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1
Monitoring The Human Condition
Study - 2009** TRENDS **
Presented By:
Warren Smith, Data Analyst
Barnstable County Dept. of Human Services
June 25, 2009
2
Background• Monitoring The Human Condition on
Cape Cod Study:– Health & Human Services Needs Assessment– Annual – Cape Cod Community Survey Findings – Five Years of Data (2004-2008)– Latest US Census Statistics– Findings Report in April – Findings Presented at May HHSAC Meeting– TRENDS Report in June
3
Today’s Presentation• Demographic Trends• Affordability Trends:
– Trade-Offs– Central Issues
• Trends in Eleven Key Areas:– Statistically-significant changes
4
Trends in Eleven Key Areas1. Food/Nutrition2. Housing3. Leisure Time/Recreation4. Medical/Dental5. Mental Health6. Overweight/Obesity7. Childcare8. Legal Assistance9. Transportation10. Discrimination11. Work/Employment
6
Population Changes
• Births• Public School Enrollment• Child Poverty• Median Income• Age Distributions• Median Age• Future Projections (Seniors/Elders)
7
1,850
1,950
2,050
2,150
2,250
2,350
2,450
2,550
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
2,470
1,987
Total Births To Barnstable County Mothers1989 - 2007
2,049
YEAR
1,905
Trendline
2005200019951990
Data Source: MA DPH MassCHIP @6/18/09
8
Total Public School Enrollment - Barnstable County, MA
30,744
29,909
29,179
28,445
27,594
26,000
26,500
27,000
27,500
28,000
28,500
29,000
29,500
30,000
30,500
31,000
2004-2005 2005-2006 2006-2007 2007-2008 2008-2009
School Year(Total PK - 12 plus SPED Enrollments as of October 1st)
Trendline
Change:-10% in past 4
years
9
17%
19%
21%
18%
16%
0%
5%
10%
15%
20%
25%
2004-2005 2005-2006 2006-2007 2007-2008 2008-2009
Low Income Students* as Percentage of Total EnrollmentBarnstable County, MA Public Schools
School Year(Enrollments as of October 1st)
Trendline
* "Low Income" as defined by Mass. Dept. of Education
Average # of Low Income Students = 5,269
10
$60,015
$56,974
$54,439
$68,290
$70,955$71,570
50,000
55,000
60,000
65,000
70,000
75,000
1 2 3
Median Income in Barnstable County, MA: 2005-2007Median Household Income and Median Family Income: (50%:50%)
YEAR
200720062005
Median Household Income
Median Family Income
Data Source: U.S. Census Bureau, Sel. Econ. Char's
(= 83% of Family Income)
(= 80% of Family Income)
( Growth: +5% in 2 Years)
( Growth: +10% in 2 Years)
11
Barnstable County Population Trends: Selected Age Groups
15,000
25,000
35,000
45,000
55,000
65,000
75,000
1 2 3
Year
Age 60+
Age 20-34
Ages 10-19
Ages 0-9
2005 2006 2007
Ages 35-59: Steady at about 78,000
Data Source:US Census Bureau (ACS)
(66,018)
(34,000)
(24,412)
(19,437)
NOTE:Cape's Population Under
Age 35 is Shrinking!(-3.5% in One Year)
(64,625)
(33,205)
(24,390)
(20,747)
12
Median Age in Barnstable County, MA (in years)
Age 46.5
Age 45.7
Age 45.6
45.0
45.2
45.4
45.6
45.8
46.0
46.2
46.4
46.6
1 2 3
YEAR
2006 20072005
+2%(in one year)
17
2nd and 1st Levels of Need
1. Air, Water, Food, Sleep, Clothing, Shelter
2. Health and Well-Being
19
Affordability Trends(2nd and 1st Level Items)
• Healthcare Affordability: (2nd level)– Health and Well-Being
• Basic Needs Affordability: (1st level)– Food– Clothing– Shelter
21
62%
74%
86%*
81%*
76%*
65%*
56%*
45%*
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
“Paying for a mental health counselor”
“Not able to afford nutritious food”
“Paying for or getting dental (insurance)care”
“Not being able to afford legal help”
“Not having enough money to pay thedoctor, the dentist, or buy presc. med's
“Not always having enough money for food”
“Not having enough money to pay forhousing”
“Not being able to afford recreationalactivities”
Percentage of Most Needy Households Reporting Problem as Minor-to-Major
Affordability Problems in Most Needy Households: Barnstable County, MA for Years 2004 - 2007
(2007)
(2007)
(2007)
(2007)
(2007)
(2007)
(2007)
(2007)
* Statistically Significant increase over 4-years
(2006)(2005)
(2004)
22
Affordability Barriers Reported in Most Needy Households:Barnstable County, MA for Years 2004-2007
57%
75%*
0% 10% 20% 30% 40% 50% 60% 70% 80%
“Could not afford fees or costs forservices”
“Paying insurance deductible/co-payments”
Percentage of Most Needy Households Reporting Barrier as Serious
(2007)
(2007)
(2004)
(2004)
* Statistically Significant increase over 4-years
(2005)
(2006)
(2005)
(2006)
(“The” Central Issue!)
23
“The” Central Issue• “Paying insurance deductible/co-payment”
– Strongly related to key affordability problems
– Correlated with “Could not afford fees or costs for services” (combined with it?)
– 58% of Most Needy households report this as a barrier to accessing needed services
– Statistical analysis (correlation) confirms strong links to affordability of nutritious food, dental care, and leisure time/recreation.
