Community Health Status Assessment: Nelson County Mobilizing for Action through Planning and Partnerships A Compilation of Data that Reflects the Community’s

Community Health Status Assessment:

Nelson County

Mobilizing for Action through Planning and Partnerships

A Compilation of Data that Reflects the Community’s Health

DemographicsSocioeconomicsHealth Resource Availability

Section One: Who are we and what do we bring to the table?

Demographics

Population Growth TJHD by Locality, 1990-2010

Albemarle (18%)

Charlottesville (8%)

Fluvanna (28%)

Greene (21%) Louisa (29%) Nelson (4%)0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

100,000

68,172

40,475

12,42910,297

20,235

12,778

98,970

43,475

25,691

18,403

33,153

15,020

1990 2000 2010

Locality (% Change 2000-2010)

Nu

mb

er

of

Pe

rso

ns

Liv

ing

in L

oca

lity

Source: Weldon Cooper Center

Percent Change in PopulationTJHD by Locality, TJHD, and Virginia

1990-2010

Source: Weldon Cooper Center and the Thomas Jefferson District Planning Commission

1990 2000 2010 % Change 1990-2000

%Change 2000-2010

Albemarle 68,172 84,186 98,970 23% 18%

Charlottesville 40,475 40,099 43,475 -1% 8%

Fluvanna 12,429 20,047 25,691 61% 28%

Greene 10,297 15,244 18,403 48% 21%

Louisa 20,235 25,627 33,153 26% 29%

Nelson 12,778 14,445 15,020 13% 4%

TJHD 164,476 199,648 234,712 21% 18%

Virginia 6,189,317 7,079,030 8,001,024 14% 13%

Age and Sex DistributionNelson County, 2010

Source: U.S. Census Bureau

Under 5 years

5 to 9 years

10 to 14 years

15 to 19 years

20 to 24 years

25 to 29 years

30 to 34 years

35 to 39 years

40 to 44 years

45 to 49 years

50 to 54 years

55 to 59 years

60 to 64 years

65 to 69 years

70 to 74 years

75 to 79 years

80 to 84 years

85 to 89 years

90 years and over

2,0001,5001,00050005001,0001,5002,000

Male Female

Age DistributionNelson County, 2000, 2010


< 18 yrs 18-24 yrs 25-44 yrs 45-64 yrs 65+ yrsNelson

0

1000

2000

3000

4000

5000

6000

3,133

920

3,692

4,280

2,420

2,892

931

3,085

5,124

2,988

2000 2010

Nu

mb

er

of

Pe

rso

ns

Liv

ing

in L

oca

lity

Racial CompositionNelson County, 2010


• Other includes: American Indian, Alaska Native, Native Hawaiian, Pacific Islander, and some other race

White83.3%

Black13.1%

Asian0.5%

Other1.5%

Two or more races1.7%

White Black AsianOther Two or more races

Percent of Population by RaceTJHD by Locality, 1980-2010

Percent of Population

1980 1990 2000 2010

Albemarle CountyBlack 11% 10% 10% 10%

White 87% 86% 85% 81%

City of CharlottesvilleBlack 18% 21% 22% 19%

White 81% 76% 70% 69%

Fluvanna CountyBlack 29% 23% 18% 15%

White 70% 77% 79% 81%

Greene CountyBlack 8% 6% 6% 6%

White 92% 93% 91% 88%

Louisa CountyBlack 33% 26% 22% 18%

White 67% 74% 77% 78%

Nelson CountyBlack 24% 19% 15% 13%

White 76% 80% 83% 83%


Percent Change in Hispanic PopulationNelson County and Virginia, 2000-2010


Nelson Virginia0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

2000 2010

Pe

rce

nt

of

To

tal P

ers

on

s L

ivin

g in

Lo

calit

y th

at

is H

isp

an

ic

305

459

51% increase

92% increase

1,102

329,540

631,825

Limited English Proficient Student Enrollment Nelson County, TJHD, and Virginia, 2002-2012

Source: Virginia Department of Education

2002-03 2003-04 2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12-1%

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

10%

11%

12%

1.9%

2.2%

2.9%

4.6%4.2%

7.2%

Nelson TJHD Virginia

Pe

rce

nt

of

To

tal S

tud

en

ts E

nro

lled

in P

ub

lic

Sch

oo

ls

SSI and Disabled OASDI BeneficiariesTJHD by Locality and Virginia, 2011

Source: U.S. Social Security Administration; U.S. Census Bureau

Total Number of

BeneficiariesTotal

PopulationPercent of the

Population

Albemarle 2,428 98,970 2.45%

Charlottesville 1,806 43,475 4.15%

Fluvanna 899 25,691 3.50%

Greene 725 18,403 3.94%

Louisa 1,850 33,153 5.58%

Nelson 891 15,020 5.93%

Virginia 355,299 8,001,024 4.44%

Residents who received SSI (Supplemental Security Income) benefits, excluding those who also received OASDI (Old-Age, Survivors, and Disability Insurance) benefits to avoid duplication, PLUS persons classified as “Disabled” who received OASDI benefits.

Percent of Supplemental Security Income (SSI) Recipients

Nelson County, 2010

Nelson County2.4%

Source: Weldon Cooper Center, County Health Rankings; U.S. Social Security Administration

*Measured as December 2010 recipients of SSI benefits divided by the total population

Percent of Students Receiving Special Education

Nelson County, 2006-2010

Source: Virginia Department of Education; U.S. Census Bureau, Small Area Health Insurance Estimates

2006 2007 2008 2009 20100%

1%

2%

3%

4%

5%

6%

7%

8%

9%

10%

11%

9.78%

8.61%

Nelson

Pe

rce

nt

of

To

tal C

hild

ren

Ag

ed

19

an

d U

n-

de

r L

ivin

g in

Lo

calit

y

2008 2009 2010 2011 2008 2009 2010 2011Nelson Virginia

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

80.1% 78.7% 77.8%85.3% 82.1% 83.2%

85.5% 86.6%

72.5%

64.8%

72.2%

84.2%

70.6% 73.2%

77.6% 79.9%

Pe

rce

nt

of

Stu

de

nts

in C

oh

ort

**

On-Time* Graduation Rate Nelson County and Virginia, 2008-2011


*The percentage of students in a cohort who earn a diploma within 4 years of entering high school**Cohort: Students who entered the ninth grade for the first time together and were scheduled to graduate 4 years later

Educational AttainmentCharlottesville Metro Area, and Virginia, 2011

Source: American Community Survey

High School 2011 Bachelor's Degree 2011 Advanced Degree 20110%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

88.1%

44.7%

21.5%

87.8%

35.1%

14.6%

Charlottesville Metro Area Virginia

Pe

rce

nt

of

To

tal P

ers

on

s A

ge

d 2

5 a

nd

O

ver

Liv

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in L

oca

lity

Socioeconomics

Median Household IncomeNelson County, Virginia, and U.S., 2000-2011

Source: U.S. Census Bureau, Small Area Income and Poverty Estimates

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011$0

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000

$35,000

$40,000

$45,000

$50,000

$55,000

$60,000

$65,000

$70,000

$75,000

$37,565

$46,055

$46,789

$61,877

$41,990

$50,502

Nelson Virginia U.S.

An

nu

al I

nco

me

in D

olla

rs

Nelson County13.1%

Source: Weldon Cooper Center; U.S. Census Bureau, Small Area Income and Poverty Estimates

Percent of Persons in PovertyNelson County, 2010

Percent of Persons in Poverty Nelson County, Virginia, and U.S., 2000-2011


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011-2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

22%

24%

26%

28%

30%

10.3%

13.6%

8.9%

11.6%

11.3%

15.9%


Pe

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nt

of

To

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ers

on

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ivin

g in

Lo

calit

y

Percent of Children in PovertyNelson County, Virginia, and U.S., 2000-2011


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011-2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

22%

24%

26%

28%

30%

14.6%

21.0%

12.2%

15.6%

16.2%

22.5%


Pe

rce

nt

of

To

tal C

hild

ren

Ag

ed

18

an

d U

nd

er

Liv

-in

g in

Lo

calit

y

2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-120%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

55%

60%

42.9%

55.2%

50.1%

30.2%

36.0%32.9%

39.7%


Pe

rce

nt

of

To

tal S

tud

en

ts E

nro

lled

in P

ub

lic

Sch

oo

ls in

Lo

calit

yPercent of Students Eligible for

Free/Reduced Lunch Nelson County, TJHD, and Virginia, 2005-2012

Source: Virginia Department of Education, School Nutrition Program

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 20110

100

200

300

400

500

600

700

800

900

1,000

1,100

1,200

410

1,099

Nelson

Nu

mb

er

of

Ho

use

ho

lds

En

rolle

dNumber of Households Receiving Supplemental Nutrition Assistance


Source: Virginia Department of Social Services

168% increase

Nelson County13.7%

Source: Weldon Cooper Center; Virginia Department of Social Services

Percent of Supplemental Nutrition Assistance Program (SNAP) Participants

Nelson County, 2010

*Measured as average monthly persons on SNAP divided by the total population

Number of Homeless PersonsTJHD, 2004-2011

Source: Thomas Jefferson Area Coalition for the Homeless (TJACH)

