Quality of Life Indicators

self-reported health status -- updated 3/19/12

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The CDC’s Behavioral Risk Factor Surveillance System survey asks adults, “How is your general health?” This self-reported behavior is important because healthy people are generally engaged in the community both socially and economically.

exercise & physical activity prevalence -- 3/18/12

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Adults are at-risk of serious cardiovascular disease when exercise and physical activity aren’t a part of their daily lives. The American College of Sports Medicine recommends a minimum of 20+ minutes of physical activity 3-5 times per week to improve adult fitness.

leading cause of death rate -- updated 5/17/12

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TMT tracked the leading cause of death in the past, and although the measure may not be as important as some other health metrics, the data do act as an early warning sign for certain diseases and associated behaviors. Understanding the causes of death helps citizens assess health risks and allows the community to target education and prevention resources. Cause of death shows why the community is losing people who still should have productive years ahead of them. Lower respiratory and chronic liver diseases remain higher than the US. Diabetes deaths were up in 2004 and have continued to rise each year; age-adjusted rates are even higher and many surpass Health People 2010 & 2020 target rates. Considering the percent of the population overweight or obese, it will be difficult for the county to improve in the near term.

youth reported substance abuse rates -- corrected 2/25/12

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No one likes to think about the youth in Washoe County engaging in risky behaviors, especially as serious as methamphetamine abuse. Yet, young do people take chances, and Washoe County is no different from other cities. The community must address substance abuse treatment capacity for adults, children, and families in order to reduce potentially negative health outcomes from risky behaviors.

According to Washoe County School District 2009 Youth Risk Behavior Survey (YRBS) results, after several years of decline, both middle and high school students reporting lifetime use of alcohol increased. The same was true for the percentage increase in high school students reporting that in the past 30-days they drove a car while drinking. High school students reporting in the past thirty days that they rode in a car driven by someone who had been drinking alcohol has steadily risen from 27.6% in 2001 to 30% in 2009. High school students reporting lifetime use of most drugs declined from 2001 to 2007, but also increased in 2009, including marijuana, cocaine, inhalants, meth, inhalants and over-the-counter (OTC) drugs. However, the use of meth, cocaine and OTC middle school drug use declined from 2007 to 2009. Reported tobacco use jumped again for high school students in 2009, but declined for middle school students.

Following the alarming 2009 YRBS results, TMT worked with the WCSD to initiate a 2010 community partners task force to undertake education, intervention and prevention actions directed at reversing these trends.  Over 25-organizations participated in the task force and worked to launch a community education campaign including Nevada students.  Student newspaper staffs were recruited, provided with all the YRBS data and information, and encouraged to creatively explore and propose solutions to the trends (also including risky suicide and sexual activity behaviors).  A "Stop Youth Risk Behavior" Day was also initiated for the Nevada Legislature. The 2011 YRBS results indicate that the work of these organizations, students and WCSD are making a difference and many of the alarming tends in 2009, are moving in a more positive direction.

youth reported sexual behaviors -- updated 2/23/12

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According to the Washoe County School District 2009 Youth Risk Behavior Survey, high school students reported having ever had sexual intercourse rose to 52.4% in 2009. The percentage of high school students reporting having had sexual intercourse before age 15 continues to rise, and those reporting they used a condom the last time they had intercourse declined from 64.9% in 2007 to 61.8% in 2009. Not surprising, the percentage of high school students reporting to have been pregnant or gotten someone else pregnant rose from 5.6% in 2007 to 7% in 2009, representing approximately 1,400 high school students.

Following the alarming 2009 YRBS results, TMT worked with the WCSD to initiate a 2010 community partners task force to undertake education, intervention and prevention actions directed at reversing these trends.  Over 25-organizations participated in the task force and worked to launch a community education campaign including Nevada students.  Student newspaper staffs were recruited, provided with all the YRBS data and information, and encouraged to creatively explore and propose solutions to the trends (also including risky suicide and substance abuse behaviors).  A "Stop Youth Risk Behavior" Day was also initiated for the Nevada Legislature. The 2011 YRBS results indicate that the work of these organizations, students and WCSD are making a difference and many of the alarming tends in 2009, are moving in a more positive direction.  Although, the percentage of high school students reporting that they have ever had sexual intercourse decreased in 2009, the percentage remains relatively consistent since 2001.

