i Letter from the Health Commissioner ii Executive Summary 1 Table of Contents 2 List of Figures and Tables 6 Introduction 7 Tools for Understanding This Report 8 Key Terms 14 Community Health Focus Groups Summary 18 About Montgomery County 20 Behavioral Health 20 Mental Health 24 Substance Misuse and Abuse 26 Accidental Drug Overdose 30 Maternal Child Health 30 Births 31 Preconception 32 Prenatal 33 Pregnancy/Postpartum 34 Birth Outcomes 36 Infant Mortality 38 Deaths 40 Chronic Disease Risks & Outcomes 40 Weight 42 Physical Activity 44 Food Insecurity & Nutrition 46 Alcohol Use 48 Tobacco Use 50 Diabetes 52 Cardiovascular Disease 54 Cancer & Preventative Screenings 58 Asthma 60 Health Risks & Outcomes 60 Injuries 62 Vaccinations 64 Communicable Diseases 66 Sexually Transmitted Diseases 68 HIV/AIDS

70 Access to Care 70 Medical Care 71 Dental Health 72 Hospital Utilization 74 Built Environment 76 Crime & Violence 80 Air Quality 81 Lead 82 Alcohol Retail Stores 83 Tobacco Vendors 84 Access to Food 85 Outdoor Recreation 86 Geographic Snapshots 88 Union, Clayton, Englewood, Butler Township & Vandalia 90 Huber Heights 92 Trotwood, Jefferson Township & Harrison Township 94 Phillipsburg, Germantown, Farmersville, German Township, Jackson Township, Brookville, Clay Township & New Lebanon 96 Riverside & Mad River Township 98 Moraine, West Carrollton, Miamisburg, & Miami Township 100 Oakwood & Kettering 102 Centerville & Washington Township 104 Dayton’s Northeast Area 106 Dayton’s North Central Area 108 Dayton’s Southwest Area 110 Dayton’s Downtown Area 112 Dayton’s Southeast Area 114 Data Sources 116 References

table of contentsCommunity Health Assessment 2019

2 I Community Health Assessment 2019

Key Community Health Indicators

Community Health Assessment 2019 • 1iv • Community Health Assessment 2019