstract Reporting System, Accessed in CHAT. Washington State Office of Financial Management Population Estimates. There were on average 6 Jefferson County resident opiate-related hospitalizations per year from 2010 to 2012, down from nearly 9 per year from 2007-09. Since 2007, rates have been higher among women. By age, rates were higher among adults 35-64 until 2010-12 when the adult age 65+ rate became the highest. In 2010-12, more than half of the drug-related hospitalizations are females and adults age 66+. The total age adjusted rate increased from 1992-98, dropped from 2000-06 and was up in 2007-09. The Jefferson County age adjusted rate is not statistically different from the Washington State rate. 0.0 5.0 10.0 15.0 20.0 25.0 30.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Age Adjusted Rate per 100,000 population Jefferson County Washington State WA rate statistically increasing since 1992-94 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Unadjusted Rate per 100,000 population Jefferson County Washington State Jefferson County and WA rates statistically increasing since 1992-94 The Health of Jefferson County April 2014, updated May 2014 Age Adjusted Opiate Related Hospitalization Rates per 100,000 by Gender male female number rate number rate % male rate rate 1992-94 1 2 33%5.2 6.1 1995-97 3 5 17.2 38%6.7 7.0 1998-00 4 5 11.1 44%8.2 8.6 2001-03 5 13.8 9 17.7 36%10.8 13.8 2004-06 6 13.7 5 6.7 55%14.6 17.3 2007-09 9 23.8 17 28.7 35%18.5 23.0 2010-12 4 14 21.0 22%21.3 24.8 Opiate Hospitalization Rates by Age Group per 100,000 population 0-34 35-64 65+ number rate number rate number rate rate rate rate 1992-94 1 1 1 4.5 7.6 5.7 1995-97 4 1 3 4.9 10.1 6.3 1998-00 3 2 4 4.6 12.9 10.1 2001-03 2 7 19.2 5 29.0 6.5 19.4 14.3 2004-06 1 5 13.1 5 26.2 8.3 25.0 20.4 2007-09 2 17 43.1 7 32.7 10.6 32.1 29.3 2010-12 1 7 17.7 10 42.9 13.1 34.3 34.3 WA rates statistically increasing overtime WA rates statistically increasing overtime Jefferson County Washington State male female Jefferson County Washington State age 0-34 age 35-64 age 65+ 21.3 0.0 5.0 10.0 15.0 20.0 25.0 30.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Male Rate per 100,000 population Jefferson County Washington State 21.0 24.8 0.0 10.0 20.0 30.0 40.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Female Rate per 100,000 population Jefferson County Washington State 0.0 10.0 20.0 30.0 40.0 50.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Adult age 35-64 rate per 100,000 population Jefferson County Washington State 0.0 10.0 20.0 30.0 40.0 50.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Adult age 65+ rate per 100,000 population Jefferson County Washington State The Health of Jefferson County April 2014, updated May 2014 F6. Opiate Related Death Rate Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Age Adjusted Opiate Related Death Rate per 100,000 Population number Jefferson County Washington State 1992-94 2 3.4 1995-97 3 6.4 1998-00 2 6.4 2001-03 5 6.8 7.2 2004-06 12 14.1 10.1 2007-09 17 22.1 11.2 2010-12 15 16.3 10.5 Unadjusted Opiate Related Death Rate per 100,000 Population number population Jefferson County Washington State 1992-94 2 68268 3.5 1995-97 3 73665 6.6 1998-00 2 77414 6.5 2001-03 5 81151 6.2 7.4 2004-06 12 84941 14.1 10.4 2007-09 17 88651 19.2 11.7 2010-12 15 89972 16.7 11.0 ICD10 CODES: F11 Mental and behavioural disorders due to use of opioids (F11.0 Acute intoxication, F11.1 Harmful use, F11.2 Dependence syndrome, F11.3 Withdrawal state, F11.4 Withdrawal state with delirium, F11.5 Psychotic disorder, F11.7 Residual and late-onset psychotic disorder, F11.8 Other mental and behavioural disorders, F11.9 Unspecified mental and behavioural disorder), T40.0 Poisoning by opium, T40.1 Poisoning by heroin , T40.2 Poisoning by other opioids, T40.3 Poisoning by methadone, T40.4 Poisoning by other synthetic narcotics, T40.6 Poisoning by other and unspecified narcotics Source: Washington State Dept. of Health Center for Health Statistics, Death Certificate Database, accessed in CHAT. Washington State Office of Financial Management Population Estimates. Opiate related deaths include opiates as the underlying or contributing cause of death. Five Jefferson County resident deaths per year were opiate-related from 2010 to 2012. Opiate-related deaths increased dramatically in the mid- 2000's. The majority of deaths are among males and adults age 35-64.The Washington rate is statistically increasing overtime. 0.0 5.0 10.0 15.0 20.0 25.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Age Adjusted Rate per 100,000 population Jefferson County Washington State 0.0 5.0 10.0 15.0 20.0 25.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Unadjusted Rate per 100,000 population Jefferson County Washington State The Health of Jefferson County April 2014, updated May 2014 Age Adjusted Opiate Related Death Rates per 100,000 by Gender male female number rate number rate % males rate rate 1993-97 3 0 100%8.3 2.5 1998-02 4 0 100%9.0 4.1 2003-07 12 20.3 10 13.9 55%11.9 7.7 2008-12 15 24.7 10 8.5 60%12.6 9.1 Opiate Death Rates by Age Group per 100,000 population 0-34 35-64 65+ number rate number rate number rate rate rate rate 1993-97 1 1 1 0.1 0.6 0.3 1998-02 1 2 1 1.4 5.0 1.5 2003-07 7 16.4 13 19.6 2 5.1 20.7 6.1 2008-12 5 11.9 18 26.2 2 7.3 26.7 7.8 male female Jefferson County Washington State age 0-34 age 35-64 age 65+ Jefferson County Washington State 0.0 5.0 10.0 15.0 20.0 25.0 30.0 1993-97 1998-02 2003-07 2008-12 Male Rate per 100,000 population Jefferson County Washington State 0.0 5.0 10.0 15.0 20.0 25.0 30.0 1993-97 1998-02 2003-07 2008-12 Female Rate per 100,000 population Jefferson County Washington State 0.0 10.0 20.0 30.0 1993-97 1998-02 2003-07 2008-12 Adult age 35-64 rate per 100,000 population Jefferson County Washington State 0.0 10.0 20.0 30.0 1993-97 1998-02 2003-07 2008-12 Adult age 0-34 rate per 100,000 population Jefferson County Washington State The Health of Jefferson County April 2014, updated May 2014 F7. Drug Related Hospitalization Rate Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Age Adjusted Drug Related Hospitalization Rate per 100,000 Population number Jefferson County Washington State 1992-94 68 112.1 99.1 1995-97 92 139.4 112.3 1998-00 124 179.1 118.0 2001-03 118 151.4 138.2 2004-06 99 118.6 153.5 2007-09 128 146.1 171.7 2010-12 118 133.3 189.9 Unadjusted Drug Related Hospitalization Rate per 100,000 Population number population Jefferson County Washington State 1992-94 68 65105 104.4 99.0 1995-97 92 70067 131.3 112.3 1998-00 124 73726 168.2 117.9 2001-03 118 75919 155.4 138.2 2004-06 99 79033 125.3 154.6 2007-09 128 82622 154.9 174.1 2010-12 118 86152 137.0 193.4 Source: Washington State Dept. of Health Center for Health Statistics, Comprehensive Hospital Abstract Reporting System, Accessed in CHAT. Washington State Office of Financial Management Population Estimates. There were on average nearly 40 Jefferson County resident drug-related hospitalizations per year from 2010 to 2012. Rates are higher among women and adults age 35-64 and 65+. More than half of the drug-related hospitalizations are females and adults age 35-64. The total age adjusted rate increased from 1992-98, dropped from 2000-06 and was up in 2007-09. The Jefferson County rates are below the Washington State rates for males and all age groups. 0.0 50.0 100.0 150.0 200.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Age Adjusted Rate per 100,000 population Jefferson County Washington State 0.0 50.0 100.0 150.0 200.