Community Health Status Report Clay County Health Department Preliminary Draft December 2011

Table of Contents

Section 1. Section 2. Section 3. Section 4. Section 5.

Demographic and Socioeconomic Characteristics pg. 3 General Health and Access to Care Indicators pg. 7 Maternal and Child Health Indicators .. pg. 9 Chronic Disease Indicators .. pg. 12 Infectious Disease Indicators . pg. 15

Section 1. Demographic and Socioeconomic Characteristics _____________________________________________________________________________________ Clay County is a rural community located in the Southeastern portion of Illinois. The county has a total population of 13,815 residents. This is a 5.1% decrease in population since 2000. Despite the decrease in total population, there was an increase in the population of 45 to 64 years old between the 2000 Census and 2010 Census. The county has an aging population. Since 2000, the median age has risen from 39.7 years to 42.2 years in 2010.
Table 1.1: Population by Age and Gender Clay Population 1990 Total population 14,460 Male 6,838 Female 7,622 Age Under 5 904 5 to 9 1108 10 to 14 1,059 15 to 19 934 20 to 24 808 25 to 34 2,064 35 to 44 1,923 45 to 54 1,475 55 to 59 669 60 to 64 716 65 to 74 1,443 75 to 84 986 85 + 371 Median age (years) U.S. Census Bureau

Clay 2000 14,560 6,987 7,573 859 992 1,009 996 789 1,684 2,084 1,896 757 702 1,273 1,044 475 39.7

Clay % 2000 100.0 48.0 52.0 5.9 6.8 6.9 6.8 5.4 11.6 14.3 13.0 5.2 4.8 8.7 7.2 3.3 (X)

Clay 2010 13,815 6,781 7,034 852 903 853 926 708 1552 1602 2083 990 878 1224 853 391 42.2

Clay % 2010 100.0 49.1 50.9 6.2 6.5 6.2 6.7 5.1 11.2 11.6 15.1 7.2 6.4 8.9 6.2 2.8 (X)

IL % 2010 100.0 49.0 51.0 6.5 6.7 6.9 7.2 6.9 13.8 13.5 14.6 6.3 5.2 6.4 4.1 1.8 36.6

percent change -5.1% -2.9% -7.1% -0.8% -9.0% -15.5% -7.0% -10.3% -7.8% -23.1% 9.9% 30.8% 25.1% -3.8% -18.3% -17.7%

Clay County has a predominantly white population, accounting for 97.7% of the countys total population. The racial makeup of the remaining 2.3% are 0.3% Black or African American, 0.2% American Indian or Alaskan Native, 0.5% Asian, 0.8% two or more races, and 0.5% of other race. People of Hispanic or Latino origin of any race accounted for 1.1% of the population.

Table 1.2: Race/Ethnicity Distribution Race Distribution Race Total Population One Race White Black or African American American Indian and Alaska Native Asian Native Hawaiian/Pacific Islander Other Race Two or More Races Hispanic or Latino* 2000 14560 14502 14345 16 33 76 2 30 58 88 Percent 100.0% 99.6% 98.5% 0.1% 0.2% 0.5% 0.0% 0.2% 0.4% 0.6% 2010 13,815 13704 13,499 47 32 63 0 63 111 151 Percent 100.0% 99.2% 97.7% 0.3% 0.2% 0.5% 0.0% 0.5% 0.8% 1.1% % Change -5.1% -5.5% -5.9% 193.8% -3.0% -17.1% -100.0% 110.0% 91.4% 71.6%

U.S. Census Bureau

There are 3,790 family households in the county, 78.3% of which are husband-wife families. Singleparent households, female or male householder alone, account for 21.7% of family households.