25
Historical Trade-Offs(Time Period: 2004-2007)
• Historically Inter-Related Affordability Cluster:– “Not able to afford nutritious food”– “Not always having enough money for food”– “Not being able to afford recreational activities”– “Not having enough money to pay for housing”– “Paying for a mental health counselor”– “Paying for or getting dental [insurance] care”– “Could not afford fees or costs for services”– “Paying insurance deductible/co-payments”
26
Today’s Trade-Offs(Latest 3-Years: 2006-2007-2008)
• Current Affordability Cluster:– “Not able to afford nutritious food”– “Not being able to afford recreational activities”– “Paying for or getting dental [insurance] care”– “Could not afford fees or costs for services”– “Paying insurance deductible/co-payments”
27
Trade-Offs Shown By Survey Cost of Living
Responses(Most Needy Households in 2008)
• To Afford Food: Trading Off
– Telephone service– Clothing store items
(all)
– Rent or lease payments
– Car/truck insurance– Transit services
• To Afford Nutritious Food:
Trading Off– Telephone service– Out-of-home fun
activities – Clothing store items– In-home fun
activities– Transit services
28
Trade-Offs (continued)
• To Afford Housing: Trading Off
– Telephone service– Electric service– Clothing store
items (school cloths)
• To Afford Medical/Dental Care:
Trading Off– Telephone service– Clothing store items
(casual cloths)
29
Trade-Offs (continued)
• To Afford Leisure Time and Recreation:
Trading Off– Nutritious foods– Clothing store items
(casual and dress cloths)
• To Afford Mental Health Care:
Trading Off– House or condo
payments
31
Definitions• Prevalence:
– How widespread is the problem/barrier?• Proportion of households reporting a problem
• Seriousness:– How detrimental is the problem/barrier?
• Degree of seriousness on a “scale” (moderate, very serious, so serious did not get needed help)
32
Food/Nutrition(Changes 2004 – 2007)
• Prevalence: – “Not always having
enough money for food” [+41%]
– “Not able to afford nutritious food” [+58%]
• Seriousness:– “Not always having
enough money for food” [+50%]
– “Not able to afford nutritious food” [+73%]
33
Housing(Changes 2004 – 2007)
• Prevalence: – “Not having enough
money to pay for housing” [+52%]
• Seriousness:– “Not having enough
money to pay for housing” [+66%]
– Overcrowding: “Not enough room in your house for all of the people who live there” [+43%]
34
Leisure Time/Recreation(Changes 2004 – 2007)
• Prevalence: – “Not being able to
afford recreational activities” [+29%]
• Seriousness:– “Not being able to
afford recreational activities” [+40%]
35
Medical/Dental(Changes 2004 – 2007)
• Prevalence: – Do any of the
house-hold insurances “provide for dental care?” [+39%]
– “Is any adult (age 18+) in Fair-to-Poor health” [+64%]
• Seriousness:– “Paying for or getting
dental (insurance) care”
[-10%]– “Not having enough
money to pay the doctor, dentist, or to buy prescription medications” [+21%]
36
Mental Health(Changes 2004 – 2007)
• Prevalence: – “Paying for a
mental health counselor” [+49%]
• Seriousness:– “Paying for a
mental health counselor” [+56%]
– “Having a lot of anxiety or stress in the household” [+19%]
37
Overweight/Obesity(Changes 2004 – 2007)
• Prevalence: – “Seriously
overweight person(s) in house-hold” [+1,749%]
• Seriousness:– “Seriously
overweight person(s) in house-hold” [+3,600%]
38
Childcare(Changes 2004 – 2007)
• Prevalence: – Average number of
“children (age 17 or younger) living in your household?” [-22%]
• Seriousness:– “Not being able to
find or afford after-school child care” [+39%]
39
Legal Assistance(Changes 2004 – 2007)
• Prevalence: – “Not being able to
afford legal help” [+27%]
• Seriousness:– “Not being able to
afford legal help” [+37%]
– “Immigration or Visa dispute” [+37%]
40
Transportation(Changes 2004 – 2007)
• Prevalence: – “Lack of
transportation” [+76%]
• Seriousness:– “Lack of
transportation” [+79%]
41
Discrimination(Changes 2004 – 2007)
• Prevalence: – “Feelings of
discrimination” [+47%]
• Seriousness:– “Feelings of
discrimination” [+69%]
– “Discrimination (due to race, age, language, sexual identity/orientation, etc.)” [+142%]
42
Work/Employment(Changes 2004 – 2007)
• Prevalence: – “All adults (age
18+) in your household are employed” [-31%]
• Seriousness:– “Unable to take
time away from work to go to services” [+17%]
43
Comment on 2008 Most Needy• Due to a much broader-based demographic profile of the
2008 Most Needy households:
– Household incomes are higher than usual:• Fewer affordability issues
– Education levels are higher
– Fewer children and child-related issues:• Fewer problems getting after-school child care
– Fewer housing issues and less overcrowding
– Fewer employed household members: • Fewer work-related access issues• Fewer leisure time/recreation issues• Fewer job training/skills upgrade issues• More retiree households
– More households have a working vehicle:• Fewer transportation issues
– Fewer feelings of discrimination
– Fewer system capacity complaints ("not accepting new clients”)
44
Q & A
• What surprised you?• What made you happy?• What made you sad?• What is most positive?• What is most negative?• What additional info do you need?• What should be next? . . . . . .
47
Who Are “Most Needy”
• Compared to Overall Cape Cod Sample:– Problems and Service Barriers:
• 2.5x to 3x Times More Households Report Problems/Barriers
also,• 2.5x to 3x Times More Seriousness Reported
49
Group #5: ALL Retired
Group #4: NOT All Retired
Group #3: Undefined Most Years
“Most Needy” Group #2
“Most Needy” Group #1
20%
80%
THEN
Working, Middle-Class Families/Individuals—”Doing OK, in General”