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Unadjusted Rate per 100,000 population Jefferson County Washington State Jefferson County and WA rates statistically increasing since 1992-94 WA rate statistically increasing since 1992-94 The Health of Jefferson County April 2014, updated May 2014 Age Adjusted Drug Related Hospitalization Rates per 100,000 by Gender male female number rate number rate % male rate rate 1992-94 35 108.4 33 118.8 51%84.2 114.7 1995-97 32 86.4 60 189.7 35%102.4 122.7 1998-00 45 136.1 79 219.3 36%108.8 127.7 2001-03 47 129.7 71 170.1 40%122.9 153.3 2004-06 38 85.2 61 143.2 38%135.7 169.6 2007-09 55 136.0 73 151.3 43%152.5 189.9 2010-12 46 99.3 72 164.9 39%168.3 211.3 Drug Hospitalization Rates by Age Group per 100,000 population 0-34 35-64 65+ number rate number rate number rate rate rate rate 1992-94 24 99.4 28 103.5 16 115.2 82.4 108.0 146.8 1995-97 33 135.0 33 108.2 26 171.8 86.1 132.8 162.3 1998-00 40 167.5 46 136.0 38 237.2 80.0 146.0 188.2 2001-03 28 118.3 49 134.5 41 237.4 88.0 169.8 241.9 2004-06 21 87.9 35 91.7 43 225.6 98.1 188.1 265.1 2007-09 26 108.4 63 159.8 39 182.4 114.9 205.0 301.4 2010-12 23 98.8 60 151.7 35 150.1 158.3 212.6 262.4 Jefferson County Washington State male female Jefferson County Washington State age 0-34 age 35-64 age 65+ 99.3 168.3 0.0 50.0 100.0 150.0 200.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Male Rate per 100,000 population Jefferson County Washington State 164.9 211.3 0.0 50.0 100.0 150.0 200.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Female Rate per 100,000 population Jefferson County Washington State 151.7 212.6 0.0 100.0 200.0 300.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Adult age 35-64 rate per 100,000 population Jefferson County Washington State 98.8 158.3 0.0 100.0 200.0 300.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Adult age 0-34 rate per 100,000 population Jefferson County Washington State 150.1 262.4 0.0 100.0 200.0 300.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Adult age 65+ rate per 100,000 population Jefferson County Washington State The Health of Jefferson County April 2014, updated May 2014 ICD-9 CODES: 292 Drug induced mental disorders (292.0 Drug withdrawal, 292.1 Drug induced psychotic disorders, 292.11 Drug induced psychotic disorder with delusions, 292.12 Drug induced psychotic disorder with hallucinations), 292.2 Pathological drug intoxication, 292.8 Other specified drug induced mental disorders (292.81 Drug induced delirium, 292.82 Drug induced persisting dementia, 292.83 Drug induced persisting amnestic disorder, 292.84 Drug induced mood disorder, 292.85 Drug induced sleep disorders, 292.89 Other, 292.9 Unspecified drug induced mental disorder), 304 Drug dependence (304.0 Opioid type, dependence, 304.1 Sedative, hypnotic or anxiolytic dependence, 304.2 Cocaine dependence, 304.3 Cannabis dependence, 304.4 Amphetamine and other psychostimulant dependence, 304.5 Hallucinogen dependence, 304.6 Other specified drug dependence, 304.7 Combinations of opioid type drug with any other, 304.8 Combinations of drug dependence excluding opioid type drug, 304.9 Unspecified drug dependence), 305 Nondependent abuse of drugs (305.2 Cannabis abuse, 305.3 Hallucinogen abuse, 305.4 Sedative, hypnotic or anxiolytic abuse, 305.5 Opioid abuse, 305.6 Cocaine abuse, 305.7 Amphetamine or related acting sympathomimetic abuse, 305.8 Antidepressant type abuse, 305.9 Other, mixed, or unspecified drug abuse), 965 Poisoning by analgesics, antipyretics, and antirheumatics (965.0 Opiates and related narcotics, 965.00 Opium (alkaloids), unspecified, 965.01 Heroin, 965.02 Methadone, 965.09 Other), 967 Poisoning by sedatives and hypnotics (967.0 Barbiturates, 967.4 Methaqualone compounds), 968 Poisoning by other central nervous system depressants and anesthetics, 968.5 Surface [topical] and infiltration anesthetics, 969 Poisoning by psychotropic agents (969.4 Benzodiazepine-based tranquilizers, 969.6 Psychodysleptics [hallucinogens], 969.7 Psychostimulants), E850 Accidental poisoning by analgesics, antipyretics, antirheumatics (E850.0 Heroin, E850.1 Methadone, E850.2 Other opiates and related narcotics, E850.3 Salicylates, E850.4 Aromatic analgesics, not elsewhere classified, E850.5 Pyrazole derivatives, E850.6 Antirheumatics [antiphlogistis], E850.7 Other non-narcotic analgesics, E850.8 Other specified analgesics and antipyretics, E850.9 Unspecified analgesic or antipyretic), E851 Accidental poisoning by barbiturates, E852 Accidental poisoning by other sedatives and hypnotics (E852.0 Chloral hydrate group, E852.1 Paraldehyde, E852.2 Bromine compounds, E852.3 Methaqualone compounds, E852.4 Glutethimide group, E852.5 Mixed sedatives, not elsewhere classified, E852.8 Other specified sedatives and hypnotics, E852.9 Unspecified sedative or hypnotic), E853 Accidental poisoning by tranquilizers (E853.0 Phenothiazine-based tranquilizers, E853.1 Butyrophenone-based tranquilizers, E853.2 Benzodiazepine-based tranquilizers, E853.8 Other specified tranquilizers, E853.9 Unspecified tranquilizer), E854 Accidental poisoning by other psychotropic agents (E854.0 Antidepressants, E854.1 Psychodysleptics [hallucinogens], E854.2 Psychostimulants, E854.3 Central nervous system stimulants, E854.8 Other psychotropic agents), E855 Accidental poisoning by other drugs acting on central and autonomic nervous system (E855.0 Anticonvulsant and anti-Parkinsonism drugs, E855.1 Other central nervous system depressants, E855.2 Local anesthetics, E855.3 Parasympathomimetics [cholinergics], E855.4 Parasympatholytics [anticholinergics and antimuscarinics] and spasmolytics, E855.5 Sympathomimetics [adrenergics], E855.6 Sympatholytics [antiadrenergics], E855.8 Other specified drugs acting on central and autonomic nervous systems, E855.9 Unspecified drug acting on central and autonomic nervous systems), E856 Accidental poisoning by antibiotics, E857 Accidental poisoning by other anti-infectives, E858 Accidental poisoning by other drugs (E858.0 Hormones and synthetic substitutes, E858.1 Primarily systemic agents, E858.2 Agents primarily affecting blood constituents, E858.3 Agents primarily affecting cardiovascular system, E858.4 Agents primarly affecting gastrointestinal system, E858.5 Water, mineral, and uric acid metabolism drugs, E858.6 Agents primarily acting on the smooth and skeletal muscles and respiratory system, E858.7 Agents primarily affecting skin and mucous membrane, ophthalmological, otorhinolaryngological, and dental drugs, E858.8 Other specified drugs, E858.9 Unspecified drug, E950 Suicide and selfinflicted poisoning by solid or liquid substances (E950.0 Analgesics, antipyretics, and antirheumatics, E950.1 Barbiturates, E950.2 Other sedatives and hypnotics, E950.3 Tranquilizers and other psychotropic agents, E950.4 Other specified drugs and medicinal substances, E950.5 Unspecified drug or medicinal substance), E962 Assault by poisoning (E962.0 Drugs and medicinal substances), E980 Poisoning by solid or liquid substances, undetermined whether accidentally or purposely inflicted (E980.0 Analgesics, antipyretics, and antirheumatics, E980.1 Barbiturates, E980.2 Other sedatives and hypnotics, E980.3 Tranquilizers and other psychotropic agents, E980.4 Other specified drugs and medicinal substances) The Health of Jefferson County April 2014, updated May 2014 F8. Drug Related Death Rate Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Age Adjusted Drug Related Death Rate per 100,000 Population number Jefferson County Washington State 1992-94 0 0.3 1995-97 0 0.9 1998-00 3 7.0 2001-03 7 9.5 10.6 2004-06 14 15.7 14.1 2007-09 20 24.5 14.9 2010-12 17 17.2 14.3 Unadjusted Drug Related Death Rate per 100,000 Population number population Jefferson County Washington State 1992-94 0 68268 0.3 1995-97 0 73665 0.9 1998-00 3 77414 7.1 2001-03 7 81151 8.6 10.9 2004-06 14 84941 16.5 14.6 2007-09 20 88651 22.6 15.5 2010-12 17 89972 18.9 14.9 Source: Washington State Dept. of Health Center for Health Statistics, Death Certificate Database, accessed in CHAT. Washington State Office of Financial Management Population Estimates. From 2007 to 2012, the primary cause of about 6 Jefferson County resident deaths each year was drug-related. The majority of deaths are among males, however overtime, more of the deaths have been among females. The vast majority are among adults age 35-64.The Washington rate is statistically increasing overtime. 