work-related injury death rate -- updated 2/27/11

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The national Healthy People 2010 target was less than a 3.2 work-related deaths rate per 100,000 population, aged 16 years and older. According to the 2010 UNLV School of Community Health Sciences report, Injury in Nevada, from 2003-2008, there were 324 occupational injury related deaths in Nevada. During this period Nevada’s occupational injury fatality rate was 1.8 per 100,000 population, slightly higher than the United States occupational injury fatality rate of 1.4 per 100,000 population. During the study period, 41% of Nevada fatal occupational injuries were transportation-related, however, this was down from 46% in 2005, and 52.5 % in 2001, as previously reported in July 2006 by the Center for Health & Data Research, Nevada State Health Division, NDHHS, as a part of the Healthy People Nevada 2010 initiative. Note that these data are likely not comparable to the tables below.

nonfatal occupational injury rate -- updated 2/28/11

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Occupational injuries can require an ER visit and lost work days, resulting in lost wages, lost productivity and higher worker compensation claims/premiums for Nevada employers. Using research from the Bureau of Labor Statistics, the article “Occupational Injury and Illness Rates, 1992-96: Why They Fell,” by Hugh Conway, Jens Svenson; Monthly Labor Review, Vol. 121, 1998, notes that the “decrease (of industrial accidents and illnesses in the 1990’s) is especially dramatic in light of the expected pattern of increased injuries and illnesses during economic expansions. The temporary drop in the rates in the early 1980s has been attributed to the concurrent effects of the recession. For example, Peter Dorman concludes that there is clearly acyclical” component to safety: it rises during periods of economic hardship, and falls during periods of growth. This may be due either to the speedup in the pace of work when orders pile up (this is implicit in Okun’s law, according to which fluctuations in output exceed fluctuations in employment), or to the influx of new, inexperienced workers when hiring expands. Source: http://www.questia.com/PM.qst?a=o&se=gglsc&d=5001403592

premature births -- updated 3/21/12

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Premature or preterm birth (less than 37 weeks of gestation) the the leading cause of death among newborn babies, and is significantly correlated to low birth weight babies with significant healthcare issues to overcome at high hospital and healthcare cost over time.  The March of Dimes estimated in 2005 that babies born prematurely cost on average $51,600.  

According to the National Kids Count site, Nevada ranked 41st in the country in preterm births in 2004.  Nevada ranked 49th for prenatal care, according to Americas' Health Rankings: Prenatal Care, 2011 Edition.

disease risk prevalence -- updated 3/19/12

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At risk behavior shows how much individual responsibility we take for our health. These behaviors put people at risk of serious illness or death. The portion of the population that is overweight is growing quickly. Many in the community are obese as well. Washoe County also has high rates of at-risk behaviors including smoking, drinking, and sedentary lifestyles. These behaviors can also lead to health problems and multiple diseases. The national Healthy People 2020 target for high blood pressure prevalence is 26.9%.

communicable diseases -- updated 5/17/12

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According to the Washoe County District Health (WCDH) Department, July 2007 communicable disease summary, Chlamydia is the most frequently reported infectious disease in the US and most commonly reported sexually transmitted disease in Washoe County, continuing to rise.  WCDHD

Communicable disease rate calculations starting 2000, use the annual total number of cases reported in the WCDH Epi-News and offical Wasoe County population totals.

adult heavy drinking -- updated 3/18/12

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The Healthy People 2020 national health target is to reduce the proportion of adults engaging in binge drinking to 24.3%.

teen birth rate -- updated 2/26/12

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According to CDC reports, the birth rate for teenage girls ages 15–19, rose in 2006 for the first time in the country in 15 years, but declined again starting in 2008. The teen birth rate peaked in 1991 at 61.8 births per 1,000 age specific teenage girls, but declined slowly until it rose almost 3% from 2005 to 2006. National Center for Health Statistics The 2009 teen birth rate for the US dropped to 39.1 births per 1,000 age specific teenage girls.