Figure 1.1: Percentage of Single Parent Households, 2010

Single Parent Household, 2010

90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% 78.3% 81.9%

Clay Illinois 14.1% 12.7% 7.6% 5.4%

Husband-wife families

Female householder, Male householder, no no husband present wife present Source: US Census Bureau

Table: 1.3: Educational Attainment by Percent of Population Age 25+ Level of Education Less than High School High School grad or higher Bachelor's or higher Source: US Census Bureau 2000 Clay IL 24.0% 18.6% 76.0% 81.4% 9.7% 26.0% 2009 Clay 14.6% 85.4% 15.6% IL 15.4% 84.6% 27.5%

Since 2000, the percentage of Clay County residents age 25+ with a high school degree or higher has risen from 76.0% to an estimated 85.4% in 2009. Clay County has also seen an increase in residents who have attained a bachelors degree or higher from 9.7% to 15.6%. Despite these increases, the percentage of residents with at least a bachelors degree is still much lower compared to the state at 27.5%. Figure 1.2: Median Household Income, 2000 - 2010

Median Household Income, 2000-2010

$60,000 $50,000 Income in Dollars $40,000 $30,000 $20,000 Clay $10,000 $0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Source: Small Area Income and Poverty Estimates, US Census Bureau Illinois $38,091 $52,967

Figure 1.3: Percent of Population in Poverty, 2000 - 2010

Percent of Population in Poverty, 2000-2010

16.5% 15.5% 14.5% 13.5% 12.5% 11.5% 10.5% 9.5% 8.5% 7.5% 15.3%

Percent

13.8%

Clay

Illinois

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Source: Small Area Income and Poverty Estimates, US Census Bureau

Figure 1.4: Unemployment Rate, 2004 - 2010

Unemployment Rate, 2004-2010

14.0 12.0 10.0 Percent 8.0 6.0 4.0 2.0 0.0 2004 2005 Clay 2006 2007 IL 2008 US 2009 2010 12.1 10.3 9.6

Source: Illinois Department of Employment Security The median household income in Clay County was $38, 091 compared to the state median household income of $52, 967. Clay County also had a higher percentage of the population living in poverty. An estimated 15.3% of Clay County residents were living in poverty compared to 13.8% of the state. Approximately 809 households, or 13% of the population, in the county received food stamps in February 2010 (Heartland Alliance). Another factor that may contribute to the poverty level is the countys high unemployment rate. Clay County has an unemployment rate of 12.1%, higher than the state and national averages of 10.3% and 9.6% respectively.

Section 2. General Health and Access to Care Indicators _____________________________________________________________________________________

Table 2.1: Leading Causes of Death Top Ten Leading Causes of Death in Clay County, 2008 Clay Rank 1 2 3 4 5 6 7 8 8 10 Cause of Death All Causes Cancer Diseases of the Heart Chronic Lower Respiratory Disease Cerebrovascular Disease Accidents Septicemia Suicide Alzheimer's Disease Diabetes Mellitus Influenza and Pneumonia Number of Deaths 182 44 43 15 13 10 6 5 4 4 3 Percent of Deaths 100.0% 24.2% 23.6% 8.2% 7.1% 5.5% 3.3% 2.7% 2.2% 2.2% 1.6% Number of Deaths 103,069 24,210 25,979 5,584 5,765 4,173 1,956 1,188 3,188 2,839 2,663

Illinois Percent of Deaths 100.0% 23.5% 25.2% 5.4% 5.6% 4.0% 1.9% 1.2% 3.1% 2.8% 2.6%

Source: Illinois Department of Public Health

In 2008, the leading cause of death in Clay County was cancer with heart disease falling in a very close second. Similarly, heart disease and cancer were the top two leading causes of death in the state of Illinois. The crude mortality rate for the county was approximately 1317.4 per 100,000 versus 803.3 per 100,000 for the state. While the crude mortality rate for Clay County is higher than the states rate, it is important to remember that this is not an age-adjusted figure. Since Clay County has an aging population, it is expected that the crude mortality rate would be higher compared to a younger population. The Illinois Department of Human Services estimates that life expectancies at birth for males to be 71.8 years and 78.79 years for females. Life expectancies at the county-level were not available.