0.0 5.0 10.0 15.0 20.0 25.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Age Adjusted Rate per 100,000 population Jefferson County Washington State 0.0 5.0 10.0 15.0 20.0 25.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Unadjusted Rate per 100,000 population Jefferson County Washington State The Health of Jefferson County April 2014, updated May 2014 Age Adjusted Drug Related Death Rates per 100,000 by Gender male female number rate number rate % males rate rate 1993-97 0 0 0.9 0.4 1998-02 5 9.7 1 83%10.6 5.9 2003-07 15 23.8 9 12.8 63%16.6 10.9 2008-12 19 28.3 12 9.9 61%17.0 12.2 Drug Death Rates by Age Group per 100,000 population 0-34 35-64 65+ number rate number rate number rate rate rate rate 1993-97 0 0 0 0.3 1.2 0.4 1998-02 2 3 1 3.9 15.2 4.7 2003-07 7 16.4 15 22.6 2 6.6 25.1 7.6 2008-12 5 11.9 25 36.4 1 7.6 26.4 7.0 Jefferson County Washington State male female Jefferson County Washington State age 0-34 age 35-64 age 65+ 0.0 5.0 10.0 15.0 20.0 25.0 30.0 1993-97 1998-02 2003-07 2008-12 Male Rate per 100,000 population Jefferson County Washington State 0.0 5.0 10.0 15.0 20.0 25.0 1993-97 1998-02 2003-07 2008-12 Female Rate per 100,000 population Jefferson County Washington State 0.0 10.0 20.0 30.0 40.0 1993-97 1998-02 2003-07 2008-12 Adult age 35-64 rate per 100,000 population Jefferson County Washington State 0.0 10.0 20.0 30.0 1993-97 1998-02 2003-07 2008-12 Adult age 0-34 rate per 100,000 population Jefferson County Washington State The Health of Jefferson County April 2014, updated May 2014 ICD-10 CODES: D52.1 Drug-induced folate deficiency anaemia, D59.0 Drug-induced autoimmune haemolytic anaemia, D59.2 Drug-induced nonautoimmune haemolytic anaemia, D61.1 Drug-induced aplastic anaemia, D64.2 Secondary sideroblastic anaemia due to drugs and toxins, E06.4 Drug-induced thyroiditis, E16.0 Drug-induced hypoglycaemia without coma, E23.1 Drug-induced hypopituitarism, E24 Cushing's syndrome, E24.2 Drug-induced Cushing's syndrome, E27.3 Drug-induced adrenocortical insufficiency, E66.1 Drug-induced obesity, F11 Mental and behavioural disorders due to use of opioids (F11.0 Acute intoxication,F11.1 Harmful use, F11.2 Dependence syndrome, F11.3 Withdrawal state, F11.4 Withdrawal state with delirium, F11.5 Psychotic disorder, F11.7 Residual and late-onset psychotic disorder, F11.8 Other mental and behavioural disorders, F11.9 Unspecified mental and behavioural disorder), F12 Mental and behavioural disorders due to use of cannabinoids (F12.0 Acute intoxication, F12.1 Harmful use, F12.2 Dependence syndrome, F12.3 Withdrawal state, F12.4 Withdrawal state with delirium, F12.5 Psychotic disorder, F12.7 Residual and late-onset psychotic disorder, F12.8 Other mental and behavioural disorders, F12.9 Unspecified mental and behavioural disorder), F13 Mental and behavioural disorders due to use of sedatives and hypnotics (F13.0 Acute intoxication, F13.1 Harmful use, F13.2 Dependence syndrome, F13.3 Withdrawal state, F13.4 Withdrawal state with delirium, F13.5 Psychotic disorder, F13.7 Residual and late-onset psychotic disorder, F13.8 Other mental and behavioural disorders, F13.9 Unspecified mental and behavioural disorder), F14 Mental and behavioural disorders due to use of cocaine(F14.0 Acute intoxication, F14.1 Harmful use, F14.2 Dependence syndrome, F14.3 Withdrawal state, F14.4 Withdrawal state with delirium, F14.5 Psychotic disorder, F14.7 Residual and late-onset psychotic disorder, F14.8 Other mental and behavioural disorders, F14.9 Unspecified mental and behavioural disorder), F15 Mental and behavioural disorders due to use of other stimulants, including caffeine (F15.0 Acute intoxication, F15.1 Harmful use, F15.2 Dependence syndrome, F15.3 Withdrawal state, F15.4 Withdrawal state with delirium, F15.5 Psychotic disorder, F15.7 Residual and late-onset psychotic disorder, F15.8 Other mental and behavioural disorders, F15.9 Unspecified mental and behavioural disorder), F16 Mental and behavioural disorders due to use of hallucinogens (F16.0 Acute intoxication, F16.1 Harmful use, F16.2 Dependence syndrome, F16.3 Withdrawal state, F16.4 Withdrawal state with delirium, F16.5 Psychotic disorder, F16.7 Residual and late-onset psychotic disorder, F16.8 Other mental and behavioural disorders, F16.9 Unspecified mental and behavioural disorder), F17 Mental and behavioural disorders due to tobacco (F17.0 Acute intoxication, F17.3 Withdrawal state, F17.4 Withdrawal state with delirium, F17.5 Psychotic disorder, F17.7 Residual and late-onset psychotic disorder, F17.8 Other mental and behavioural disorders , F17.9 Unspecified mental and behavioural disorder), F18 Mental and behavoural disorders due to use of volatile solvents (F18.0 Acute intoxication, F18.1 Harmful use, F18.2 Dependence syndrome, F18.3 Withdrawal state, F18.4 Withdrawal state with delirium, F18.5 Psychotic disorder, F18.7 Residual and late-onset psychotic disorder, F18.8 Other mental and behavioural disorders, F18.9 Unspecified mental and behavioural disorder), F19 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances (F19.0 Acute intoxication, F19.1 Harmful use, F19.2 Dependence syndrome, F19.3 Withdrawal state, F19.4 Withdrawal state with delirium, F19.5 Psychotic disorder, F19.7 Residual and late-onset psychotic disorder, F19.8 Other mental and behavioural disorders, F19.9 Unspecified mental and behavioural disorder), G21.1 Other drug-induced secondary parkinsonism, G24.0 Drug-induced dystonia, G25.1 Drug-induced tremor, G25.4 Drug-induced chorea, G25.6 Drug-induced tics and other tics of organic origin, G44.4 Drug-induced headache, not elsewhere classified, G62.0 Drug-induced polyneuropathy, G72.0 Drug-induced myopathy, I95.2 Hypotension due to drugs, J70.2 Acute drug-induced interstitial lung disorders, J70.3 Chronic drug-induced interstitial lung disorders, J70.4 Drug-induced interstitial lung disorder, unspecified, L10.5 Drug-induced pemphigus, L27.0 Generalized skin eruption due to drugs and medicaments, L27.1 Localized skin eruption due to drugs and medicaments, M10.2 Drug-induced gout, M32.0 Drug-induced systemic lupus erythematosus, M80.4 Drug-induced osteoporosis with pathological fracture, M81.4 Drug-induced osteoporosis, M83.5 Other drug-induced osteomalacia in adults, M87.1 Osteonecrosis due to drugs, R78.1 Finding of opiate drug in blood, R78.2 Finding of cocaine in blood, R78.3 Finding of hallucinogen in blood, R78.4 Finding of other drugs of addictive potential in blood, R78.5 Finding of psychotropic drug in blood, X40 Accidental poisoning by and exposure to nonopioid analgesics, antipyretics and antirheumatics, X41 Accidental poisoning by and exposure to antiepileptic, sedative-hypnotic, antiparkinsonism and psychotropic drugs, not elsewhere classified, X42 Accidental poisoning by and exposure to narcotics and psychodysleptics [hallucinogens], not elsewhere classified, X43 Accidental poisoning by and exposure to other drugs acting on the autonomic nervous system, X44 Accidental poisoning by and exposure to other and unspecified drugs, medicaments and biological substances, X60 Intentional self-poisoning by and exposure to nonopioid analgesics, antipyretics and antirheumatics, X61 Intentional self-poisoning by and exposure to antiepileptic, sedative-hypnotic, antiparkinsonism and psychotropic drugs, not elsewhere classified, X62 Intentional self-poisoning by and exposure to narcotics and psychodysleptics [hallucinogens], not elsewhere classified, X63 Intentional self-poisoning by and exposure to other drugs acting on the autonomic nervous system, X64 Intentional self-poisoning by and