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Klickitat County 17 84 15 18 11 72 22 14 0 10 20 30 40 50 60 70 0 Income Below 100% FPL Lacking College Degree Non-White, or Hispanic Lacking Health Insurance Percent Klickitat County and Washington State Demographic Factors Chronic Disease Profile Sociodemographic Risk Factors 80 90 10 KlickitatCounty WA State In Klickitat County … • One in six households have income less than the federal poverty level.1 • Five out of six adults age 25 and older do not have a college degree. • Fifteen percent of the population is non-white or Hispanic. • One in six adults have no medical insurance. Compared to Washington State … • Klickitat County has more people below poverty, fewer college graduates, and fewer non-whites or Hispanics than the state average. • No other differences are statistically detectable. 1. Federal Poverty Level (FPL) is determined based on household income and household size. In 2008, FPL for a family of four was $21,200. Error bars show the 95 percent confidence intervals around the estimate. Confidence intervals are not given for census data. Data Sources: US Census Bureau, 2008 SAIPE (income) 2000 Decennial Census (education, race/ethnicity); WA Behavioral Risk Factor Surveillance System 2006‐2008 (health insurance). See Appendix for additional information. For persons with disabilities, this document is available on request in other formats. To submit a request, please call 1- [PHONE REDACTED] (TDD/TTY 1-[PHONE REDACTED]). Para personas discapacitadas, este documento está disponible a su pedido en otros formatos. Para hacer su pedido, llame al 1-[PHONE REDACTED] (TDD/TTY 1-[PHONE REDACTED]). DOH 345-271 1 ---PAGE BREAK--- Adult Health Risk Factors 17 73 39 16 8 12 9 74 37 16 3 9 0 10 20 30 40 50 60 70 80 90 100 Food Insecurity Inadequate Fruit/Veg Consumption Inadequate Physical Activity Cigarette Smoking Smokeless Tobacco Use Home SHS Exposure Age-Adjusted Percent Health Risk Factors Among Adults in Klickitat County and Washington State Klickitat County WA State In Klickitat County … • One out of six households experience food insecurity.1 • Almost three fourths of adults do not eat enough fruits and vegetables.2 • Two out of five adults do not get adequate physical activity.3 • One out of six adults currently smoke cigarettes.4 • Eight percent of adults use smokeless tobacco.5 • One out of eight adults are exposed to secondhand smoke in the home.6 Compared to Washington State … • More Klickitat County adults experience food insecurity and more use smokeless tobacco than the state average. • No other differences are statistically detectable. 1. Food Insecurity occurs when people run out of food, eat less, skip meals, or go hungry, or when they subsist on a nutrient poor diet, because they cannot afford to buy food. 2. CDC recommends eating five servings of fruits and vegetables per day. 3. CDC recommends 30 min of moderate physical activity five times a week, or 20 minutes of vigorous physical activity three times a week for adults. 4. An adult is classified as a “current smoker” if (s)he reported having smoked more than 5 packs (100 cigarettes) in his/her lifetime, and also reported currently using tobacco “every day” or “some days”. 5. An adult is classified as a “current smokeless tobacco user” if (s)he reported having ever tried smokeless tobacco and has used smokeless tobacco products in the past 30 days. 6. Home secondhand smoke exposure measured by respondents reporting any smoking in the home in the past 30 days. Data Source: WA Behavioral Risk Factor Surveillance System, 2007 (food insecurity), 2005&2007 (nutrition, physical activity), 2006‐ 2008 (smoking). See Appendix for additional information. For persons with disabilities, this document is available on request in other formats. To submit a request, please call 1- [PHONE REDACTED] (TDD/TTY 1-[PHONE REDACTED]). Para personas discapacitadas, este documento está disponible a su pedido en otros formatos. Para hacer su pedido, llame al 1-[PHONE REDACTED] (TDD/TTY 1-[PHONE REDACTED]). DOH 345-271 2 ---PAGE BREAK--- Youth (10th grade) Health Risk Factors 13 8 87 51 78 16 14 7 75 57 75 15 0 10 20 30 40 50 60 70 80 90 100 Smoking Smokeless Tobacco Use Inadequate Fruit & Vegetable