Although the teen birth rate is declining nationally, this is not the case in Nevada. Nevada had the highest pregnancy rate in the nation for teens aged 15–19 in 2000, and was 8th in the nation that year for teen births in the same age group; Nevada ranked 2nd in the nation for the teen pregnancy rate in 2005. After steady declines, the teen birth rate rose 1.6% in Nevada from 2005 to 2006, and similarly 1.8% in Washoe County, which rose again in 2007 and 2008, although slightly below Nevada's rate and Clark County. The state and local cost to Nevada taxpayers associated with teen childbearing in 2004 was $31 million, or 46% of the total public cost in Nevada of $67 million. Public Cost of Teen Childbearing report

The National Campaign to Reduce Teen Pregnancy’s goal is to reduce the rate of teen pregnancy and unplanned pregnancy in young adults by one-third between 2006 and 2015. The National Campaign to Reduce Teen Pregnancy

According to the Guttmacher Institute's, Contraceptive Needs and Services: National and State Data, May 2010:

• In 2008, there were 554,500 women of reproductive age (aged 13-44) in Nevada, 316,000 in need of contraceptive services and supplies. Of these: 37,900 were under the age of 20 and 278,100 were aged 20-44; 33,100 aged 20-44, were below 100% of the federal poverty level; and 166,900 were Non-Hispanic white, 27,600 were Non-Hispanic black, and 86,900 were Hispanic. A January 2010, Guttmacher Institute report estimated that 80% of teen pregnancies are unintended.
• In 2008, there were 142,400 women in Nevada in need of publicly supported contraceptive services and supplies. Of these, 37,900 were in need of publicly supported services because they were sexually active teenagers, and 104,600 because they had incomes below 250% of the federal poverty level.
• In 2006-2007, 22.2% of women aged 15-44 in Nevada were uninsured, while 5.6% were enrolled in Medicaid.
• In 2008, the annual net savings from averted Medicaid births was estimated at $23 million (costs estimated at $9,998 per Medicaid birth)

adult tobacco use -- updated 3/19/12

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The Healthy People 2020 national target is to reduce the proportion of adult cigarette smoking to at least a 12%. Although the portion of adult cigarette smokers in Washoe County has decreased over five years, the percentage of adults who report currently smoking increased, as well as those who report smoking everyday in 2009, but decreased again in 2010. Washoe County adult smoking peaked in 1999 at 28.8%, as did the state of Nevada at 31.5%. Nevada was second only to Kentucky in the percentage of adult smokers by 2001. As a state with a high smoking prevalence, exposure to secondhand smoke is also greater, especially for children. Both smoking and exposure to secondhand smoke also impact health outcomes, including cardiovascular diseases, cancer, respiratory diseases and asthma.

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The World Health Organization reports global secondhand smoke risks and findings that correlate to half of the deaths from heart disease, cancer, lung infections and asthma, however, 15-states continue to have no smoke-free bans exposing children and adults to health and related economic-risks.

substance abuse treatment capacity -- updated 9/30/10

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Substance abuse treatment capacity data availability is limited. The Children’s Cabinet began their new ADAPT project in July 2009 as a local effort under the National Fight Crimes Invest in Kids Initiatives, with first year start-up funding provided by a $140,000 COPS grants from the Washoe County Sheriff’s Office. Project ADAPT is a collaborative and involves intensive case management services, afterschool programming and academic services, and substance abuse prevention, intervention and treatment strategies. The Children’s Cabinet expects to service as many as 200 youth in the 2010-11 project year.

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According to a January 9, 2007 Reno Gazette-Journal article:

Treatment options for adolescent meth addicts in Washoe County got a boost recently when Elko-based Vitality Center was awarded more than $700,000 in federal funding for residential and outpatient treatment. Vitality Center will replace Reno’s SageWind, which is suspending its juvenile residential and outpatient program at the end of June for financial reasons. Sagewind had been the only juvenile residential treatment center in the area, while Quest Counseling, a 3-year-old Reno outpatient center for juveniles, is trying to expand into a separate 10-bed residential facility. Quest received no state Bureau of Alcohol and Drug Abuse funding during this last disbursement cycle because evaluators said Vitality Center could help more children. Instead, it will rely on funding from contracts and private donations.

Vitality Center has been offering adolescent services since 1979, most recently in Elko. The new BADA funding will go toward three buildings in Sun Valley that will provide a total of 30 residential beds for juveniles. Those buildings had been used for adult treatment. ‘There is a big need for adolescent care in Washoe County,’ said Vitality Center CEO Dorothy North. “Just looking at the numbers you can see treatment is a priority. Even if we fill all of our beds to capacity, there will be plenty of room for other agencies to fill their capacities, too.”