exposure to other and unspecified drugs, medicaments and biological substances, X85 Assault by drugs, medicaments and biological substances, Y10 Poisonings by and exposure to nonopioid analgesics, antipyretics and antirheumatics, undetermined intent , Y11 Poisoning by and exposure to antiepileptic, sedative- hypnotic, antiparkinsonism and psychotropic drugs, not elsewhere classified, undetermined intent, Y12 Poisoning by and exposure to narcotics and psychodysleptics [hallucinogens], not elsewhere classified, undetermined intent, Y13 Poisoning by and exposure to other drugs acting on the autonomic nervous system, undetermined intent, Y14 Poisoning by and exposure to other and unspecified drugs, medicaments and biological substances, undetermined intent The Health of Jefferson County April 2014, updated May 2014 F9. Alcohol and Drug Related Deaths as a Proportion of all Deaths Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 # of drug or alc deaths total deaths % # of drug or alc deaths total deaths % 1998-00 57 829 6.9 11451 130273 8.8 2001-03 76 846 9.0 12903 135617 9.5 2004-06 116 889 13.0 15279 136597 11.2 2007-09 135 966 14.0 16827 141756 11.9 2010-11*87 683 12.7 12.6 *Only 2 years of data available. Source: Risk and Protection Profile for Substance Abuse Prevention in Washington State Alcohol and drug related deaths includes all contributing causes of death. In 2010-11 each year on average 43 Jefferson County resident deaths were related to drugs or alcohol, that's about 1 in every 7 deaths. The proportion of all Jefferson deaths that were alcohol or drug related was statistically worse than WA in 2007-09 but no longer different in 2010-11. The Washington rate has been statistically worsening since 1998-00. Jefferson County Washington State Definition: The proportion is the annual number of deaths, with alcohol- or drug-related causes, per 100 deaths. Evaluation is based on all contributory causes of death for direct and indirect associations with alcohol and drug abuse. 0 5 10 15 1998-00 2001-03 2004-06 2007-09 2010-11* % o f a l l d e a t h s Jefferson County Washington State WA rate statistically increasing since 1998-00 The Health of Jefferson County April 2014, updated May 2014 Disease Category ICD-10 Code Diseases Directly Attributable to Alcohol Alcoholic psychoses F10, F10.3-F10.9 Alcohol dependence syndrome F10.2 Alcoholic polyneuropathy G62.1 Alcoholic cardiomyopathy I42.6 Alcoholic gastritis K29.2 Alcoholic fatty liver K70.0 Acute alcoholic hepatitis K70.1, K70.4 Alcoholic cirrhosis of the liver K70.3 Alcoholic liver damage, other K70.2, K70.9, K70 Excessive blood level of alcohol, toxic effect of alcohol R78.0, T51 Accidental poisoning by alcohol X45, Y15 Nondependent abuse of Alcohol F10.1 Alcohol-induced pseudo-Cushing's syndrome E24.4 Degeneration of nervous system due to alcohol G31.2 Alcoholic myopathy G72.1 Maternal care for (suspected) damage to fetus from alcohol O35.4 Newborn affected by maternal use of alcohol P04.3 Fetal alcohol syndrome (dysmorphic)Q86.0 Suicide attributable to alcohol X65 Alcoholic Pellagra E52 Diseases Indirectly Attributable to Alcohol Neoplasms Breast C50, D05 Esophagus C15, D00.1 Larynx C32 , D02.0 Lip, oral cavity, pharynx C00-C14, D00.0 Liver C22, D01.5 Cardiovascular Cardiomyopathy I42.0 - I42.2, I42.5, I42.7- I42.9 Hypertension I10-113, O10-O14, O16 Digestive System Cirrhosis K71.7, K74.5-K74.6 Duodenal Ulcers K26 Pancreatitis, acute K85 Pancreatitis, chronic K86.1- K86.3, K86.9 Other Diseases or Conditions Epilepsy G40.3,G40.4,G40.6,G40.9 Seizures R56 Tuberculosis A16-A19 Accident or Injury Causes: Motor vehicle traffic and non-traffic accidents V02–V04, V09.0, V09.2, V12–V14, V19.0–V19.2, V19.4–V19.6, V20–V79, V80.3– V80.5, V81.0–V81.1, V82.0–V82.1, V83–V86, V87.0–V87.8, V88.0–V88.8, V89.0, V89.2 Disease Category ICD-10 Code Pedal cycle and other road vehicle accidents V01, V05–V06, V09.1, V09.3–V09.9, V10–V11, V15–V18, V19.3, V19.8–V19.9, V80.0–V80.2, The Health of Jefferson County April 2014, updated May 2014 , , , , V80.6–V80.9, V82.2–V82.9, V87.9, V88.9, V89.1, V89.3, V89.9 Water transport accidents V90-V94 Air & space transport accidents V95-V97 Accidental falls W00-W19 Accidents caused by fire X00-X09 Accidental drowning and submersion W65-W74 Homicide & other purposely inflicted injury X86–Y09, Y87.1 Other X31, W79, W50-W52, W20- W34, Y15-Y19 Diseases Directly Attributable to Drugs Drug psychoses F11-F16, F18-F19 Drug dependence syndrome F11-F16, F18-F19 Polyneuropathy due to drugs G62.0 Drug dependence during pregnancy F11-F16, F18-F19 Suspected damage to fetus from drugs O35.5, Noxious influences affecting fetus P04.4 Drug reactions, intox., withdrawal specific to newborn P96.1 Selected drug poisonings R78,R78.1-R78.6, T38 ; excludes Y40-59.9 (therapeutic use) Selected accidental drug poisonings X40-X44 Accidental Poisonings (magic mushrooms, huffing and other drug use)X46-X49 Nondependent abuse of drugs F11-F16, F18-F19 Assault by poisoning using drugs and medicaments x85 Drug induced myopathy G72.0 Poisoning by drugs, accidentally or purposely inflicted Y10-Y14 Suicides attributable to drugs x60-64 Diseases Indirectly Attributable to Drugs AIDS (from IV drug use exposure)B20-B24 Cardiovascular Endocarditis I33.0, I33.9 Other Hepatitis A B15.9 Hepatitis B B16-B16.9 Hepatitis C B17-B19.9 Suicides due to alcohol or drugs are now considered direct AOD-related deaths, other suicides are not apportioned. This bi dfiii i li ih C S dfiii The Health of Jefferson County April 2014 F10. State-Funded Alcohol or Drug Service Clients Jefferson County and Washington State Source: DSHS Risk and Protective Profile for Substance Abuse Prevention Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Adult Adult Number Rate per 1,000 Population Washington State 1997-99 887 14.7 60352 10.9 2000-02 703 11.0 64008 11.6 2003-05 790 11.8 67047 12.7 2006-08 971 13.3 73248 13.9 2009-11 874 11.5 76036 13.6 Youth (10-17) Youth Number Rate per 1,000 Population Washington State 2000-02 156 19.4 8046 11.8 2003-05 132 16.8 7865 11.0 2006-08 93 12.7 7334 10.7 2009-11 93 13.6 6819 11.2 Jefferson County Note: Counts of individuals receiving state-funded alcohol or drug services are unduplicated. Services include treatment, assessment, and detox. Jefferson County About 31 Jefferson County youth received state-funded alcohol or drug services each year from 2009 to 2011. The Jefferson County rate has been above the Washington rate; both rates are statistically unchanged overtime. About 280 Jefferson County residents received state-funded alcohol or drug services each year from 2010 to 2012. The Jefferson County rate has been the same as Washington since 2000-02, slightly higher only in 1997-99. Both the Jefferson and Washington rates are unchanged overtime. 11.5 13.6 0.0 5.0 10.0 15.0 20.0 1997-99 2000-02 2003-05 2006-08 2009-11 Ad m i s s i o n r a t e p e r 1 , 0 0 0 a d u l t s a g e 1 8 + Jefferson County Washington State 13.6 11.2 0.0 5.0 10.0 15.0 20.0 2000-02 2003-05 2006-08 2009-11 Ad m i s s i o n r a t e p e r 1 , 0 0 0 y o u t h a g e 1 0 - 17 Jefferson County Washington State The Health of Jefferson County April 2014 Jefferson County, Washington State Source: Behavioral Risk Factor Surveillance System Note: Starting with 2011, BRFSS results cannot be compared historically due to changes in the survey methodology. 2001 2003-05 (WA 05) 2007-09 (WA09)2011-12 Jefferson County 2.9 2.9 2.9 3.2 Washington State 3.3 3.3 3.3 3.8 gender 2001 2003-05 2007-09 2011-12 male 1.7 2.9 2.0 2.6 female 3.9 3.0 3.6 3.7 age group 18-34 3.2 5.1 4.9 n<30 35-64 3.3 3.1 3.2 4.2 65+1.7 1.2 1.3 1.6 education level high school or less 2.8 3.0 4.4 2.9 some college 3.8 3.2 3.9 3.5 4+ years college 2.2 2.7 1.6 3.2 G1. Average number of days adults report poor mental health in the past 30 days On average, in 2011-12, Jefferson County adults report 3.2 days of poor mental health in the past month, slightly below Washington State adults who report 3.8 days. The average days are higher among females and younger adults. 