Figure 2.1: Percent of Population without Insurance Coverage, 2009

Percent of Population Uninsured, 2009

30.0% 25.0% Percent of Population 20.0% 15.0% 10.0% 5.0% 0.0% Under 65 19 and under 18 - 39 40 - 64 4.9% 4.9% 13.6% 15.0% 13.8% 14.3% Clay Illinois 24.5% 22.3%

Age

Source: US Census Bureau, Small Area Health Insurance Estimates In 2009, an estimated 13.6% of Clay County residents under the age of 65 did not have insurance coverage compared to 15.0% in Illinois. Residents between the ages of 18 to 39 years are most likely to be uninsured with an estimated 22.3% of 18-39 year olds uninsured. Table 2.2: Years of Potential Life Lost, 2006 Years of Potential Life Lost (YPLL), 2006 Clay Total for All Races Malignant Neoplasms 58 Motor Vehicle Accidents 30 Accidents 30 Lung Cancer 29 Diseases of Heart 21 Coronary Heart Disease 21 Fires and Burns 10 Suicide 10 Cerebrovascular Diseases 7 Diabetes Mellitus 7
Source: IPLAN Data System

Illinois Accidents Malignant Neoplasms Diseases of Heart Perinatal Conditions Coronary Heart Disease Motor Vehicle Accidents Homicide Firearms Congenital Malformations Suicide 85,216 73,388 54,578 45,158 36,136 31,128 27,677 27,275 19,618 17,193

In 2006, cancers account for the highest number of years of potential life lost (YPLL) in the county at 58 years of life lost. Accidents, specifically motor vehicle accidents, are second in the county for YPLL. For the state of Illinois, accidents are first on the list of highest number of YPLL.

Section 3. Maternal and Child Health Indicators _____________________________________________________________________________________ Table 3.1 Birth by Characteristics, 2009
Low Birth Resident County Total Births Weight (<2,500 grams) Births ILLINOIS Clay 171,077 178 14,372 17 Percent 8.4 9.6 Very Low Birth Weight (<1,500 grams) Births 2,655 1 Percent 1.6 * Births 17,109 20 Percent 10 11.2 Preterm (<37 weeks)

*does not meet standards of reliability, numerator <10 or denominator <100

Source: Birth Characteristics by Resident County 2009, IDPH

Table 3.2: Birth by Characteristics Continued, 2009

Adequate Resident County Total Births Prenatal Care (Kotelchuck) ** Births ILLINOIS Clay 171,077 178 125,932 157 Percent 80.2 92.4 Births 53,296 49 Percent 31.5 28 Births 69,728 75 Percent 40.8 42.1 Cesarean Section ** Mother Unmarried Not H.S. Graduate, Age 20+ ** Births 21,313 13 Percent 14 8.3

Source: Birth Characteristics by Resident County 2009, IDPH

In 2009, there were 178 births in Clay County. Infants born to Clay County mothers were slightly more likely to be low birth weight or preterm babies. However, Clay County mothers were significantly more likely to have adequate prenatal care at 92.4% compared to the state at 80.2%.

Table 3.3: Birth by Demographics, 2009

Resident County ILLINOIS Total Births 171,077 Sex Male 87,706 Female 83,371 White 130,629 Race Black 30,186 0 Other 10,262 2 Hispanic Origin 40,369 2

Clay 178 80 98 176 Source: Birth Demographics by Resident County 2009, IDPH

Table 3.4: Birth by Demographics Continued, 2009

Resident County ILLINOIS Total Births 171,077 Mother's Age Group (Years) < 20 16,376 20 - 24 36,342 25 - 29 47,462 30 - 34 44,169 35 - 39 21,649 7 40 + 5,067 4

Clay 178 21 55 59 32 Source: Birth Demographics by Resident County 2009, IDPH

Approximately 11.8% of births in Clay County were to teen mother less than 20 years of age. This is higher than the state teen birth rate of 9.6% in 2009.