2004 2005 2006 2007 2008 2009 2010 20110

50

100

150

200

250

300

129

277

235

35 18

Sheltered Unsheltered

Nu

mb

er

of

Ho

me

less

Pe

rso

ns

Unemployment RateNelson County, TJHD, Virginia, and U.S., 2000-2011

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 20110%

1%

2%

3%

4%

5%

6%

7%

8%

9%

10%

11%

Nelson; 2.3%

Nelson; 5.4%

TJHD 2.1%

TJHD 5.5%

Virginia 2.3%

6.2%

4.0%

8.9%

Nelson TJHD Virginia United States

Per

cent

of T

otal

Per

sons

Age

d 16

and

Ove

r Li

ving

in L

ocal

ity

Source: Virginia Workforce Connection

Health Resource Availability

Sources of Health Insurance Virginia and U.S., 2010

Source: Kaiser Family Foundation

Virginia United States

Employer; 49%

Medicare; 13%

Medicaid; 16%

In-di-vidual; 5%

Other

Pub-lic; 1%

Uninsured;

16%

Employer; 55%

Medicare; 12%

Medicaid; 9%

In-di-vid-ual; 5%

Other Pub-lic; 4%

Uninsured; 14%

Percentages may not sum to 100% due to rounding effects

Health Insurance Coverage by AgeVirginia, 2010-2011

Source: U.S. Census Bureau, Annual Social and Economic Supplement

< 18 yrs 18-64 65+ yrs0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

67.7%70.3%

61.8%

35.4%

18.0%

94.9%

5.9%

18.8%

0.8%

Private Government Not Covered

Pe

rce

nt

of

To

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ers

on

s in

Ag

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rou

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ivin

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in L

oca

lity

Estimated Uninsured Persons, 18-64Nelson County, TJHD, and Virginia, 2005-2010

Source: U.S. Census Bureau, Small Area Health Insurance Estimates

2005 2006 2007 2008 2009 20100%

5%

10%

15%

20%

25%

30%

35%


Pe

rce

nt

of

To

tal P

ers

on

s A

ge

d 1

8 t

o 6

4 L

ivin

g

in L

oca

lity

Estimated Uninsured Persons <19 YearsNelson County and Virginia, 2006-2010

Source: U.S. Census Bureau, Small Area Health Insurance Estimates

2006 2007 2008 2009 20100%

2%

4%

6%

8%

10%

12%

14%

16%

18%

15.2%

10.2%

12.8%

7.9%

10.4%

7.0%


Pe

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nt

of

Pe

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ns

Ag

ed

Le

ss t

ha

n 1

9 Y

ea

rs

Liv

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in L

oca

lity

Medicaid Enrollment and Spending by Recipient Group Virginia and U.S., FY 2009

Source: Kaiser Family Foundation

Enrollment 0.95M

Spending $5.55B

Enrollment 62.59M

Spending $346B


0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

55%

25%

49%

21%

16%

10%

26%

14%

11%

20%

10%

23%

18%

45%

15%

42%

Children Adults Elderly Disabled

Pe

rce

nt

of

To

tal E

nro

llme

nt/

Sp

en

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g

United StatesVirginia

Number of Primary Care ProvidersTJHD by Locality, 2011

Source: UVA Physician Directory; Martha Jefferson Hospital Physician Directory

Internal

MedicinePediatrics

Family Medicine

OB/GYN Geriatrics

Albemarle/Charlottesville 65 39 67 27 8

Fluvanna 3 1 4 - 1

Greene - - 4 - -

Louisa 1 1 8 - -

Nelson - - 9 - -

TJHD 69 41 92 27 9

Number of Charlottesville Free Clinic Medical Patients

TJHD by Locality, FY2012

61040.48%

52134.57%

1036.83%

583.85%

916.04%

261.73%

956.30%

30.20%

Albemarle Charlottesville Fluvanna Greene Louisa Nelson Other Unknown

Source: Charlottesville Free Clinic

Number of Dental Service ProvidersTJHD by Locality, 2012

Source: Community Dental Center; DentaQuest; yellow pages

Dentists in General Practice, Oral Surgery and Pediatric Specialists

Albemarle/Charlottesville 189

Fluvanna 11

Greene 8

Louisa 9

Nelson 10

Number of Charlottesville Free Clinic Dental Patients

TJHD by Locality, FY2012

Source: Charlottesville Free Clinic

98952.80%

55829.79%

1105.87%

985.23%

573.04%

30.16%

542.88%

40.21%

Albemarle Charlottesville Fluvanna Greene Louisa Nelson Other Unknown

Average Number of Community Dental Center Patients Served Per Month, FY2010-2012

Source: Community Dental Center

FY2010 FY2011 FY20120

50

100

150

200

250

300

350

400

450

500

550

600

495

564

522

Ave

rag

e N

um

be

r o

f P

atie

nts

Se

rve

d P

er

Mo

nth

Medicaid/FAMIS Enrollees <19 Years Receiving Dental Services

Nelson County and TJHD, FY 2007- FY 2010

Source: Virginia Smiles for Children

2006-2007 2007-2008 2008-2009 2009-20100%

10%

20%

30%

40%

50%

60%

41.8%44.2%

47.2%

50.3%

40.4%

44.2%46.4%

52.3%

Nelson TJHD

Pe

rce

nt

of

To

tal P

ed

iatr

ic M

ed

ica

id/F

AM

IS

En

rolle

es

Liv

ing

in L

oca

lity

Number of Licensed Mental Health Providers TJHD by Locality, 2011

Source: Mental Health America

Clinicians Practices

PsychiatristsLicensed Therapists

Total Practices

Practices Serving Youth

Practices Accepting Medicaid

Albemarle/Charlottesville

24 115 66 7 35

Fluvanna 0 3 3 2 2

Greene 0 1 1 1 1

Louisa 2 16 4 2 2

Nelson 0 3 2 2 2

TJHD 26 135 73 11 39

Number of Region Ten Community Services Board Direct Service Staff

TJHD by Locality, 2012

Source: Region Ten

Number of Mental Health

Direct Service Staff

Albemarle/Charlottesville 161

Fluvanna 11

Greene 15

Louisa 14

Nelson 18

TJHD 219

All mental health direct service staff at Region Ten – anyone who provides mental health services, whether licensed or not

Number of Public Health Staff by SpecialtyTJHD by Locality, 2012

Local Health

Department

Number of Full-Time Equivalent Positions

Public Health Nurses

Environmental Health

SpecialistsNutritionists Clinicians

Public Health

Specialists

Albemarle/Charlottesville

10.65 9.00 3.70 0.70 4.40

Fluvanna 2.40 1.47 0.19 0.11 0.80

Greene 2.45 1.52 0.29 0.11 0.80

Louisa 4.85 2.59 0.63 0.37 2.00

Nelson 2.15 1.42 0.19 0.11 0.80

TJHD 22.50 16.00 5.00 1.40 8.80

Source: Thomas Jefferson Health District

Section Two: What are the strengths and risks in our community that

contribute to health?

Community ResourcesCommunity SafetyEnvironmental QualityHealth Behaviors

Community Resources

JAUNT PassengersNelson County, FY2008-FY2012

Source: Jaunt Ridership Report

*Passengers are counted by trip and may be duplicated

FY08 FY09 FY10 FY11 FY120

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000

16,018

14,037

18,508

Nelson

Nu

mb

er

of

Pa

sse

ng

ers

(b

y p

lace

of

ori

gin

)

JAUNT Passengers by TypeTJHD, FY2008–FY2012

Source: Jaunt Ridership Report

FY08 FY09 FY10 FY11 FY120

50,000

100,000

150,000

200,000

250,000

300,000

350,000

75,353 82,703 84,080 81,128 86,606

92,19696,408 96,110 98,122 100,738

67,17879,322 84,377 93,819

93,279

Medical Elderly and Disabled (nonmedical)Children and Youth Elderly Nutrition ServicesRural Routes Other

Nu

mb

er

of

Pa

sse

ng

ers

Recreational Facilities TJHD by Locality and Virginia, 2009

Source: County Health Rankings

Albemarle Charlottesville Fluvanna Greene Louisa Nelson Virginia0

5

10

15

20

25

12.6

21.3

7.8

5.4

9.1

6.5

11

Fa

cilit

ies

pe

r 1

00

,00

0 P

ers

on

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ivin

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Lo

cal-

ity

National Bench-mark

Food Stores by TypeNelson County, 2009

Source: U.S. Department of Agriculture

4

167

7

1

Grocery stores Supercenters & club stores Convenience storesSpecialized food stores Fast-food restaurants Full-service restaurantsFarmers' markets

Number of children < 5 yrs old residing in locality 7,832 1,592 1,310 2,029 727

Licensed Childcare Centers & Preschool Programs

Number of Slots Available (Includes 1 mo to 5 yrs old and 6-12 yrs old after school) 3,919 279 434 381 393