3.2 3.8 0 1 2 3 4 2001 2003-05 (WA 05) 2007-09 (WA09) 2011-12 av e r a g e d a y s o f p o o r me n t a l h e a l t h Jefferson County Washington State The Health of Jefferson County April 2014 Jefferson County, Washington State Source: Behavioral Risk Factor Surveillance System Note: Starting with 2011, BRFSS results cannot be compared historically due to changes in the survey methodology. 2001 2003-05 (WA 05) 2007-09 (WA09)2011-12 Jefferson County 8%9%10%10% Washington State 9%10%10%12% 2011-12 Jefferson County 20% Washington State 21% *Has a doctor, nures or other healthprofessional EVER told you that you have a depressive disorder, including depression, major depression, dysthymia, or minor depression? G2. Adults reporting mental distress or depression About 1 in 10 Jefferson County and Washington State adults reported 14 or more days of poor mental health in the past month. In Jefferson County, the rate appears to be increasing since 2001. The Port Townsend rate increased from 2001 to 2003-05 but could not be calculated in 2007-09. In WA State, the rate is higher among females, younger adults and adults with lower levels of education. Adults reporting 14 or more poor mental health days in the past 30 days Adults reporting ever told by doctor they have depression* Question: Has a doctor, nures or other health professional EVER told you that you have a depressive disorder, including depression, major depression, dysthymia, or minor depression? Question: Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days in the past 30 days was yourmental health not good? 10% 12% 0% 5% 10% 15% 20% 25% 2001 2003-05 (WA 05) 2007-09 (WA09) 2011-12 Jefferson County Washington State The Health of Jefferson County April 2014 Jefferson County Public Health School Based Health Clinics, Chimacum and Port Townsend High Schools Source: Jefferson County Public Health School Based Health Clinic Evaluation Data SERVICES PROVIDED BY JEFFERSON MENTAL HEALTH FUNDED BY One-Tenth of One Percent Sales Tax Compared to 2009/10 when SBHC MH services began, the number of individuals and total visits have steadily increased over time. For Chimacum, the spike in 2010-11 in number of individuals and visits is due to increased MH services in May/June 2011 to help students cope after the suicide of a classmate. The total number of clients in 2012-13 compared to 2011-12 is up slightly in Chimacum, down slightly in Pt Townsend and similar in Quilcene. The total visits in 2012-13 compared to 2011-12 are up in Chimacum and Port Townsend and similar in Quilcene. Compared to the 2009-10 school year, the number of individuals seen has increased over 100% and the number of visits has increased nearly 200%! G3. School Based Health Clinic Mental Health Visits The Health of Jefferson County April 2014 SERVICES PROVIDED BY JEFFERSON PUBLIC HEALTH Family issues, relationships, and school performance are among the top reasons students visits the School Based Health Centers. 2012-13 Port Townsend Chimacum total visits 375 377 # individuals 143 144 2011-12 Port Townsend Chimacum total visits 395 499 # individuals 136 154 0 50 100 150 200 250 300 Family Issues Relationships School Performance Mental Health Screening Eating/Weight Issues Stress Drug/Alcohol Use Depression Self Esteem Abuse (sexual, physical, etc.) Anxiety Anger Management Domestic Violence Grief/Loss Homelessness Suicide Ideation SBHC Behavioral Health Issues Addressed *addressed at fewer than 5 visits The Health of Jefferson County April 2014 G4. Youth Report Depressive Feelings Jefferson County and Washington State Source: Healthy Youth Survey, askhys.net 8th grade 10th grade 12th grade 8th grade 10th grade 12th grade 2002 30%35%28%26%29%29% 2004 34%36%42%29%33%32% 2006 27%30%23%25%30%29% 2008 20%25%29%24%30%29% 2010 31%30%20%25%30%28% 2012 25%35%32%26%31%30% YOUTH NOT LIKELY TO SEEK HELP IF DEPRESSED 8th grade 10th grade 12th grade 8th grade 10th grade 12th grade 2002 55%50%38%42%42%39% 2004 50%51%40%43%44%39% 2006 63%43%38%43%44%41% 2008 37%32%45%46%43%42% 2010 42%46%37%44%43%40% 2012 47%46%52%42%41%40% Note: Participation in the Healthy Youth Survey is voluntary. Data are not reported when the grade-level response rate is less than 40%. Results represent students participating in the survey and likely represent all students in the grade level. YOUTH REPORT FEELING SO SAD OR HOPELESS FOR 2 WEEKS IN A ROW THEY STOPPED USUAL ACTIVITIES One in 4 eighth graders and about 1 in 3 tenth and twelfth graders report depressive feelings. Rates are similar to WA and relatively unchanged overtime. Of students who report depressive feelings, about half would be not likely to seek help, higher than WA, about 4 in 10. Jefferson rates were down in 2008 and 2010 but up slightly in 2012. WA rates are relatively unchanged over time. Question: During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities? 0% 20% 40% 60% 80% 100% Washington State 8th grade 10th grade 12th grade 0% 20% 40% 60% 80% 100% Jefferson County 8th grade 10th grade 12th grade 0% 20% 40% 60% 80% 100% Washington State 8th grade 10th grade 12th grade 0% 20% 40% 60% 80% 100% Jefferson County 8th grade 10th grade 12th grade The Health of Jefferson County April 2014, updated May 2014 G5. Youth Report Considering Suicide Jefferson County and Washington State Source: Healthy Youth Survey, askhys.net Question: During the past 12 months, did you ever seriously consider attempting suicide? 8th grade 10th grade 12th grade 8th grade 10th grade 12th grade 2002 17%26%17%15%18%14% 2004 18%21%18%14%18%14% 2006 11%19%5%11%15%12% 2008 14%14%14%14%17%15% 2010 19%19%10%15%18%14% 2012 15%24%19%17%19%17% 2012 Made a suicide plan 15%14%9%14%14%14% Attempted suicide 5%11%7%8%8%6% Note: Participation in the Healthy Youth Survey is voluntary. Data are not reported when the grade-level response rate is less than 40%. Results represent students participating in the survey and likely represent all students in the grade level. YOUTH REPORT CONSIDERING ATTEMPTING SUICIDE IN THE PAST YEAR Nearly 1 in 4 Jefferson 10th graders, about 1 in 5 Jefferson 12th and WA 10th graders and 1 in 6 Jefferson 8th graders and WA 8th and 12th graders reported considering suicide in the past year. About 1 in 7 Jefferson 8th and 10th graders and WA 8th, 10th and 12th graders reported making a suicide plan. In Jefferson, 11% of 10th graders reported attempting suicide in 2012. 0% 10% 20% 30% 40% 50% Washington State 8th grade 10th grade 12th grade 0% 10% 20% 30% 40% 50% Jefferson County 8th grade 10th grade 12th grade 9% 7% Made a suicide plan Attempted suicide Jefferson County Washington State 12th grade 15% 5% Made a suicide plan Attempted suicide Jefferson County Washington State 8th grade 14% 11% Made a suicide plan Attempted suicide Jefferson County Washington State 10th grade The Health of Jefferson County April 2014, updated May 2014 G6. Suicide Related Hospitalization Rates Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Age adjusted rate per 100,000 Number Jefferson County Washington State 1992-1994 35 66.7 55.7 1995-1997 56 96.2 51.8 1998-2000 64 105.3 46.6 2001-2003 42 74.9 51.3 2004-2006 25 37.1 54.8 2007-2009 46 65.9 54.8 2010-2012 26 37.0 54.5 *Jefferson County rate significantly higher than Washington State rate. Suicide Hospitalization Rates by Gender male female number aa rate % of total number aa rate aa rate aa rate 1992-1994 13 48.2 37%22 87.3 43.9 39%68.1 1995-1997 17 54.5 30%39 136.9 40.6 39%63.5 1998-2000 21 80.4 33%43 129.6 36.7 39%56.9 2001-2003 16 53.7 38%26 93.8 39.4 38%63.7 2004-2006 8 25.4 32%17 48.7 42.9 39%67.1 2007-2009 13 37.1 28%33 92.7 41.4 38%68.7 2010-2012 9 24.6 