Consumption Inadequate Physical Activity Drinks Sugar Sweetened Beverages at School Drinks Soda Twice a Day Age-Adjusted Percent Health Risk Factors Among 10th Grade Youth in Klickitat County and Washington State Klickitat County WA State Klickitat County 10th graders… • One out of eight smoke.1 • One out of 12 use smokeless tobacco products.1 • Almost nine out of 10 do not eat enough fruits and vegetables.2 • Half do not get enough physical activity.3 • Over three fourths drink sugar sweetened beverages at school.4 • One out of six drink soda two or more times a day. Compared to Washington State 10th graders … • Fewer 10th grade students in Klickitat County eat enough fruits and vegetables than the state average. • No other differences are statistically detectable. 1. A youth is classified as a “current smoker” or “current smokeless tobacco user” if he or she reported using tobacco on one or more days within the past 30 days. 2. CDC recommends five servings of fruits and vegetables a day. 3. CDC recommends 60 minutes moderate or vigorous physical activity every day for youths. 4. Includes soda, fruit juice, sports drinks, kool‐aid, etc. Error bars show the 95percent confidence intervals around the estimate. Data Source: WA Healthy Youth Survey, 2008. See Appendix for additional information. For persons with disabilities, this document is available on request in other formats. To submit a request, please call 1- [PHONE REDACTED] (TDD/TTY 1-[PHONE REDACTED]). Para personas discapacitadas, este documento está disponible a su pedido en otros formatos. Para hacer su pedido, llame al 1-[PHONE REDACTED] (TDD/TTY 1-[PHONE REDACTED]). DOH 345-271 3 ---PAGE BREAK--- Adult Health Risk Conditions 25 26 31 25 25 32 0 10 20 30 40 50 60 70 90 100 Obesity Hypertension High cholesterol Age-Adjusted Per Health Risk Conditions Among Adults in Klickitat County and Washington State 80 cent Klickitat County WA State In Klickitat County … • A fourth of adults are obese.1 • A fourth of adults have high blood pressure.2 • Almost a third of adults have high cholesterol.2 Compared to Washington State … • There are no statistically detectable differences between Klickitat County and Washington State. 1. Obesity in adults is defined as body mass index > 30 kg / m 2. 2. Self reported lifetime prevalence – Survey respondent answered “yes” to “have you ever been told by a health care professional that you have high blood pressure (or high cholesterol). Error bars show the 95 percent confidence intervals around the estimate. Data Source: WA Behavioral Risk Factor Surveillance System, 2006‐2008 (Obesity), 2005&2007 (hypertension, cholesterol). See Appendix for additional information. For persons with disabilities, this document is available on request in other formats. To submit a request, please call 1- [PHONE REDACTED] (TDD/TTY 1-[PHONE REDACTED]). Para personas discapacitadas, este documento está disponible a su pedido en otros formatos. Para hacer su pedido, llame al 1-[PHONE REDACTED] (TDD/TTY 1-[PHONE REDACTED]). DOH 345-271 4 ---PAGE BREAK--- Adult Preventive Care 39 26 34 50 26 26 28 54 0 10 20 30 40 50 60 80 90 100 Lack Screening for Breast Cancer Lack Screening for Cervical Cancer Lack Screening for Colorectal Cancer Lack of preventive care: people w/ diabetes Age-Adjusted Per Preventive Care Among Adults in Klickitat County and Washington State Klickitat County WA State 70 cent In Klickitat County … • Two out of five women age 40 and over have not been screened for breast cancer.1 • A fourth of women age 18 and over have not been screened for cervical cancer.1 • A third of men and women age 50 and over have not been screened for colorectal cancer.1 • Half of people with diabetes have not received recommended preventive care.2 Compared to Washington State … • Fewer Klickitat County women are screened for breast than the state average. • No other differences are statistically detectable. 1. CDC recommends women aged 40+ should have a mammogram every two years, women 18+ should have a PAP test every three years, and men and women aged 50+ should have either a sigmoid colonoscopy or a fecal occult blood test every two years. 