Number of Facilities 54 4 7 12 7

Number of those Facilities that Accept

Ages

1 mo to 1 yr old 19 2 1 1 -1 to 2 yrs old 6 - 1 - -2 to 4 yrs old 23 - 3 7 54 to 5 yrs old 6 2 2 4 2

Family Day Homes

Number of Slots Available (Includes 1 mo to 5 yrs old and 6-12 yrs old after school) 174 44 0 76 12

Number of Facilities 16 4 0 7 1

Number of those Facilities that Accept

Ages

1 mo to 1 yr old 12 2 - 7 11 to 2 yrs old 1 2 - - -2 to 4 yrs old 3 - - - -4 to 5 yrs old - - - - -


Licensed Child Care FacilitiesTJHD by Locality, 2012

Fluvanna

GreeneLouisa

Nelson

Charlotte

sville &

Albemarle

Community Safety

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 20110

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

11000

12000

13000

14000

3,724.50

2,782.93

6,016.59

4,336.80

Nelson TJHD

Re

po

rte

d G

rou

p A

Off

en

ses*

pe

r 1

00

,00

0

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Liv

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lity

Reported Crime Incident Rates Nelson County and TJHD, 2000-2011

*Reported Group A Offenses; arson, assault, bribery, burglary, counterfeiting/forgery, destruction/damage/vandalism of property; drug/narcotic; embezzlement; extortion/blackmail; fraud; gambling; homicide; kidnapping/abduction; larceny/theft; motor vehicle theft; pornography/obscene material; prostitution; robbery; sex, forcible and non-forcible; stolen property; weapon law violations

Source: Department of State Police, Virginia Uniform Crime Reporting Program

Violence Incidence Rates in SchoolsNelson County, TJHD, and Virginia, 2007-2011


0

2

4

6

8

10

12

14

16

18

20

22

24

2624.95

3.92

8.14

4.34 3.85

0.61

2.66

0.38

3.78

5.54

15.47

2.74

6.53

2.64

5.20

0.36

2.571.00

1.58

6.08

12.73

3.465.03

2.47

6.67

0.35

5.14

0.96 1.45

4.82


Inci

de

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pe

r 1

,00

0 S

tud

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in

Pu

blic

Sch

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ls in

Lo

calit

y

Founded Child Abuse and Neglect Rates

TJHD and Virginia, 2000-2011


*Five-year rolling averages of Rate of Abuse and Neglect per 1,000 Children (Founded Investigations and Duplicated)

2000-04 2001-05 2002-06 2003-07 2004-08 2005-09 2006-10 2007-110

1

2

3

4

5

6

7

1.94

2.853.03

2.47

TJHD Virginia

Fo

un

de

d C

hild

Ab

use

an

d N

eg

lect

Re

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pe

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0 C

hild

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Ag

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0-1

7 L

ivin

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Lo

calit

y

Reported Adult Abuse and Neglect Rates, TJHD and Virginia, 2008-2011


2008 2009 2010 20110

1

2

3

4

5

6

7

8

9

10

11

12

5.254.96

2.41 2.88

TJHD Virginia

Ad

ult

Pro

tect

ive

Se

rvic

e R

ep

ort

s p

er

1,0

00

A

du

lts A

ge

d 1

8 a

nd

Ove

r L

ivin

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Lo

calit

y

Drug/Narcotic Arrest RatesNelson County, TJHD, and Virginia, 2000-2011


2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-10 2009-110

100

200

300

400

500

600

700

800

900

1000

1100

1200

293.1318.4

439.2

495.0455.4

595.7


Dru

g/N

arc

otic

Arr

est

s p

er

10

0,0

00

Pe

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ns

Liv

-in

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Lo

calit

y

Driving Under the Influence (DUI) Arrest Rates Nelson County, TJHD, and Virginia, 2000-2011

2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-10 2009-110

50

100

150

200

250

300

350

400

450

500

550

600

650

700

750

800

850

900

188.2

120.2

TJHD 348.4

251.9

Virginia 352.0 368.0


DU

I A

rre

sts

pe

r 1

00

,00

0 P

ers

on

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ivin

g in

Lo

calit

y


Environmental Quality

Air Quality Index Report Charlottesville, Fairfax, Richmond, and Virginia Beach

2011

Source: Environmental Protection Agency

Air Quality Rating

Total Number of

Days Monitored

(Number of days at each rating)

Good Moderate

Unhealthy for

Sensitive Groups

Unhealthy for

Anyone

Charlottesville CBSA 330 (91%) 34 (9%) 0 (0%) 0 (0%) 364

Fairfax CBSA 295 (82%) 54 (15%) 9 (2%) 2 (1%) 360

Richmond CBSA 283 (78%) 70 (19%) 11 (3%) 1 (0%) 365

Virginia Beach CBSA 276 (76%) 79 (21%) 10 (3%) 0 (0%) 365*Cities are defined as Core Based Statistical Areas (CBSA) – Charlottesville CBSA includes Albemarle, Fluvanna, Greene, and Nelson Counties and the City of Charlottesville; Richmond CBSA includes the Amelia, Caroline, Charles City, Chesterfield, Cumberland, Dinwiddie, Goochland, Hanover, Henrico, King And Queen, King William, Louisa, New Kent, Powhatan, Prince George and Sussex Counties as well as the Cities of Colonial Heights, Hopewell, Petersburg and Richmond.

Good and Impaired Streams in Watersheds Nelson County, 2008


Maury Middle James - Buffalo Rivanna South Fork Shenandoah0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

23

7827

117

33

5928

39

Impaired Streams Good Streams

Pe

rce

nt

of

To

tal S

tre

am

s in

Wa

ters

he

d

Watersheds that Drain IntoNelson County


Middle James - Buffalo

Rivanna

South Fork Shenandoah

MauryNelsonCounty

Impaired StreamsNelson County, 2010

Source: Thomas Jefferson District Planning Commission

Tye River North Fork

Buffalo River

Rockfish River

Rivanna: Biological Health ScoresNelson County, 2006-2009

Source: StreamWatch

6%

22%

56%

13%

3%

Very Good Good

Fair Poor

Very Poor

Samples are scored per an index that reflects the composition and diversity of the array of captured organisms. Site health is assessed based on all scores generated during the assessment window

Lead Exposure: At-Risk Zip Codes*TJHD by Locality, 2011

Source: Virginia Department of Health, Lead Safe Virginia

Albemarle 2290122931

(Covesville)22937

(Esmont)22943

(Greenwood)22947

(Keswick)22959

(North Garden)24590

(Scottsville)

Charlottesville 22903

Fluvanna 23022 23084

Greene 22935(Dyke)

Louisa 23024

Nelson 22938 (Faber)

22964 (Piney River)

22969 (Schuyler

)

22971 (Shipman)

24464 (Montebello

)

24553 (Gladstone)

*VDH identifies areas in Virginia at risk for lead exposure as those with more than 27% of homes built before 1950 and/or those with an increased prevalence of children with elevated blood lead levels (EBLL)

Elevated Blood Lead Level Tests and Results in Children <72 Months of Age

Nelson County and TJHD, 2004-2011

Source: Virginia Department of Health, Lead Safe Virginia

2004 2005 2006 2007 2008 2009 2010 20110

10

20

30

40

50

60

70

80

90

100

0

250

500

750

1,000

1,250

1,500

1,750

2,000

2,250

2,500

3 41

23 3

30

11

9 63 10 10

894 90

150127 113

198 176 195

859

963

2,153

1,929

1,052

1,980

1,852

2,402

Nelson TJHD NelsonTJHD

Nu

mb

er

of

Te

sts

Re

turn

ing

Po

sitiv

e (

ba

rs)

Nu

mb

er

of

Ch

ildre

n <

72

Mo

nth

s o

f A

ge

Te

ste

d

(Lin

es)

Health Behaviors

Low dietary polyunsaturated fatty acids (PUFA)

Low intake of fruits and vegetables

Alcohol use

High dietary trans fatty acids

Low dietary omega-3 fatty acids

High dietary salt

High LDL cholesterol

High blood glucose

Physical inactivity

Overweight-obesity (high BMI)

High blood pressure

Tobacco smoking

0 100 200 300 400 500

15

58

64

82

84

102

113

190

191

216

395

467

Septicemia

Kidney Disease

Influenza and Pneumonia

Alzheimer's Disease

Diabetes

Unintentional Injuries

Chronic Lower Respiratory Diseases

Stroke

Cancer

Heart Disease

-10% 0% 10% 20% 30%

1.4%

1.8%

2.5%

2.8%

3.1%

4.7%

5.1%

6.3%

23.1%

37.2%

Percentage of Total Deaths Deaths (in thousands)

Source: Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, et al. (2009) The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors. PLoS Med 6(4):Heron, M., Tejada-Vera, B. (2009). Deaths: Leading Causes for 2005. National Vital Statistics Reports. 58(8)