35%17 48.5 41.6 38%67.7 Source: Washington State Dept. of Health, Center for Health Statistics, Comprehensive Hospital Abstract Reporting System (CHARS). Accessed in: Community Health Assessment Tool (CHAT) In 2010-12, on average each year about 8 Jefferson County residents had a suicide-related hospitalization. Both Jefferson and WA rates are statistically unchanged overtime. The Jefferson rate was higher than Washington State between 1995 and 2003. Suicide-related hospitalizations were statistically higher among females in 1998-2000 in Jefferson County and all years in WA. In Jefferson, more than 1 in 4 suicide hospitalizations are adults age 55 and older compared to about 1 in 7 in WA. Jefferson County Washington State male female % of total 37.0 54.5 0.0 20.0 40.0 60.0 80.0 100.0 120.0 1992-1994 1995-1997 1998-2000 2001-2003 2004-2006 2007-2009 2010-2012 ag e -ad j u s t e d r a t e p e r 1 0 0 , 0 0 0 po p u l a t i o n Jefferson County Washington State The Health of Jefferson County April 2014, updated May 2014 Suicide Hospitalization Rates by Age Group 15-54 55+ number rate number rate rate rate Jefferson WA 1992-1994 29 92.3 4 87.6 21.0 11%7% 1995-1997 47 138.5 7 29.4 79.1 21.8 13%8% 1998-2000 50 140.7 13 49.5 70.7 20.9 20%9% 2001-2003 38 104.7 3 77.8 23.1 7%9% 2004-2006 18 50.0 7 20.6 83.9 24.2 28%10% 2007-2009 32 90.6 12 31.0 83.3 27.8 26%12% 2010-2012 19 56.8 7 16.5 81.3 31.7 27%15% # age under 15 1992-1994 2 1995-1997 2 1998-2000 1 2001-2003 1 2004-2006 0 2007-2009 2 2010-2012 0 Washington State age 15-54 age 55 and older Percent age 55+ Jefferson County The Health of Jefferson County April 2014 G7. Suicide Death Rate Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Age-Adjusted Suicide Death Rate per 100,000 Population number Jefferson County Washington State 1992-1994 7 7.8 13.9 1995-1997 8 11.6 13.9 1998-2000 10 11.0 12.9 2001-2003 9 11.2 12.7 2004-2006 19 20.8 12.6 2007-2009 16 13.3 13.1 2010-2012 14 13.3 14.2 Suicide Death Rates by Gender male female number rate % of total number rate rate rate 1992-1994 7 15.0 100%0 23.4 80%5.6 1995-1997 6 14.6 75%2 23.7 81%5.1 1998-2000 7 18.8 70%3 21.6 80%5.1 2001-2003 7 16.1 78%2 21.0 80%5.1 2004-2006 16 37.1 84%3 20.4 78%5.4 2007-2009 13 19.2 81%3 21.1 78%5.6 2010-2012 11 16.1 79%3 22.4 77%6.4 Source: Washington State Dept. of Health, Center for Health Statistics, Death Certificate Database. Accessed in: Community Health Assessment Tool (CHAT). Fewer than 5 Jefferson County residents committed suicide each year between 2010 and 2012; down from the 2004- 2009 but higher than 1992-2003. The Jefferson and WA rates are statistically the same, except for during 2004-06. Both the Jefferson and WA rates are statistically unchanged overtime. In both Jefferson and WA, male rates are above female rates and account for about 80% of all suicides. In Jefferson and WA, older adult rates are above younger adult rates, however older adults make up about half of Jefferson suicides and one-third of WA suicides. Jefferson County Washington State male female % of total 13.3 14.2 0.0 5.0 10.0 15.0 20.0 1992-1994 1995-1997 1998-2000 2001-2003 2004-2006 2007-2009 2010-2012 ag e -ad j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n Jefferson County Washington State The Health of Jefferson County April 2014 Suicide Death Rates by Age Group 15-54 55+ number rate number rate rate rate Jefferson WA 1992-1994 2 5 22.5 16.4 20.2 71%28% 1995-1997 4 4 17.5 18.0 50%25% 1998-2000 5 13.2 5 18.6 15.3 19.1 50%29% 2001-2003 3 6 19.8 15.2 18.4 67%29% 2004-2006 10 26.0 9 25.8 15.6 17.2 47%29% 2007-2009 5 13.3 11 27.7 15.8 18.7 69%33% 2010-2012 2 11 25.2 17.2 20.0 79%34% Jefferson County Washington State age 15-54 age 55 and older Percent age 55+ The Health of Jefferson County, April 2014, Updated May 2014 G8. Mental Illness Hospitalization Rate Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Age Adjusted Hospitalization Rate per 100,000 Population number Jefferson County Washington State 1992-94 362 557.7 509.9 1995-97 362 542.3 501.3 1998-00 382 542.4 512.5 2001-03 299 411.5 481.8 2004-06 249 302.9 429.9 2007-09 269 287.6 409.2 2010-12 272 353.9 448.7 Source: Washington State Dept. of Health Center for Health Statistics, Comprehensive Hospital Abstract Reporting System, Accessed in CHAT There were on average 91 Jefferson County mental illness hospitalizations per year from 2010 to 2012. The Jefferson rate has been statistically lower than WA since 2001. 353.9 448.7 0.0 100.0 200.0 300.0 400.0 500.0 600.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Age Adjusted Rate per 100,000 population Jefferson County Washington State Jefferson and WA rates statistically decreasing since 1992-94 The Health of Jefferson County, April 2014, Updated May 2014 G9. Jefferson Mental Health Clients Unduplicated Client Count: number 2009 796 2010 868 2011 967 2012 1328 2013*1496 *includes 416 non-RSN clients Total Services Provided: number 2009 11611 2010 14884 2011 14581 2012 19467 2013 22769 2013 Unduplicated Clients by Age: JMH, RSN School Based Health Clinics under age 18 283 158 age 18-59 518 older adults 60+279 Total 1080 Source: Jefferson Mental Health In 2013, Jefferson Mental Health served nearly 1,500 individuals in nearly 23,000 services, double the numbers from 2009. About one-quarter of JMH clients are under age 18, another quarter are age 60 and older. 158 youth were served by JMH at the School Based Health Clinics. 22769 0 5000 10000 15000 20000 25000 2009 2010 2011 2012 2013 1496 0 500 1000 1500 2000 2009 2010 2011 2012 2013* The Health of Jefferson County April 2014, updated May 2014 H1. Child Injury and Accident Hospitalizations Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Washington Counties like us injury/accident hospitalizations child (birth-17) hospitalizations %%% 2000 17 330 5.2 3.8 4.7 2001 21 322 6.5 3.7 4.2 2002 26 303 8.6 3.7 4.4 2003 10 300 3.3 3.3 4.0 2004 28 308 9.1 3.9 4.7 2005 15 284 5.3 4.2 4.9 2006 17 319 5.3 4.0 4.4 2007 18 277 6.5 3.9 4.1 2008 15 290 5.2 4.0 4.1 2009 20 280 7.1 4.1 4.2 2010 10 259 3.9 4.2 4.1 2011 18 248 7.3 4.3 4.2 Jefferson County Source: DSHS Risk and Protective Profile for Substance Abuse Prevention in Washington State In 2011, about 7% of hospitalizations of Jefferson County children aged 0 to 17 were for injury or accidents - higher than Washington State (4%) and Counties like Jefferson (4%). The Jefferson rate has been above the Washington and Counties like Jefferson rate in most years. 7.3 4.3 4.2 0.0 2.0 4.0 6.0 8.0 10.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 % i n j u r y / a c c i d e n t ho s p i t a l i z a t i o n s Jefferson County Washington Counties like us The Health of Jefferson County April 2014, updated May 2014 H2. Adult Female Injury and Accident Hospitalizations Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Washington Counties like us injury/accident hospitalizations female (18+) hospitalizations %%% 2000 195 1533 12.7 11.1 11.7 2001 230 1546 14.9 11.7 12.6 2002 229 1491 15.4 11.9 13.2 2003 215 1493 14.4 12.3 13.7 2004 241 1449 16.6 13.2 14.8 2005 199 1379 14.4 13.3 15.5 2006 262 1649 15.9 13.5 15.7 2007 297 1689 17.6 13.5 15.8 2008 264 1543 17.1 14.3 16.2 2009 336 1638 20.5 15.1 16.8 2010 266 1449 18.4 15.4 16.5 2011 234 1318 17.8 16.1 16.7 Source: DSHS Risk and Protective Profile for Substance Abuse Prevention in Washington State In 2011, 1 in 6 hospitalizations of Jefferson County women aged 18 and older were for injury or accidents. The Jefferson rate was statistically higher (worse) than WA every year except 2000, 2005 and 2011. The Jefferson rate is slightly higher than the rate for counties like Jefferson. The Jefferson rate is statistically increasing since 2000. Jefferson County 17.8 16.1 16.7 0.0 5.0 10.0 15.0 20.0 25.