Table 3.5: Infant Mortality

Year County ILLINOIS CLAY Births 180,503 167

2006 Infant Deaths 1,343 -IM Rate 7.4 -0Births 180,530 170

2007 Infant Deaths 1,196 2 IM Rate 6.6 ** Births 176,634 164

2008 Infant Deaths 1,263 1 IM Rate 7.2 **

*does not meet standards of reliability, numerator <10 or denominator <100

Source: Infant Mortality Number by County 2006-2008, IDPH

Figure 3.1: Mothers Who Smoke During Pregnancy

Mothers Who Smoke During Pregnancy, 2001-2006

Percent of Pregnant Mothers 40.0% 35.0% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% 2001 2002 2003 2005 2006 Source: IPLAN Data System 10.5% 10.0% 9.6% 8.6% 8.6% 33.8% 27.5% 25.9% 25.7% Clay Illinois 34.5%

HP 2020 Target: 1.4%

Clay County has a significantly higher percentage, 25.7%, of expecting mothers who smoke during pregnancy compared to the states rate of 8.6%. This rate is much higher than HP 2020s target to reduce the percentage of mother who smoke during pregnancy to 1.4%.

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Figure 3.2: Mothers Who Drink During Pregnancy

Mothers Who Drink During Pregnancy, 2001 - 2006

2.0% Percent of Pregnant Mothers HP 2020 Target: 1.7% 1.5%

1.0% 0.6% 0.5% 0.3% 0.0% 2001 2002 2003 2005 2006 Clay Illinois

Source: IPLAN Data System

Although Clay County rates of mothers who drink during pregnancy are higher compared to the state, both Clay County and Illinois are well below the HP 2020 target of 1.7%.

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Section 4. Chronic Disease Indicators _____________________________________________________________________________________

Table 4.1: Crude Mortality Rates Crude Mortality Rates, 2008 Clay IL All Deaths 1317.4 803.3 Cancer 318.5 188.7 Coronary Heart Disease 311.3 202.5 Cerebrovascular 94.1 44.9 Chronic Liver Disease * 8.9 * If < 10 events, no rate calculated Source: Illinois Department of Public Health

Table 4.2: Cancer Incidence and Mortality Rates, 2004 - 2008 Clay County Incidence Mortality Type of Cancer Male Female Male Female All Sites 706.9 430.8 237.7 156.2 Colorectal 82.6 51.8 31.9 17.7 Lung & Bronchus 117.1 64.8 69.1 46.0 Breast -106.6 -21.0 Prostate 208.2 -26.7 -Cervix -4.8 -Overcall cancer death rate, HP 2020 target: 160.6 deaths per 100,000 Source: American Cancer Society, Illinois Cancer Registry

Illinois Incidence Male Female 577.0 433.8 63.9 46.5 89.9 59.8 -123.9 157.7 --8.8 Mortality Male Female 235.4 163.4 23.9 16.5 71.1 42.2 -25.2 26.2 ---

Although the incidence rates of cancer in Clay County is higher than the state average, mortality rates are approximately the same as Illinois cancer mortality rates. The higher incidence rates can be due to successful cancer detection programs in which a larger proportion of the county participates in routine cancer screenings.

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Figure 4.1: Percent of Adults with Diagnosed with Diabetes

Percent of Adults with Diagnosed Diabetes, 2004 - 2008

8.5% 8.3% Percent of Population 8.0% 7.5% 7.5% 7.0% 6.5% 6.0% 2004 2005 2006 2007 2008 Clay IL

Source: National Diabetes Surveillance System, CDC

Figure 4.2: Percent of Population Considered Obese

Percent of Population Obese, 2004 - 2008

28.0% 27.0% 27.0% Percent of Population 26.9% 26.0% 25.0% 24.0% 23.0% 23.0% 22.0% 2004 2005 2006 2007 2008 24.7% 25.1% 25.1% 25.4% 25.6% Clay IL 27.6% 27.4%