Leading Causes of Death Deaths Attributable to Individual Risk Factors

Leading vs. Actual Causes of Death

Self-Reported Adult SmokersTJHD and Virginia, 2000-2010

2000-2002 2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 2007-2009 2008-20100%

5%

10%

15%

20%

25%

17.6% 17.9%

22.9%

18.0%

TJHD Virginia

Pe

rce

nt

of

Ad

ults

Ag

ed

20

an

d O

ver

Liv

ing

in

Lo

calit

y

Healthy People 2020

Source: Virginia Department of Health, Virginia Behavioral Risk Factor Surveillance Survey

Tobacco Facts Virginia, 2012


Adult Smoking Rank(1st = low smoking rates)

31st N/A

Cigarette Tax(per pack)

$0.30($0.35 local tax for Cville)

$1.46

Cigarette Tax Rank(1st = high taxes)

50th N/A

FY 2012 Funding for State TC Programs(millions)

$8.4 $456.7

Tobacco Prevention Spending % of CDC Target

8.1% 12.5%

Tobacco Prevention Spending Rank(1st =high spending rates)

30th N/A

Source: Campaign for Tobacco-Free Kids; City of Charlottesville City Treasurer Website

Physical InactivityTJHD by Locality and Virginia, 2009

Source: Behavioral Risk Factor Surveillance System; County Health Rankings *Numbers are self-reported

Albemarle Charlottesville Fluvanna Greene Louisa Nelson Virginia0%

5%

10%

15%

20%

25%

30%

35%

19%

26%

22%

24%

30%

25%24%

Est

ima

ted

pe

rce

nt

of

ad

ults

ag

ed

20

an

d o

ver

rep

ort

ing

no

le

isu

re t

ime

ph

ysic

al a

ctiv

ity

Obesity Trends Among U.S. Adults1985

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System


No Data <10% 10%–14%



No Data <10% 10%–14% 15%–19%




No Data <10% 10%–14% 15%–19% ≥20%




No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%




No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%




Percentage of Adults Who Are Obese TJHD by Locality, 2009

Nelson County26.4%

Source: Centers for Disease Control and Prevention: National Diabetes Surveillance System

**Body mass was derived from self-report of height and weight from adults 20 and Over.

*Obese = Body Mass Index (BMI) ≥30, or ~ 30 lbs. overweight for 5’ 4” person

Percentage of Adults Who Are Obese TJHD and Virginia, 2000-2010

Source: Virginia Department of Health, Virginia Behavioral Risk Factor Surveillance Survey

2000-2002 2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 2007-2009 2008-2010

-5%

0%

5%

10%

15%

20%

25%

30%

35%

21.6%

27.6%

21.0%

25.9%

TJHD Virginia

Pe

rce

nt

of

Ad

ults

Ag

ed

20

an

d O

ver

Liv

ing

in L

oca

l-ity

Percentage of 5th &10th Graders Who Are Overweight or Obese

Nelson County Public Schools, 2009-2011

Source: Blue Ridge Medical Center

5th 10th 5th 10th 5th 10th2008-2009 2009-2010 2010-2011

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

25.0%15.7%

20.3%13.1% 14.9% 17.5%

25.6%

32.8% 26.1%

22.6%

31.2% 29.9%

% Overweight % Obese

Pe

rce

nt

of

Fift

h a

nd

Te

nth

Gra

de

rs E

nro

lled

in

Pu

blic

Sch

oo

ls in

Lo

calit

y

Seat Belt UsageVirginia, 1987-2011

Source: Virginia Department of Motor Vehicles, Highway Safety Office

19871988

19891990

19911992

19931994

19951996

19971998

19992000

20012002

20032004

20052006

20072008

20092010

20110%5%

10%15%20%25%30%35%40%45%50%55%60%65%70%75%80%85%90%95%

100%

32.5%

81.8%

Virginia

National Average

Pe

rce

nt

of

Dri

vers

an

d P

ass

en

ge

rs U

sin

g S

ea

t B

elts

Three Year Rolling Average Number of Hospitalizations from Motor/Other Vehicle Accidents With and Without Safety

Device Usage, Nelson County, 2007-2011

Source: Virginia Department of Health, Office of Emergency Medical Services

*Safety Devices include air bags, child safety seats, helmets, and safety belts; note that the presence of a safety device does not necessarily imply that it was used (properly or otherwise). Similarly, "none" does not necessarily mean that safety device was not used

2007-09 2008-10 2009-110

2

4

6

8

10

12

10.010.7

9.7

9.710.3

8.0

Nelson with SD Nelson without SD

Nu

mb

er

of

Ho

spita

liza

tion

s fr

om

MV

As

Source: Virginia Department of Health, Division of Immunization

2008 2009 2010 20110%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

95.9% 95.1% 94.8% 93.4%

40.9%

95.7%

84.8%

94.7%

Public School Private School

Pe

rce

nt

of

Kin

de

rga

rte

ne

rs E

nro

lled

in R

e-

po

rtin

g S

cho

ols

*Percentage of Adequately Immunized

KindergartenersTJHD, 2008-2011

*Includes schools that submit student immunization survey results in the Fall of each year – approximately 30 public schools and 6 private schools (only 2 private schools reported in 2008)

2008 2009 2010 20110%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%97.5% 97.0% 97.8%

88.4%

21.4%

94.9%

81.8%78.8%

Public School Private School

Pe

rce

nt

of

Six

th G

rad

ers

En

rolle

d in

Re

po

rt-

ing

Sch

oo

ls*

Percentage of Adequately Immunized Sixth Graders

TJHD, 2008-2011

*Includes schools that submit student immunization survey results in the Fall of each school year – approximately 10 public schools and approximately 8 private schools (only 2 private schools reported in 2008)

Source: Virginia Department of Health, Division of Immunization

Section Three: What is our health status?

Maternal and Child HealthLeading Causes of DeathCancerUnintentional InjuryInfectious DiseasesAmbulatory Care Sensitive ConditionsMental Health

Maternal and Child Health

Live Birth RatesNelson County, TJHD, and Virginia, 1998-2011

Source: Virginia Department of Health, Division of Health Statistics

*Live Births Counted by Place of Residence

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 20110

2

4

6

8

10

12

14

16

18

20

Nelson 13.7

8.3

12.9

10.8

Virginia 13.9

12.7


Liv

e B

irth

s* p

er

1,0

00

To

tal P

ers

on

s L

ivin

g in

Lo

cal-

ity

Infant Mortality Rates*TJHD and Virginia,1999-2011


*Deaths among infants <1year of age

1999-2003 2000-2004 2001-2005 2002-2006 2003-2007 2004-2008 2005-2009 2006-2010 2007-20110

2

4

6

8

10

12

14

16

18

20

22

7.06.3

7.2 7.0

TJHD Virginia

Healthy People 2020

Infa

nt

De

ath

s p

er

1,0

00

Liv

e B

irth

s b

y P

lace

of

Re

si-

de

nce

Infant Mortality Rates* by Race TJHD, Virginia, and U.S., 1999-2011


1999-2003 2000-2004 2001-2005 2002-2006 2003-2007 2004-2008 2005-2009 2006-2010 2007-20110

2

4

6

8

10

12

14

16

18

20

22

14.9

17.3

13.8

13.8

TJHD White 5.7

TJHD White 4.5

Virginia White; 5.6 Virginia White; 5.4

TJHD Black Virginia Black U.S. Black TJHD White Virginia White U.S. White

Healthy People 2020

Infa

nt D

eath

s pe

r 1,

000

Live

Birt

hs b

y P

lace

of

Res

iden

ce

*Deaths among infants <1year of age

Neonatal Death Rate* TJHD and Virginia, 1999-2011


*Deaths among infants <28 days of age

1999-2003 2000-2004 2001-2005 2002-2006 2003-2007 2004-2008 2005-2009 2006-2010 2007-20110

2

4

6

8

10

12

14

16

18

20

22

4.4 4.3

5.0 4.7

TJHD Virginia

Healthy People 2020

Infa

nt

De

ath

s p

er

1,0

00

Liv

e B

irth

s b

y P

lace

of

Re

si-

de

nce

Percentage of Preterm* BirthsNelson County, TJHD, West Central Perinatal Region and

Virginia, 2001-2010

Source: Virginia Department of Health

*Percent of live births born less than 37 weeks gestation

2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 2007-2009 2008-20100%

1%

2%

3%

4%

5%

6%

7%

8%

9%

10%

11%

12%

13%

8.59%

6.28%

8.27% 8.29%

9.77%

8.73%

10.37% 10.26%

Nelson TJHD West Central Perinatal Region Virginia

Pe

rce

nt

of

To

tal L

ive

Bir

ths

by

Pla

ce o

f R

esi

-d

en

ce

Healthy People 2020

Percentage of Low-Weight* BirthsNelson County, TJHD, Virginia, and U.S., 1999-2011


*Low Birth Weight = Live Births Weighing <2500 grams

1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-10 2009-110%

1%

2%

3%

4%

5%

6%

7%

8%

9%

10%

11%

12%

13%

14%

8.9%

5.8%TJHD 7.1%

TJHD 7.6%Virginia 7.9%

Virginia 7.9%

U.S. 7.5%

8.2%

Nelson TJHD Virginia U.S.