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 % i n j u r y / a c c i d e n t ho s p i t a l i z a t i o n s Jefferson County Washington Counties like us *Jefferson rate statistically increasing since 2000 The Health of Jefferson County April 2014, updated May 2014 H3. Unintentional Injury (Accident) Deaths Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Age Adjusted Death Rate per 100,000 Population number Jefferson County Washington State 1992-94 19 30.8 33.1 1995-97 28 40.0 34.3 1998-00 40 54.3 34.3 2001-03 37 45.7 36.0 2004-06 46 49.9 39.4 2007-09 58 52.2 39.6 2010-12 60 49.4 38.0 Top 3 Causes of Accidental Death (Primary Cause of Death): 2010-12 RANK # of deaths crude rate per 100,000 age adjusted rate per 100,000 RANK # of deaths crude rate per 100,000 age adjusted rate per 100,000 Falls 1 25 28 15 2 2399 12 12 Poisoning 2 16 18 16 1 2442 12 11 Motor Vehicle-Traffic 3 11 12 10 3 1498 7 7 2007-09 Poisoning 1 16 19 20 1 2505 13 12 Motor Vehicle-Traffic 2 15 17 12 3 1720 9 9 Falls 3 14 16 10 2 2230 11 11 Accidental Fall Deaths Source: Washington State Dept. of Health, Center for Health Statistics, Death Certificate Database. Accessed in: Community Health Assessment Tool (CHAT) Jefferson County Washington State From 2007-2012, there were about 20 unintentional injury deaths of Jefferson County residents, the rate is statistically unchanged overtime and not statistically different compared to WA. In 2010-12, the top cause of accident deaths in Jefferson was falls followed by poisoning and motor vehicles; while not statistically different overtime, in 2007-09 the top cause was poisoning followed by motor vehicle and falls. WA rates by top cause are not different from Jefferson. In 2010-12, on average 8 Jefferson County residents died each year of accidental death due to falls. The Jefferson and Washington State rates are not statistically different and both have been statistically increasing (worsening) overtime. 15.2 11.3 0 10 20 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 ag e a d j u s t e d r a t e pe r 1 0 0 , 0 0 0 po p u l a t i o n Jefferson County Washington State Jefferson and WA rates statistically increasing overtime. 49.4 38.0 0.0 10.0 20.0 30.0 40.0 50.0 60.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 Age Adjusted Rate per 100,000 population Jefferson County Washington State WA rate statistically increasing since 1992-94 The Health of Jefferson County April 2014, updated May 2014 # of deaths population crude rate per 100,000 aarate per 100,000 # of deaths population crude rate per 100,000 aarate per 100,000 1992-94 1 68268 840 15771203 5.3 6.2 1995-97 1 73665 964 16701631 5.8 6.6 1998-00 5 77414 6.5 4.8 1125 17475009 6.4 7.0 2001-03 7 81151 8.6 5.5 1477 18156531 8.1 8.7 2004-06 6 84941 7.1 4.3 1762 18927589 9.3 9.6 2007-09 14 88651 15.8 9.4 2230 19805489 11.3 11.2 2010-12 25 89972 27.8 15.2 2399 20260348 11.8 11.3 Accidental Poisoning Deaths # of deaths population crude rate per 100,000 aa rate per 100,000 # of deaths population crude rate per 100,000 aarate per 100,000 1992-94 1 68268 555 15771203 3.5 3.5 1995-97 5 73665 6.8 7.4 910 16701631 5.4 5.3 1998-00 5 77414 6.5 7.3 1161 17475009 6.6 6.5 2001-03 6 81151 7.4 8.6 1414 18156531 7.8 7.6 2004-06 10 84941 11.8 11.8 2050 18927589 10.8 10.5 2007-09 16 88651 18.0 20.4 2505 19805489 12.6 12.2 2010-12 16 89972 17.8 16.4 2442 20260348 12.1 11.6 Jefferson County Washington State Jefferson County Washington State In 2010-12, on average 5 Jefferson County residents died each year of accidental death due to poisoning. The Jefferson and Washington State rates are not statistically different and both have been statistically increasing (worsening) overtime. 16.4 11.6 0 10 20 30 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 ag e a d j u s t e d r a t e p e r 10 0 , 0 0 0 p o p u l a t i o n Jefferson County Washington State Jefferson and WA rates statistically worsening overtime The Health of Jefferson County April 2014, updated May 2014 H4. Accidental Fall (primary cause) Deaths by Age and Gender Jefferson County and Washington State ICD10 Codes: W00 - W19; X80; Y01; Y30 JEFFERSON COUNTY by AGE Note: there were no fall deaths for Jefferson residents under age 25 therefore data are not presented. # fall deaths total age 25-64 population rate per 100,000 age 25- 64 % of total fall deaths # fall deaths total age 65+ population rate per 100,000 age 65+ % of total fall deaths 1993-1997 1 62664 100 0 25163 0 1998-2002 0 70833 0 9 27931 32.2 100 2003-2007 2 76952 14 12 32500 36.9 86 2008-2012 2 80198 6 32 38753 82.6 94 2008-2012:# fall deaths by 5-year age group for those age 65+ female male age 65-69 2 0 age 70-74 1 2 age 75-79 1 0 age 80-84 3 3 age 85+14 6 WASHINGTON STATE # fall deaths total age 25-64 population rate per 100,000 age 25- 64 % of total fall deaths # fall deaths total age 65+ population rate per 100,000 age 65+ % of total fall deaths 1993-1997 286 14407812 2.0 18 1205 3143164 38.3 78 1998-2002 290 15791298 1.8 14 1739 3321612 52.4 84 2003-2007 431 17091478 2.5 14 2524 3584751 70.4 84 2008-2012 501 18267446 2.7 13 3373 4109647 82.1 86 % of total fall deaths to Washington residents under age 25 by 5-year period: 3%; 2%; 1%; 1% JEFFERSON COUNTY by GENDER # fall deaths total female population aa rate per 100,000 females % of total fall deaths # fall deaths total male population aa rate per 100,000 males % of total fall deaths 1993-1997 0 60796 0 1 58899 1.6 100 1998-2002 7 66917 6.4 78 2 64305 3.0 22 2003-2007 6 71727 4.7 43 8 69801 7.1 57 2008-2012 22 75356 14.7 65 12 74023 9.8 35 WASHINGTON STATE # fall deaths total female population aa rate per 100,000 females % of total fall deaths # fall deaths total male population aa rate per 100,000 males % of total fall deaths 1993-1997 717 13735116 4.9 47 818 13596541 8.7 53 1998-2002 1001 14809130 5.9 48 1078 14695526 10.1 52 2003-2007 1505 15830380 8.0 50 1489 15749180 12.1 50 2008-2012 2006 16818667 9.5 51 1914 16722084 13.6 49 Jefferson FEMALE Jefferson MALE Source: Washington State Dept. of Health, Center for Health Statistics, Death Certificate Database. Accessed in: Community Health Assessment Tool (CHAT) BY AGE: The vast majority of fall deaths are among adults age 65 and older; in Jefferson in 2008-12, two-thirds of fall deaths are among adults 85+. Fall deaths among adults age 65+ are increasing over time. BY GENDER: Fall deaths are evenly distributed between males and females. The rates for both genders appear to be increasing slightly over time. Washington FEMALE Washington MALE Jefferson Age 25-64 Jefferson Age 65 and older Washington age 25-64 Washington age 65 and older The Health of Jefferson County April 2014 H5. Accidental Poison (primary cause) Deaths by Age and Gender Jefferson County and Washington State ICD10 Codes: X40-49. JEFFERSON COUNTY by AGE # poison deaths total age <25 population rate per 10,000 age <25 % of total poison deaths # poison deaths total age 25-64 population rate per 10,000 age 25-64 % of total poison deaths # poison deaths total age 65+ population rate per 10,000 age 65+ % of total poison deaths 1990-1994 1 31867 *17 3 62664 4.8 50 2 25163 *33 1995-1999 1 32458 *13 6 70833 8.5 75 1 27931 *13 2000-2004 1 32076 *5 17 76952 22.1 89 1 32500 *5 2005-2009 3 30428 *12 22 80198 27.4 85 1 38753 *4 *n<5 therefore rate not calculated WASHINGTON STATE # poison deaths total age <25 population rate per 100,000 age <25 % of total poison deaths # poison deaths total age 25-64 population rate per 100000 age 25- 64 % of total poison deaths # poison deaths total age 65+ population rate per 100000 age 65+ % of total poison deaths 1990-1994 92 9780681 0.9 7 1157 14407812 8.0 88 72 3143164 2.3 5 1995-1999 125 10391746 1.2 6 1845 15791298 11.7 91 66 3321612 2.0 3 2000-2004 285 10903331 2.6 8 2988 17091478 17.5 88 117 3584751 3.3 3 2005-2009 342 11163658 3.1 8 3610 18267446 19.8 87 194 4109647 4.7 5 Jefferson Under Age 25 Washington Under Age 25 