2. For people with diabetes, recommended preventive care includes annual foot exam, annual eye exam, and bi‐annual hemoglobin A1c test. Error bars show the 95 percent confidence intervals around the estimate. Data Source: WA Behavioral Risk Factor Surveillance System, 2006‐2008. See Appendix for additional information. For persons with disabilities, this document is available on request in other formats. To submit a request, please call 1- [PHONE REDACTED] (TDD/TTY 1-[PHONE REDACTED]). Para personas discapacitadas, este documento está disponible a su pedido en otros formatos. Para hacer su pedido, llame al 1-[PHONE REDACTED] (TDD/TTY 1-[PHONE REDACTED]). DOH 345-271 5 ---PAGE BREAK--- Adult Chronic Disease Rates For persons with disabilities, this document is available on request in other formats. To submit a request, please call 1- [PHONE REDACTED] (TDD/TTY 1-[PHONE REDACTED]). Para personas discapacitadas, este documento está disponible a su pedido en otros formatos. Para hacer su pedido, llame al 1-[PHONE REDACTED] (TDD/TTY 1-[PHONE REDACTED]). DOH 345-271 6 12 6 7 9 7 6 0 2 4 6 8 10 12 14 16 18 20 Asthma Diabetes Heart Disease & Stroke Age-Adjusted Percent Chronic Disease Prevalence Among Adults in Klickitat County and Washington State Klickitat County WA State In Klickitat County … • One in eight adults have asthma.1 • One in 16 adults have diabetes.1 • One in 14 adults have had a heart attack, coronary heart disease, angina, or stroke.1 Compared to Washington State … • There are no statistically detectable differences between Klickitat County and Washington State. Data on cancer-related disease burden will be available in the near future. 1. Self reported lifetime prevalence – Survey respondent answered “yes” to “have you ever been told by a health care professional that you have asthma (or diabetes, stroke, etc). Error bars show the 95 percent confidence intervals around the estimate. Data Source: WA Behavioral Risk Factor Surveillance System, 2006‐2008. See Appendix for additional information. ---PAGE BREAK--- Appendix: Data Sources & Definitions The following provides a brief description of each data system and definitions of technical terms used in this report. Data represented in this profile were obtained from a variety of sources. Analyses for this report were completed using Intercooled Stata 10.0. Some estimates were obtained from previously published reports. DATA SYSTEMS: Population Data Population data were taken from U.S. Census Bureau. The primary purpose of the census is the apportionment of congressional seats. The full 2000 census collects basic demographic information by age, sex, and race/ethnicity from the entire US population. The Census Bureau also serves as a source of data about the nation’s people and economy. The 2000 census included a random sample of respondents who were given a longer questionnaire with questions regarding education, income, employment, and other socioeconomic factors. The Small Area Income and Poverty Estimate (SAIPE) is conducted annually to provide up-to-date information on the distribution of income and poverty. Data related to income were obtained from the 2008 US Census Bureau Small Area Income and Poverty Estimate (SAIPE). For more information on the SAIPE go to: http://www.census.gov Data related to education were obtained from the 2000 Decennial Census, (long questionnaire). For more information on the 2000 Decennial Census, go to: http://www.census.gov Data related to race/ethnicity were obtained from the Washington State Office of Financial Management (OFM). Washington State OFM produces intercensal county population estimates by age, sex, and race / ethnicity. For more information go to the OFM Population web site: http://www.ofm.wa.gov/pop/default.asp Behavioral Risk Factor Surveillance System The Behavioral Risk Factor Surveillance System is an annual telephone survey that provides indicators of health risk behavior, preventive practices, attitudes, health care use and access, and prevalence of selected diseases in Washington. was first implemented in Washington State in 1987, and is supported in part by the national Centers for Disease Control and Prevention. The survey includes a sample of English or Spanish (since 2003) speaking adults age 18 years and older in households with landline telephones. Interviews are