Healthy People 2020

Per

cent

of T

otal

Liv

e B

irths

by

Pla

ce o

f Res

i-de

nce

Percentage of Low-Weight Births* by Race, Nelson County, TJHD, and Virginia, 1999-2011


1999-01

2000-02

2001-03

2002-04

2003-05

2004-06

2005-07

2006-08

2007-09

2008-10

2009-11

0%50%

100%150%200%250%300%350%400%450%500%550%600%650%700%750%800%850%900%950%

1000%

Nelson Black TJHD Black Virginia Black Nelson White TJHD WhiteVirginia White

Pe

rce

nt

of

To

tal L

ive

Bir

ths

by

Pla

ce o

f R

esi

-d

en

ce

Healthy People 2020

*Low Birth Weight = Live Births Weighing <2500 grams

Teen Pregnancy Rates: Ages 10-19Nelson County, TJHD, and Virginia, 2000-2011


2000-2002 2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 2007-2009 2008-2010 2009-20110

5

10

15

20

25

30

35

40

45

50

55

60

65

34.9

19.1

23.2

15.6

29.6

21.3


Pre

gn

an

cie

s p

er

1,0

00

Fe

ma

les

Ag

ed

10

to

19

Teen Pregnancy Rates: Ages 15-17Nelson County, TJHD, and Virginia, 2000-2011


2000-2002 2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 2007-2009 2008-2010 2009-20110

5

10

15

20

25

30

35

40

45

50

55

60

65

70

33.4

9.9

27.6

13.3

31.3

19.1


Pre

gn

an

cie

s p

er

1,0

00

Fe

ma

les

Ag

ed

15

-17

Healthy People 2020

Teen Pregnancy Rates by Race: Ages 10-19, Nelson County, TJHD, and Virginia, 2000-2011


2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-10 2009-110

5

10

15

20

25

30

35

40

45

50

55

60

65

70

75

47.5

Nelson Black 16.7

41.2

26.2

48.7

35.1

31.8

19.4

19.5

13.8

23.6

Virginia White 16.7


Pre

gnan

cies

per

1,0

00 F

emal

es A

ged

10 to

19

Induced Termination Rates Nelson County, TJHD and Virginia, 2003-2011


2003-2005 2004-2006 2005-2007 2006-2008 2007-2009 2008-2010 2009-20110

2

4

6

8

10

12

14

16

18

20

22

24

26

28

30

32

12.6

8.8

12.1

11.7

16.215.1


Ind

uce

d T

erm

ina

tion

s p

er

1,0

00

Wo

me

n A

ge

d 1

5-4

4

2000-2002 2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 2007-2009 2008-20100%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Nelson 81.7%

Nelson 75.6%TJHD 79.3%

TJHD 77.0%

84.7% 83.2%


Pe

rce

nt

of

To

tal L

ive

Bir

ths

to M

oth

ers

by

Pla

ce o

f R

esi

de

nce

Healthy People 2020

Percentage of Mothers Entering Prenatal Care in the 1st Trimester

Nelson County, TJHD and Virginia, 2000-2010


Percentage of Total Live Births with Prenatal Care Beginning in the First 13 Weeks

Percentage of Mothers Who had 10 or More Prenatal Care Visits

Nelson County, TJHD, and Virginia, 1999-2010

1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Nelson 79.2%

64.0%

TJHD 79.8%

66.0%

82.7%

77.7%


Pe

rce

nt

of

To

tal L

ive

Bir

ths

to M

oth

ers

by

Pla

ce o

f R

esi

de

nce


Percentage of Mothers With <12th Grade Education

Nelson County and Virginia, 2002-2010

2002 2003 2004 2005 2006 2007 2008 2009 20100%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

14%Nelson 12%

15%

Virginia 12%

Nelson Virginia

Pe

rce

nt

of

To

tal L

ive

Bir

ths

to M

oth

ers

by

Pla

ce o

f R

esi

de

nce


Percentage of Mothers Who Smoke During Pregnancy

Nelson County, TJHD, and Virginia, 1999-2008

1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-080%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%


Healthy People 2020 Pe

rce

nt

of

To

tal L

ive

Bir

ths

to M

oth

ers

by

Pla

ce o

f R

esi

de

nce


Reported Substance Exposed Infants*TJHD, FY1999-2011


99-00 00-01 01-02 02-03 03-04 04-05 05-06 06-07 07-08 08-09 09-10 10-110

2

4

6

8

10

12

14

16

18

20

22

24

2

22

TJHD

Nu

mb

er

of

Re

po

rte

d S

ub

sta

nce

Exp

ose

d

Infa

nts

*Newborn infants that may have been exposed to controlled substances prior to birth (as indicated by a positive drug toxicology of the mother with presence of a controlled substance or by the child being born dependent on a controlled substance and demonstrating withdrawal symptoms) or have a diagnosis of fetal alcohol syndrome

Leading Causes of Death

Mortality RatesNelson County, TJHD, and Virginia, 1999-2010


1999-2001 2000-2002 2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 2007-2009 2008-20100