Last year, juveniles accounted for 15 percent of all admissions involving meth into BADA-funded treatment centers. Nevada has historically underfunded all substance-abuse treatment, but especially treatment for youth, said Assemblywoman Sheila Leslie. ‘There is a strong sense of denial about the seriousness of the problem,’ Leslie said. ‘No one likes to think about the image of a youth shooting up meth or prostituting themselves to buy drugs, yet we know the situation exists today right here in Reno.’

obesity -- updated 3/19/12

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Obesity is an indicator of increased risk of multiple diseases (diabetes, cardiovascular and heart disease, respiratory diseases, cancer, hypertension, stroke, liver and gallbladder disease, and other diseases), as well as the lifestyle in the Truckee Meadows. Being overweight increases healthcare costs for families, as well as lost business productivity, negatively impacting the health of our economy. Washoe County may be less obese than the state or nation, but the number of adults reporting overweight or obese in the CDC’s Behavioral Risk Factor Surveillance System survey is increasing at an alarming rate.  

Data sources vary for Nevada, but according to a 2006 report by the Trust for America’s Health (TFAH), Nevada’s adult obesity rate was 21.0%, ranking it the 42nd heaviest in the nation. Nationally, the obesity rate was 23.1%. Every state still exceeded the national Healthy People 2010 obesity rates of 15% by the year 2010;  Healthy People 2020 target is now 30.6%. No state experienced a decrease in the last year reported. TFAH recommendations include: community-driven efforts that increase access to healthy foods for low-income areas and improve the "built environment" (i.e., sidewalks, parks, bike paths); school-based efforts to strengthen physical fitness curricula and improve nutritional content; and employer-sponsored programs that offer more places and time to work out, subsidize health club memberships, and provide better insurance coverage for preventive services. Trust for America's Health.

Most health ratings list obesity and overweight rates separately. The standard used by researchers to define a person’s weight according to their height is Body Mass Index (BMI). An individual is overweight when their BMI is 25–29.9. An adult with a BMI of 30 or more is considered obese. Local surveys to assess the prevalence of overweight for the Washoe County District Health Department reported 2003 obesity for Washoe County at 19.4%. WCDHD  The Health District distributed a detailed report on overweight and obesity across lifespan, reported in their Epi-News, November 9, 2011, Vol. 31, No. 19 (the analysis includes Washoe County childhood BMI groupings and recommendations for prevention and intervention).

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low birth weight babies -- updated 3/2212

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The 2020 national goal for low birth weight babies—babies born alive who weigh less than 2,500 grams (5.5 pounds)—is not to exceed 7.8% of live births. Washoe County and Nevada not only exceed the national goal, but low birth weight as a percentage of live births continues to rise; and Washoe County continues to exceed Clark County. This is alarming also because low birth weight babies experience more long-term developmental and neurological disabilities than normal weight babies.  Health Services Research reported in a 1989 study that $1 spent on prenatal care saves $2.57 on medical care for low birth weight babies—imagine what that same $1 would save today.

According to CDC’s National Center for Vital Statistics, the national percent of births with low birth weight was 8.3% in 2006. According to the County Health Rankings project through the University of Wisconsin Population Health Institute in collaboration with the Robert Wood Johnson Foundation, the average percent of low birth weight births from 2000-2006 in Washoe County was 8.2% compared to 7.9 % for the state, 7.9% for Clark County and 7.6% for Carson City.

According to the National Kids Count, Nevada ranked 46th in country based upon the 15% change from 2000 (7.2%) to 2006 (8.3%);  Nevada ranked 41st in the country with a 13.6% preterm birth rate in 2004, compared to 12.3% rate nationally.

childhood immunizations -- updated 2/21/11

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Vaccinations can reduce the number of children who contract severe illnesses and prevent the spread of vaccine-preventable diseases later in life. The national Healthy People 2010 goal is 80% of all two-year old children immunized. In the early 1990s, the immunization rate for Nevada was under 40% for 2-year olds. Now it is over 60% for current federal standards. To reach the final 40% of 2-year olds will require a great deal more effort. Nevada continues to have one of the lowest immunization rates in the nation, ranking 51st in the CDC, National Immunization Survey, 2007. The Nevada Immunization Coalition is committed to turning things around and sorting out their major barriers to reaching the children of Nevada.

According to America’s Health Rankings, Nevada ranked 50th in the nation for the percentage of children ages 19 to 35 months immunization coverage (4:3:1:3:3 series) from 2005 through 2008 and 47th in 2009;  50th (4:3:1:3 series) from 2005 through 2008, and 49th in 2009.