Source: Washington State Dept. of Health, Center for Health Statistics, Death Certificate Database. Accessed in: Community Health Assessment Tool (CHAT) BY AGE: The vast majority of poison deaths are among adults age 25-64 - about 4 Jefferson resident deaths from 2010-12. Poison deaths among adults age 25-65 are over 80% of all poison deaths from 2000 to 2012. In Washington, poison death rates for all age groups appear to be increasing over time. BY GENDER: The majority of poison deaths are among males however a clear trend in Washington State indicate that poison deaths are increasing among women. The rates for both genders appear to be increasing over time, unclear for Jefferson females. Jefferson Age 25-64 Jefferson Age 65 and older Washington age 25-64 Washington age 65 and older The Health of Jefferson County April 2014 JEFFERSON COUNTY by GENDER # poison deaths total female population rate per 10,000 females % of total poison deaths # poison deaths total male population rate per 10,000 males % of total poison deaths 1990-1994 1 60796 *17 5 58899 9.2 83 1995-1999 3 66917 *38 5 64305 9.5 63 2000-2004 7 71727 8.8 37 12 69801 20.8 63 2005-2009 7 75356 5.1 27 19 74023 28.3 73 *n<5 therefore rate not calculated WASHINGTON STATE # poison deaths total female population rate per 10,000 females % of total poison deaths # poison deaths total male population rate per 10,000 males % of total poison deaths 1990-1994 315 13735116 2.3 24 1006 13596541 7.2 76 1995-1999 605 14809130 4.0 30 1431 14695526 9.4 70 2000-2004 1248 15830380 7.7 37 2142 15749180 13.1 63 2005-2009 1639 16818667 9.3 40 2507 16722084 14.5 60 Jefferson MALE Washington MALE Jefferson FEMALE Washington FEMALE I1. Communicable Disease Rates Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Rate per 100,000 # Jeffers on WA 2000 24 91.3 71.7 2001*26 97.5 59.8 2002**7 25.8 61.6 2003 16 58.5 62.5 2004*28 100.9 60.5 2005 27 95.2 65.5 2006 12 41.6 48.5 2007*28 95.7 60.9 2008 25 84.4 60.1 2009 26 87.3 55.9 2010*33 110.5 64.5 2011 31 103.2 69.0 *Jefferson rate statistically higher than Washington. 2012*60 199.7 132.8 **Jefferson rate statistically lower than Washington Ca m p y l o b a c t e r i o s Cr y p t o s p o r i d i o s i s E. C o l i Gi a r d i a s i s He p a t i t i s A a c u t e Le g i o n e l l o s i s Li s t e r i o s i s Ly m e d i s e a s e Ma l a r i a Mu m p s Pe r t u s s i s Q F e v e r Ra b i e s p o s t e x p o s u r e pr o p h y l a x i s Sa l m o n e l l o s i s Sh i g e l l o s i s Su s p e c t e d R a b i e s Ex p o s u r e Tu l a r e m i a Ty p h o i d f e v e r Vi b r i o s i s ( n o n - ch o l e r a ) Ye r s i n i o s i s 2000 1 0 0 9 5 0 0 0 0 0 0 0 0 5 4 0 0 0 0 0 2001 7 0 0 5 0 0 0 0 0 0 10 0 0 3 1 0 0 0 0 0 2002 3 0 1 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 1 2003 4 0 1 4 0 0 0 0 0 0 1 0 1 4 0 0 1 0 0 0 2004 2 0 0 2 0 0 1 0 1 0 19 0 1 2 0 0 0 0 0 0 2005 8 0 0 7 0 0 0 0 0 0 8 0 0 2 1 0 0 0 0 1 2006 1 0 0 6 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 2 2007 3 2 0 4 2 0 0 0 0 1 0 0 9 2 1 0 0 0 2 2 2008 1 5 3 9 1 0 0 1 0 0 0 0 1 4 0 0 0 0 0 0 2009 7 5 0 6 0 0 0 0 0 0 0 0 3 4 0 0 0 0 1 0 2010 6 8 1 9 0 0 0 1 0 0 2 0 3 3 0 0 0 0 0 0 2011 7 7 1 6 0 1 1 1 0 0 2 1 0 1 2 0 0 1 0 0 2012 5 7 4 9 1 0 0 1 0 0 25 0 0 4 0 3 0 0 1 0 Total 55 34 11 76 9 1 2 4 1 1 67 1 18 39 9 3 1 1 4 6 Rates of notifiable communicable diseases spiked in 2012 due to a pertussis outbreak. Rates in Jefferson and WA are not statistically different overtime, years when Jefferson rates are higher than WA rates are noted below with an *. Source: Washington State Dept. of Health. Accessed in: 0.0 50.0 100.0 150.0 200.0 250.0 2000 2001*2002**2003 2004*2005 2006 2007*2008 2009 2010*2011 2012* ra t e p e r 1 0 0 , 0 0 0 p o p u l a t i o n Jefferson WA The Health of Jefferson County April 2014 The Health of Jefferson County April 2014 I2. Sexually Transmitted Infection Rates Jefferson County and Washington State Trend assessed using Joinpoint Regression Program 4.0.4 - May 2013 Rate per 100,000 Number Jefferson County Washington 1992-94 85 124.5 320.7 1995-97 61 82.8 244.5 1998-00 99 127.9 283.9 2001-03 147 181.1 344.4 2004-06 170 200.1 397.3 2007-09 159 179.4 389.6 2010-12 180 200.1 427.4 STI rates by gender male female number rate % of total number rate rate rate 1992-1994 18 53.5 21%67 193.6 191.1 39%448.8 1995-1997 13 35.9 21%48 128.2 140.2 39%347.8 1998-2000 27 71.2 27%72 182.3 171.6 39%395.3 2001-2003 46 115.5 31%101 244.4 219.7 38%468.3 2004-2006 58 138.5 34%112 260.2 259.6 39%533.8 2007-2009 50 113.9 31%107 239.2 239.7 38%537.1 2010-2012 54 121.1 30%126 277.6 285.9 38%567.8 Source: Washington State Dept. of Health. Accessed in: Community Health Assessment Tool (CHAT) In 2010-12, on average each year there were about 60 sexually transmitted infection diagnoses reported for Jefferson County residents. Both Jefferson and WA rates are statistically increasing overtime. The Jefferson rate was statistically lower than Washington. STI rates are statistically higher among females, 70% of all Jefferson cases in 2010-12. Rates are increasing for both males and females overtime. More than 60% of cases are among young adults age 15-24 however rates are statistically increasing among adults age 25-64. Jefferson County Washington State male female % of total 0.0 50.0 100.0 150.0 200.0 250.0 300.0 350.0 400.0 450.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 ra t e p e r 1 0 0 , 0 0 0 p o p u l a t i o n Jefferson County Washington 121.1 277.6 0 200 400 1992-1994 1995-1997 1998-2000 2001-2003 2004-2006 2007-2009 2010-2012 ra t e p e r 1 0 0 , 0 0 0 Jefferson MALE Jefferson FEMALE Male and Female rates statistically increasing overtime. The Health of Jefferson County April 2014 STI rates by age group 15-24 25-64 number rate number rate rate rate Jefferson WA 1992-1994 60 1033.6 18 50.9 1511.2 164.2 71%64% 1995-1997 34 536.8 5 59.3 1146.4 141.5 56%62% 1998-2000 66 959.3 4 65.0 1316.1 169.6 67%64% 2001-2003 92 1269.0 4 113.3 1568.0 207.1 63%64% 2004-2006 106 1396.8 8 119.0 1721.6 257.2 62%62% 2007-2009 102 1323.0 9 100.2 1724.7 251.0 64%63% 2010-2012 111 1521.5 12 141.1 1904.9 299.0 62%61% * # age under 15 # age 65 and older 1992-1994 3 1 1995-1997 0 0 1998-2000 3 0 2001-2003 0 1 2004-2006 1 1 2007-2009 1 0 2010-2012 0 0 CHLAMYDIA male female number rate % of total number rate rate rate 1992-1994 12 35.7 83%59 170.5 85.2 325.8 1995-1997 7 19.3 84%36 96.1 74.8 260.0 1998-2000 20 52.7 76%63 159.5 107.7 311.2 2001-2003 32 80.4 73%86 208.1 138.2 379.1 2004-2006 32 76.4 74%93 216.0 162.7 425.1 2007-2009 33 75.2 74%95 212.3 166.2 450.0 2010-2012 39 87.5 74%109 240.1 195.5 487.7 Washington State age 15-24 age 25 to 64 Percent age 15-24 Jefferson County Sexually transmitted infection rates are highest among young adults age 15-24 - they represent more than 60% of all STI cases. The Jefferson rate for age 15-24 is statistically unchanged overtime while the WA rate is statistically increasing. The Jefferson rate is lower than the WA rate in all years but 2001-03. The rate among adults age 25-64 is statistically increasing overtime in both Jefferson and WA. The Jefferson rate is statistically lower than WA. Jefferson County MALE FEMALE Washington State 240.1 487.7 0.0 200.0 400.0 600.0 1992-94 1995-97 1998-00 2001-03 2004-06 2007-09 2010-12 ra t e p e r 1 0 0 , 0 0 0 f e m a l e po p u l a t i o n FEMALE CHLAMYDIA RATE Jefferson County Washington WA rate statistically increasing overtime The Health of Jefferson County April 2014 GONORRHEA male female number rate % of total number rate rate rate 1992-1994 2 50%2 71.3 63.4 1995-1997 1 67%2 42.1 37.6 1998-2000 2 33%1 41.9 34.6 2001-2003 4 33%2 58.8 41.9 2004-2006 7 16.7 30%3 67.9 53.0 2007-2009 6 13.7 33%3 47.5 42.7 2010-2012 4 33%2 54.9 33.0 Jefferson County Washington State MALE FEMALE The Health of Jefferson County April 2014