100

200

300

400

500

600

700

800

900

1,000

1,100

1,200

956.1

761.7857.8

678.5

882.9

747.7

Nelson TJHD VirginiaAg

e-A

dju

ste

d D

ea

ths

pe

r 1

00

,00

0 P

ers

on

s L

ivin

g in

Lo

cal-

ity

Mortality Rates by Race Nelson County, TJHD, and Virginia, 2000-2010


2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100

100

200

300

400

500

600

700

800

900

1,000

1,100

1,200

1,300

1,400

1173.6

1277.0

TJHD Black 1093.6

TJHD Black 896.1

Virginia Black 1083.9

Virginia Black 916.0

1004.2

812.9

815.2

681.8

831.5

728.0

Nelson Black TJHD Black Virginia Black Nelson White TJHD WhiteVirginia WhiteA

ge-A

djus

ted

Dea

ths

per

100,

000

Per

sons

Liv

ing

in L

ocal

-ity

Five Leading Causes of DeathTJHD and Virginia, 2010

1. Cancer

2. Heart Disease

3. Stroke

4. Chronic Respiratory Disease (Chronic Obstructive Pulmonary Disease (COPD) and Asthma)

5. Unintentional Injuries


Leading Causes of Death By AgeVirginia, 2010Youth/Teens


6.1%

24.2%

3.0%

6.1%

60.6%

<1 Year

32.4%

12.4%

5.7%

1.0%

48.6%

1-14 Years

11.1%

7.3%

0.6%

0.3%

80.6%

15-24 Years

Leading Causes of Death By AgeVirginia, 2010

Adults


21.4%

21.3%

3.0%1.1%

53.2%

25-39 Years

47.0%

31.9%

5.4%

3.5% 12.2%

40-59 Years

52.5%

30.4%

5.5%

7.4%

4.2%60-64 Years

Leading Causes of Death By AgeVirginia, 201065 and over


50.7%

30.0%

6.6%

9.8%

2.9%

65-74 Years

39.5%

36.1%

9.6%

11.1%

3.7%75-84 Years

22.0%

50.8%

14.5%

8.1%

4.6%85 and over Years

Heart Disease Death RatesNelson County, TJHD, and Virginia, 1999-2010


1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100

25

50

75

100

125

150

175

200

225

250

275

300

325

259.5

176.2

222.6

148.8

243.3

171.6


Ag

e-A

dju

ste

d H

ea

rt D

ise

ase

De

ath

s p

er

10

0,0

00

P

ers

on

s L

ivin

g in

Lo

calit

y

Heart Disease Death Rates by Race Nelson County, TJHD, and Virginia, 2000-2009

2000-2004 2001-2005 2002-2006 2003-2007 2004-2008 2005-20090

25

50

75

100

125

150

175

200

225

250

275

300

325297.6

202.9

255.7

214.0

Virginia Black; 274.5

227.4

Nelson White 274.1

167.0

193.0

149.3

216.6

178.1


Ag

e-A

dju

ste

d H

ea

rt D

ise

ase

De

ath

s p

er

10

0,0

00

Pe

rso

ns

Liv

ing

in L

oca

lity


Five-year rolling averages

Stroke-Related Death Rates Nelson County, TJHD, and Virginia, 1999-2010


1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100

10

20

30

40

50

60

70

80

90

100

110

120

60.8 Nelson 45.0

78.2

TJHD 44.2

67.2

41.9


Ag

e-A

dju

ste

d S

tro

ke-R

ela

ted

De

ath

s p

er

10

0,0

00

Pe

rso

ns

Liv

ing

in L

oca

lity

Stroke-Related Death Rates by Race TJHD and Virginia, 2000-2009

2000-2002 2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 2007-20090

10

20

30

40

50

60

70

80

90

100

110

120110.9

52.5

69.5

39.9

87.3

60.9

60.1

39.0

TJHD Black TJHD White Virginia Black Virginia White

Ag

e-A

dju

ste

d S

tro

ke-R

ela

ted

De

ath

s p

er

10

0,0

00

P

ers

on

s L

ivin

g in

Lo

calit

y


Cancer-Related Death RatesNelson County, TJHD, and Virginia, 1999-2010


1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100

25

50

75

100

125

150

175

200

225

250

275

300

214.6

183.7190.4

TJHD 179.6

206.9

Virginia 174.5


Ag

e-A

dju

ste

d C

an

cer

De

ath

s p

er

10

0,0

00

Pe

r-so

ns

Liv

ing

in L

oca

lity

Cancer-Related Death Rates by RaceNelson County, TJHD, and Virginia, 2000-2009


2000-2004 2001-2005 2002-2006 2003-2007 2004-2008 2005-20090

25

50

75

100

125

150

175

200

225

250

275

300

238.0

213.7

225.2TJHD Black 222.1

249.7

220.6Nelson White 189.8

188.2

179.0171.5

189.1

176.4

Nelson Black TJHD Black Virginia Black Nelson WhiteTJHD White Virginia White

Ag

e-A

dju

ste

d C

an

cer

De

ath

s p

er

10

0,0

00

P

ers

on

s L

ivin

g in

Lo

calit

y


COPD-Related Death RatesNelson County, TJHD, and Virginia, 2000-2010


Four-year rolling averages

1999-02 2000-03 2001-04 2002-05 2003-06 2004-07 2005-08 2006-09 2007-100

5

10

15

20

25

30

35

40

45

50

55

60

65

43.6 43.3

40.5

34.9

42.5

38.6


Ag

e-A

dju

ste

d C

OP

D D

ea

ths

pe

r 1

00

,00

0 P

er-

son

s L

ivin

g in

Lo

calit

y

COPD-Related Death Rates by Race TJHD and Virginia, 2000-2009


2000-03 2001-04 2002-05 2003-06 2004-07 2005-08 2006-090

5

10

15

20

25

30

35

40

45

50

55

60

65

38.1

21.2

31.526.3

44.7

39.0

46.3

42.6

TJHD Black Virginia Black TJHD White Virginia White

Ag

e-A

dju

ste

d C

OP

D D

ea

ths

pe

r 1

00

,00

0 P

ers

on

s L

ivin

g in

Lo

calit

y

Diabetes-Related Death RatesNelson County, TJHD, and Virginia, 1999-2010


1999-03 2000-04 2001-05 2002-06 2003-07 2004-08 2005-09 2006-100

5

10

15

20

25

30

35

40

45

50

55

37.6

Nelson 20.3

21.1

15.7

23.7

Virginia 20.1


Ag

e-A

dju

ste

d D

iab

ete

s D

ea

ths

pe

r 1

00

,00

0

Pe

rso

ns

Liv

ing

in L

oca

lity


Diabetes-Related Death Rates by RaceTJHD and Virginia, 2000-2009


2000-2002 2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 2007-20090

5

10

15

20

25

30

35

40

45

50

55

38.3

41.5

47.8

37.9

TJHD White; 19.5

12.5

Virginia White 19.7

16.3


Ag

e-A

dju

ste

d D

iab

ete

s D

ea

ths

pe

r 1

00

,00

0

Pe

rso

ns

Liv

ing

in L

oca

lity

Unintentional Injury Death RatesTJHD and Virginia, 1999-2010



1999-02 2000-03 2001-04 2002-05 2003-06 2004-07 2005-08 2006-09 2007-100

5

10

15

20

25

30

35

40

45

50

55

60

65

70

7569.6

51.8

TJHD 33.8

38.4

Virginia 34.0 34.5


Ag

e-A

dju

ste

d U

nin

ten

tion

al I

nju

ry D

ea

ths

pe

r 1

00

,00

0 P

ers

on

s L

ivin

g in

Lo

calit

y

Unintentional Injury Death Rates by Race TJHD and Virginia, 2000-2009


2000-03 2001-04 2002-05 2003-06 2004-07 2005-08 2006-090

5

10

15

20

25

30

35

40

45

50

55

60

65

70

75

39.7

47.8

33.4

53.5

TJHD White 35.3

39.9VA White, 35.9

38.6


Ag

e-A

dju

ste

d D

ea

ths

pe

r 1

00

,00

0 P

ers

on

s L

iv-

ing

in L

oca

lity


Suicide and Homicide Rates TJHD and Virginia, 1999-2009

Source: Virginia Department of Health, Virginia Online Injury Reporting System

1999-2001

2000-2002

2001-2003

2002-2004

2003-2005

2004-2006

2005-2007

2006-2008

2007-2009

0

2

4

6

8

10

12

14

16

18

20

4.60

2.80

6.12

4.98

14.49

TJHD Suicide 11.4111.05

Virginia Suicide 11.54

TJHD Homicide Virginia Homicide TJHD Suicide Virginia SuicideAge

-Adj

uste

d D

eath

s pe

r 100

,000

Per

sons

Liv

ing

in L

ocal

ity

Youth Suicide Rates TJHD and Virginia, 2004-2008

• Suicide is the third leading cause of death for 10-24 year-olds.

• On average, two Virginia youths die each week from suicide.

• The suicide rate is higher in males than the rate of females.

• The White suicide rate is 2.4 times higher than the Black suicide rate.