conducted in English or Spanish, by a survey firm under contract to the Department of Health (DOH), following survey administration protocols established by Centers for Disease Control and Prevention (CDC). The data are weighted to represent all adults. The data may underestimate some health behaviors associated with populations speaking neither English nor Spanish, transient populations, institutionalized persons, and military personnel in military housing. Due to 7 ---PAGE BREAK--- the nature of self-reported data, there may be some underestimation of risk factors that are seen as socially unacceptable. For more information on Washington State go to: For technical notes on the Washington State go to: For more information on national go to: Healthy Youth Survey Data The Washington State Healthy Youth Survey (HYS) is a school-based survey of students in grades 6th, 8th, 10th and 12th in a random sample of public schools in Washington State. It is administered every other year during class time and contains questions about behaviors that result in unintentional and intentional injury seat belt use, fighting and weapon carrying); physical activity and dietary behaviors fruit and vegetable consumption); alcohol, tobacco, and other drug use; and related risk and protective factors. The survey includes items from the CDC-sponsored Youth Risk Behavior Survey (YRBS) and Youth Tobacco Survey, the National Institute on Drug Abuse-sponsored Monitoring the Future survey, and the Social Development Research Group’s Risk and Protective Factor Assessment instrument. In 2008, 32,531 students participated in the Healthy Youth Survey and contributed to the statewide results. In addition, 165,781 students participated and contributed to local level results for counties, educational service districts, school districts and school buildings. For more information on the HYS, go to: For technical notes on the HYS, go to: School-based surveys may underestimate risk behaviors associated with youth who drop out of school or do not attend school. Due to the self-reported nature of the data, certain behaviors may be under-reported. DEFINITIONS Hispanic Origin: Persons of Hispanic Origin used by the Census Bureau refers to “the ancestry, nationality group, lineage, or country of birth of the person or the person’s parents or ancestors before their arrival in the United States.” Persons of Hispanic Origin have their origins in a Hispanic or Spanish-speaking country such as Mexico, Cuba, Puerto Rico, or the Spanish-speaking countries of Central or South America, regardless of race. The Behavioral Risk Factor Surveillance System and the Healthy Youth Survey (HYS) treats Hispanic as an ethnic group. For additional Washington State guidelines for using racial and ethnic groups in data analysis, go to: http://www.doh.wa.gov/data/guidelines/REGL2010_1.htm 8 ---PAGE BREAK--- 9 95% Confidence intervals: Sometimes called the “margin of error.” Commonly used with survey data to account for the differences in estimates that are due to random factors or chance. Confidence intervals are typically expressed as a range between an upper and lower value which will contain the population or "true" prevalence 95% of the time. Statistically detectable: Also known as “Statistically significant”. An observed difference between two populations is determined to be statically detectable (significant) if it is unlikely to have occurred randomly or by chance. If there is more than a 5% probability that the differences we see are just due to chance, we say that there is no statistically detectable (or significant) difference. Age-Adjusted: Age-adjustment allows for comparisons between two or more populations that differ in their age distribution. This is particularly important for age- related diseases like diabetes. Age adjustment calculates what the percentages would be if both populations had the same age distribution. Insufficient Data: In our reporting of county-level data we suppressed rates and frequencies that fell below certain criteria to protect confidentiality of individuals, and reduce problems with data reliability. If 10 or fewer respondents reported a condition, or if there were 50 or fewer total respondents, we report “insufficient data.”