Source: National Diabetes Surveillance System, CDC

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Figure 4.3: Percent of Population No Leisure-Time Physical Activity

Percent of Population No Leisure-Time Physical Activity, 2004-2008

29.0% 28.0% Percent of Population 27.0% 26.0% 25.0% 24.0% 23.0% 22.0% 21.0% 20.0% 2004 2005 2006 2007 2008 28.0% 26.4% Clay IL

Source: National Diabetes Surveillance System, CDC

Figure 4.4: Percent of Population that Smokes

Percent of Population that Smokes, 1998-2008 30.0%

Percent of Population 25.0% 20.0% 15.0% 10.0% 5.0% 1998 2002 2005 2008 22.9% 21.3% Clay Illinois HP 2020 Target: 12.0%

Source: Illinois Behavioral Risk Factor and Surveillance System

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Section 5. Infectious Disease Indicators _____________________________________________________________________________________ Table 5.1: Cases & Rates of Chlamydia, Gonorrhea, and Syphilis, 2005-2009 Rates Cases N/A Rates are per 100,000 population. Chlamydia Chlamydia COUNTY 2005 2006 2007 2008 2009 2005 2006 2007 2008 2009 CLAY 11 9 10 23 20 75.5 61.8 68.7 158.0 137.4 TOTAL 50,559 53,586 55,470 59,169 60,542 407.1 431.5 446.6 476.4 487.5 ILLINOIS Total Ill. Excluding 27,705 29,937 33,289 33,704 33,750 290.9 314.4 349.6 353.9 354.4 Chicago Gonorrhea COUNTY 2005 2006 2007 2008 2009 2005 2006 2007 2008 2009 CLAY 3 2 0 2 2 20.6 13.7 0 13.7 13.7 TOTAL 20,019 20,186 20,813 20,674 19,962 161.2 162.5 167.6 166.5 160.7 ILLINOIS Total Ill. Excluding Chicago COUNTY CLAY TOTAL ILLINOIS Total Ill. Excluding Chicago 10,130 10,292 11,425 10,165 8,955 106.4 108.1 120 106.7 94

2005 0 922 177

2006 1 698 216

2007 0 688 195

Early Syphilis 2008 2009 0 825 207 0 1,094 320

2005 0 7.4 1.9

2006 6.9 5.6 2.3

2007 0 5.5 2

2008 0 6.6 2.2

2009 0 8.8 3.4

CLAY 0 1 TOTAL 525 431 464 ILLINOIS Total Ill. Excluding 107 136 133 Chicago Source: Illinois Department of Public Health

Primary and Secondary Syphilis 0 0 0 0 554 129 750 189 4.2 1.1

6.9 3.5 1.4

0 3.7 1.4

0 4.5 1.4

0 6 2

The rates of infection for chlamydia and gonorrhea in Clay County are significantly lower compared to the rates of infection across the state-level and Illinois counties excluding Chicago. Generally, rates of syphilis in the county are also well below syphilis rates across the states. Only one case of syphilis was reported between the years 2005 2009.

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Table 5.2: Incidence Rates of HIV/AIDS, 2010 2010 HIV (non-AIDS) Cases Cumulative 2005-2010 Diagnosed Living as Cases HIV as of of Diagnosed Diagnosis County 12/31/10 12/31/10 since 2005 Rate Clay Totals 0 871 4 15785 0 7178 0.0 9.3

Diagnosed as of 12/31/10 0 445 84

2010 AIDS Cases Cumulative Living as Cases of Diagnosed 12/31/10 since 2005 3 17820 2786 4 5942 1003

2005-2010 AIDS Diagnosis Rate 4.9 7.7 3.8

Downstate Counties* 163 2478 1099 4.1 *Downstate counties are all Illinois counties excluding Cook and collar counties
Source: IDPH, http://www.idph.state.il.us/aids/Surv_Report_1210.pdf

No new cases of HIV (non-AIDS) were reported between the years 2005 - 2010. Since 2005, four cases of AIDS have been diagnosed.

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