Source: Virginia Department of Health, Office of Family Health Services

TJHD Virginia0

2

4

6

8

10

4.39

6.86

2004-2008

Dea

ths

per

100,

000

Per

sons

Liv

ing

in L

ocal

ity

Cancer

Lung Cancer Incidence RatesNelson County, TJHD, and Virginia, 1999-2008

Nelson TJHD Virginia0

5

10

15

20

25

30

35

40

45

50

55

60

65

70

75

80

85

61.6564.43 64.44

83.64

69.8768.40

Ag

e-A

dju

ste

d R

ate

of

Lu

ng

& B

ron

chu

s C

an

cer

Ca

ses

pe

r 1

00

,00

0 P

ers

on

s L

ivin

g in

Lo

calit

y

19

99

-2

00

3

19

99

-2

00

3

19

99

-2

00

3

20

04

-2

00

8

20

04

-2

00

8

20

04

-2

00

8

Source: Virginia Cancer Registry

Lung Cancer Incidence Rates by Race TJHD and Virginia, 1999-2008


Black White Black WhiteTJHD Virginia

0

5

10

15

20

25

30

35

40

45

50

55

60

65

70

75

80

85

73.38

63.31

69.12

64.39

78.06

69.0671.73

68.91

Ag

e-A

dju

ste

d R

ate

of

Lu

ng

& B

ron

chu

s C

an

cer

Ca

ses

pe

r 1

00

,00

0 P

ers

on

s L

ivin

g in

Lo

calit

y

19

99

-2

00

3

19

99

-2

00

3

19

99

-2

00

3

19

99

-2

00

3

20

04

-2

00

8

20

04

-2

00

8

20

04

-2

00

8

20

04

-2

00

8

Lung Cancer Death Rates TJHD and Virginia, 1996-2007


1996-2000 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 2003-20070

5

10

15

20

25

30

35

40

45

50

55

60

65

70

75

80

85

55.252.5

60.7

54.8

TJHD Virginia

Ag

e-A

dju

ste

d R

ate

of

Lu

ng

Ca

nce

r D

ea

ths

pe

r 1

00

,00

0 P

ers

on

s L

ivin

g in

Lo

calit

y

Breast Cancer Incidence Rates Nelson County, TJHD, and Virginia, 1999-2008



20

40

60

80

100

120

140

160

180

200

106.35

144.81

124.5

146.6

127.52 124.81

Ag

e-A

dju

ste

d R

ate

of

Fe

ma

le B

rea

st C

an

cer

Ca

ses

pe

r 1

00

,00

0 F

em

ale

s L

ivin

g in

Lo

calit

y

19

99

-2

00

3

19

99

-2

00

3

19

99

-2

00

3

20

04

-2

00

8

20

04

-2

00

8

20

04

-2

00

8

Breast Cancer Incidence Rates by Race TJHD and Virginia, 1999-2008



0

10

20

30

40

50

60

70

80

90

100

110

120

130

140

150

160

129.15

147.74

118.13

126.59133.84

125.95 127.06 124.83

Ag

e-A

dju

ste

d R

ate

of

Fe

ma

le B

rea

st C

an

cer

Ca

ses

pe

r 1

00

,00

0 F

em

ale

s L

ivin

g in

Lo

calit

y

19

99

-2

00

3

19

99

-2

00

3

19

99

-2

00

3

19

99

-2

00

3

20

04

-2

00

8

20

04

-2

00

8

20

04

-2

00

8

20

04

-2

00

8

Breast Cancer Death Rates TJHD and Virginia, 1996-2007


1996-2000 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 2003-20070

10

20

30

40

50

60

70

80

90

100

26.6

20.9

28.825.4

TJHD Virginia

Ag

e-A

dju

ste

d R

ate

of

Bre

ast

Ca

nce

r D

ea

ths

pe

r 1

00

,00

0 P

ers

on

s L

ivin

g in

Lo

calit

y

Prostate Cancer Incidence RatesNelson County, TJHD, and Virginia, 1999-2008



25

50

75

100

125

150

175

200

225

202.11

154.94

165.13165.51 163.15 160.73

19

99

-20

03

19

99

-20

03

19

99

-20

03

20

04

-20

08

20

04

-20

08

20

04

-20

08

Ag

e-A

dju

ste

d R

ate

of

Pro

sta

te C

an

cer

Ca

ses

pe

r 1

00

,00

0 M

ale

s L

ivin

g in

Lo

calit

y

Prostate Cancer Incidence Rates by Race, TJHD and Virginia, 1999-2008



0

25

50

75

100

125

150

175

200

225

250

275

207.16

145.56

248.15

148.09

202.91

156.68

242.00

145.10

Ag

e-A

dju

ste

d R

ate

of

Pro

sta

te C

an

cer

Ca

ses

pe

r 1

00

,00

0 M

ale

s L

ivin

g in

Lo

calit

y

19

99

-2

00

3

19

99

-2

00

3

19

99

-2

00

3

19

99

-2

00

3

20

04

-2

00

8

20

04

-2

00

8

20

04

-2

00

8

20

04

-2

00

8

Prostate Cancer Death RatesTJHD and Virginia, 1996-2007


1996-2000 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 2003-200705

101520253035404550556065707580859095

100105

34.2 TJHD 27.3

36.8

Virginia 26.6

TJHD Virginia

Ag

e-A

dju

ste

d R

ate

of

Pro

sta

te C

an

cer

De

ath

s p

er

10

0,0

00

Pe

rso

ns

Liv

ing

in L

oca

lity

Colorectal Cancer Incidence Rates Nelson County, TJHD, and Virginia, 1999-2008



5

10

15

20

25

30

35

40

45

50

55

60

65

7066.80

53.0850.20

38.20

44.17 45.14

Ag

e-A

dju

ste

d R

ate

of

Co

lore

cta

l Ca

nce

r C

ase

s p

er

10

0,0

00

Pe

rso

ns

Liv

ing

in L

oca

lity

19

99

-2

00

3

19

99

-2

00

3

19

99

-2

00

3

20

04

-2

00

8

20

04

-2

00

8

20

04

-2

00

8

Colorectal Cancer Incidence Rates by Race, TJHD and Virginia, 1999-2008



0

5

10

15

20

25

30

35

40

45

50

55

60

65

7067.45

50.93

59.66

48.57

60.97

41.66

55.02

43.24

Ag

e-A

dju

ste

d R

ate

of

Co

lore

cta

l Ca

nce

r C

ase

s p

er

10

0,0

00

Pe

rso

ns

Liv

ing

in L

oca

lity

19

99

-2

00

3

19

99

-2

00

3

19

99

-2

00

3

19

99

-2

00

3

20

04

-2

00

8

20

04

-2

00

8

20

04

-2

00

8

20

04

-2

00

8

Colorectal Cancer Death RatesTJHD and Virginia, 1996-2007


1996-2000 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 2003-20070

5

10

15

20

25

30

35

40

45

50

55

60

65

70

18.9

15.6

21.4

17.3

TJHD Virginia

Ag

e-A

dju

ste

d R

ate

of

Co

lore

cta

l Ca

nce

r D

ea

ths

pe

r 1

00

,00

0 P

ers

on

s L

ivin

g in

Lo

calit

y

Unintentional Injury

Percent of Hospitalizations due to Unintentional Injury by Cause



Falls; 47.0%

Motor Vehicles/Other Transport Crashes;

22.9%

Struck by, against, 3.0%

Poisoning; 4.4%

Bites/Stings; 2.6%

Other/Unspecified; 20.1%

Hospitalizations due to Unintentional Injury by Cause and Age Group, Nelson County, 1999-2009

0-19 20-64 65+

Number % Number % Number %

Falls 14 15% 124 28% 318 73%

Motor Vehicle/Other Transport Crashes

46 51% 144 32% 32 7%

Struck by, against 10 11% 12 3% 7 2%

Poisoning 2 2% 21 5% 20 5%

Bites, Stings 4 4% 13 3% 8 2%

Other/Unspecified 15 16% 131 29% 49 11%


Rates of Hospitalizations due to Falls among Persons Aged 65+, Nelson County, TJHD, and Virginia, 1999-2009

Source: Virginia Online Injury Reporting System, Virginia Department of Health

1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-090

25

50

75

100

125

150

175

200

225

115.00

Nelson 194.51

151.86

168.08

160.99

Virginia 193.04

Nelson TJHD VirginiaRe

po

rte

d H

osp

ital D

isch

arg

es

for

Inju

rie

s d

ue

to

Fa

lls p

er

10

0,0

00

Pe

rso

ns

Ag

ed

65

an

d O

ver

Liv

ing

in L

oca

lity

Rates of Unintentional Injury Deaths by CauseNelson County, TJHD, and Virginia,1999-2009


Falls Transport Crashes Suffocation Poisoning Drowning Fire/Flame Other/Unspecified0

5

10

15

20

25

30

5.82

26.81

3.564.47

1.12999999999998

3.71

9.45

5.54

17.13

2.75 3.670.960000000000001 1.1

5.5

5.4

13.04

2.32

5.89

1.06 1.22

4.66


Ag

e-A

dju

ste

d U

nin

ten

tion

al I

nju

ry D

ea

ths

pe

r 1

00

,00

0 P

ers

on

s L

ivin

g in

Lo

calit

y

Rates of Motor Vehicle AccidentsNelson County, TJHD, and Virginia, 2000-2011

Source: Virginia Department of Motor Vehicles

*Crashes are by place of occurrence

2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-10 2009-110

250

500

750

1,000

1,250

1,500

1,750

2,000

2,250

2,500

2,750

3,000

3,250

3,500

2046.23 2025.78

2317.64

1659.472010.26

1471.82


Mo

tor

Ve

hic

le A

ccid

en

ts p

er

10

0,0

00

Pe

rso

ns

Liv

ing

in L

oca

lity

Motor Vehicle Crash Fatality RatesNelson, TJHD, and Virginia, 2000-2011


Five Year Averages

2000-04 2001-05 2002-06 2003-07 2004-08 2005-09 2006-10 2007-110

5

10

15

20

25

30

35

40

45

50

30.31 30.74

19.98

16.20

12.73

10.38


Mo

tor

Ve

hic

le C

rash

Fa

talit

ies

pe

r 1

00

,00

0 P

er-

son

s L

ivin

g in

Lo

calit

y

Percent of Alcohol-Related Motor Vehicle Crashes, Nelson, TJHD, and Virginia, 2000-2011


2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-10 2009-110%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

11.3%9.2%

8.1%8.5%

7.9%7.4%


Pe

rce

nt

of

To

tal M

oto

r V

eh

icle

Cra

she

s b

y P

lace

o

f O

ccu

rre

nce

Percent of Alcohol-Related Motor Vehicle Crash Fatalities, TJHD and Virginia, 2000-2011


2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-10 2009-110%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

44.5%

33.0%

38.3%

37.0%

TJHD Virginia

Pe

rce

nt o

f To

tal M

oto

r V

eh

icle

Cra

sh F

ata

litie

s in

w

hic

h A

lco

ho

l wa

s In

volv

ed

--

by

Pla

ce o

f O

ccu

rre

nce

v

Infectious Diseases

Rates of Reportable Communicable Diseases, TJHD and Virginia, 2000-2010

CommunicableDisease

TJHD Virginia

AverageNumber of

Cases

Average RatePer 100,000*

AverageNumber of

Cases

Average RatePer 100,000*

Chlamydia 559 260.2 23,406 306.7

Gonorrhea 134 62.3 8,723 119.3

Pertussis 56 26.3 246 3.3

Salmonellosis 35 16.3 1,186 15.8

Giardiasis 33 15.5 489 6.5

Chicken Pox 25 11.7 1,079 14.3

Campylobacteriosis 21 9.8 687 9.2

Lyme Disease 20 9.1 514 6.7

Source: Virginia Department of Health, Division of Surveillance and Investigation

*Population data based on U.S. Census Data for TJHD and State of Virginia (2000-2010)

Chlamydia Incidence RatesNelson County, TJHD, and Virginia,1997-2010

1997-99 1998-00 1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100

25

50

75

100

125

150

175

200

225

250

275

300

325

350

375

400

425

Nelson; 189.2

167.5

219.6

280.7

Virginia 189.3

397.7


po

rte

d C

ase

s o

f Ch

lam

ydia

pe

r 1

00

,00

0 P

ers

on

s L

ivin

g in

Lo

cal-

ity

Source: Virginia Department of Health, Division of Disease Prevention

Gonorrhea Incidence RatesNelson County, TJHD, and Virginia,1997-2010

1997-99 1998-00 1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100

20

40

60

80

100

120

140

160

45.5

28.2

94.3

68.6

134.4

109.4


po

rte

d C

ase

s o

f Go

no

rrh

ea

pe

r 1

00

,00

0 P

ers

on

s L

ivin

g in

Lo

cal-

ity


HIV and AIDS Incidence RatesTJHD and Virginia, 1997-2009


1997-99 1998-00 1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-090

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

8.2

5.9

10.2

6.1

13.5 13.4

15.1

8.9

TJHD HIV TJHD AIDS Virginia HIV Virginia AIDSRe

po

rte

d C

ase

s o

f HIV

/AID

S p

er

10

0,0

00

Pe

rso

ns

Liv

ing

in L

oca

l-ity

Syphilis (early) Incidence RatesTJHD and Virginia,1999-2010


1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100

1

2

3

4

5

6

7

8

0.5

2.8

4.1

6.8

TJHD Virginia

Rep

orte

d C

ases

of

Syp

hilis

per

100

,000

Per

sons

Liv

ing

in L

ocal

ity

Pertussis Incidence RatesTJHD, and Virginia, 1999-2010


1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100

5

10

15

20

25

30

35

40

45

50

20.4 16.4

2.23.5

TJHD VirginiaRe

po

rte

d C

ase

s o

f Pe

rtu

ssis

pe

r 1

00

,00

0 P

ers

on

s L

ivin

g in

Lo

cal-

ity

Chicken Pox Incidence RatesTJHD and Virginia, 1999-2010


1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100

5

10

15

20

25

30

2.1

16.3

12.7

12.1

TJHD VirginiaRep

orte

d C

ases

of C

hick

en P

ox p

er 1

00,0

00 P

erso

ns L

ivin

g in

Loc

ality

Hepatitis B Incidence RatesTJHD and Virginia, 1999-2010


1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

2.3

0.4

2.4

1.4

TJHD Virginia

Healthy People 2020

Re

po

rte

d C

ase

s o

f He

pa

titis

B p

er

10

0,0

00

Pe

rso

ns

Liv

ing

in L

o-

calit

y

Salmonellosis Incidence RatesTJHD and Virginia,1999-2010


1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100

2

4

6

8

10

12

14

16

18

20

22

18.5

14.0

17.4

14.9

TJHD Virginia

Healthy People 2020

Rep

orte

d C

ases

of

Sal

mon

ello

sis

per

100,

000

Per

sons

Liv

ing

in L

ocal

ity

Campylobacteriosis Incidence Rates TJHD and Virginia,1999-2010


1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100

2

4

6

8

10

12

14

16

18

14.2

11.7

8.5 9.5

TJHD Virginia

Rep

orte

d C

ases

of

Cam

pylo

bact

erio

sis

per

100,

000

Per

sons

Li

ving

in L

ocal

ity

E. Coli O157:H7 Incidence Rates TJHD and Virginia, 1999-2010


1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

2.7

3.4

1.0

2.3

TJHD Virginia

Healthy People 2020

Rep

orte

d C

ases

of

E.

Col

i O15

7:H

7 pe

r 10

0,00

0 P

erso

ns L

ivin

g in

Loc

ality

Giardiasis Incidence Rates TJHD and Virginia,1999-2010


1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100

2

4

6

8

10

12

14

16

18

20

22

24

26

28

17.8

12.8

6.3

6.2

TJHD VirginiaRe

po

rte

d C

ase

s o

f Gia

rdia

sis

pe

r 1

00

,00

0 P

ers

on

s L

ivin

g in

Lo

-ca

lity

Legionellosis Incidence Rates TJHD and Virginia, 1999-2010


1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

1.932.1

1.87

0.9

TJHD VirginiaRe

po

rte

d C

ase

s o

f Le

gio

ne

llosi

s p

er

10

0,0

00

Pe

rso

ns

Liv

ing

in L

o-

calit

y

Lyme Disease Incidence Rates TJHD and Virginia, 1999-2010


1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100

5

10

15

20

25

30

TJHD 1.7

25.3

Virginia 2.0

13.2

TJHD VirginiaRep

orte

d C

ases

of

Lym

e D

isea

se p

er 1

00,0

00 P

ers

on

s Li

ving

in L

ocal

ity

Spotted Fever Rickettsiosis Incidence Rates, TJHD and Virginia, 1999-2010


1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0

0.5

4.4

0.3

1.5

TJHD Virginia

Rep

orte

d C

ases

of S

potte

d F

ever

Ric

ketts

iosi

s pe

r 10

0,00

0 P

erso

ns L

ivin

g in

Loc

ality

Tuberculosis Incidence RatesTJHD and Virginia, 1999-2010


1999-01 2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0

1.8

2.9

4.4

3.6

TJHD Virginia

Healthy People 2020

Re

po

rte

d C

ase

s o

f Tu

be

rcu

losi

s p

er

10

0,0

00

Pe

rso

ns

Liv

ing

in L

o-

calit

y

Ambulatory Care-Sensitive Conditions

Source: Virginia Department of Health, Virginia Behavioral Risk Factor Surveillance System

Percent of Adults Diagnosed with Diabetes (Self-Reported), TJHD and Virginia, 2000-2010

2000-2002 2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 2007-2009 2008-20100%

1%

2%

3%

4%

5%

6%

7%

8%

9%

10%

3.9%

8.7%

6.1%

7.8%

TJHD Virginia

Pe

rce

nt

of

To

tal A

du

lts A

ge

d 2

0 a

nd

Ove

r L

ivin

g

in L

oca

lity

Hospital Discharge Rates for DiabetesTJHD and Virginia, 2000-2011

Source: VDH Data Warehouse; Virginia Hospital Information Systems

2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-10 2009-110

2

4

6

8

10

12

14

16

18

20

22

24

26

28

30

32

34

TJHD 15.8317.01

Virginia 15.4614.82

TJHD Virginia

Ag

e-A

dju

ste

d H

osp

ital D

isch

arg

es

for

Dia

be

tes

p

er

10

,00

0 P

ers

on

s L

ivin

g in

Lo

calit

y

Hospital Discharge Rates for DiabetesTJHD by Locality, 2000-2010

Source: Virginia Hospital Information Systems

2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100

2

4

6

8

10

12

14

16

18

20

22

24

26

28

30

32

34

23.84

24.65

Albemarle Charlottesville FluvannaGreene Louisa Nelson

Ag

e-A

dju

ste

d H

osp

ital D

isch

arg

es

for

Dia

be

tes

p

er

10

,00

0 P

ers

on

s L

ivin

g in

Lo

calit

y

Hospital Discharge Rates for AsthmaNelson County, TJHD, and Virginia, 2000-2010

2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100

2

4

6

8

10

12

14

16

18

20

22

18.80

16.5015.85

11.94

14.9912.66


Ag

e-A

dju

ste

d H

osp

ital D

isch

arg

es

for

Ast

hm

a p

er

10

,00

0 P

ers

on

s L

ivin

g in

Lo

calit

y


Hospital Discharge Rates for Hypertension, TJHD and Virginia, 2000-2011


2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-10 2009-110

1

2

3

4

5

6

7

8

9

10

TJHD; 2.69 TJHD; 2.68

Virginia; 2.68 Virginia; 2.64

TJHD Virginia

Age

-Adj

uste

d H

ospi

tal D

isch

arge

s fo

r H

yper

tens

ion

per

10,0

00 P

erso

ns L

ivin

g in

Loc

ality

Hospital Discharge Rates for COPDNelson County, TJHD, and Virginia, 2000-2010

2000-02 2001-03 2002-04 2003-05 2004-06 2005-07 2006-08 2007-09 2008-100

5

10

15

20

25

30

23.30

26.10

22.49

17.69

21.52

18.18


Ag

e-A

dju

ste

d H

osp

ital D

isch

arg

es

for

CO

PD

pe

r 1

0,0

00

Pe

rso

ns

Liv

ing

in L

oca

lity


Mental Health Indicators

Average Number of Poor Physical/Mental Health in the Last 30 Days (Self-reported)

TJHD by Locality, TJHD and Virginia, 2004-2010

Source: County Health Rankings

*Numbers are self-reported

Albemarle Charlottesville Fluvanna Greene Louisa Nelson TJHD Average Virginia0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

5

2.2

2.9

3.4

2.9

4.7

1.2

2.883.2

2.5 2.8

2.1

2.8

3.7

2.5 2.73

3.2

Average Number of Physically Unhealthy Days reported in past 30 daysAverage Number of Poor Mental Health Days reported in past 30 daysNational Benchmark for Physically Unhealthy DaysNational Benchmark for Poor Mental Health Days

Nu

mb

er*

of

Ph

ysic

ally

Un

he

alth

y/P

oo

r M

en

tal H

ea

lth D

ays

0%

5%

10%

15%

20%

25%

30%

25%

12%11%

9%

7% 7%

3%2%

Pe

rce

nt

of

To

tal R

eg

ion

Te

n P

atie

nts

Se

rve

d

Region Ten Community Services Board’s Most Frequent Diagnosed Disorders, 2011

Source: Region Ten Community Services Board

Number of Emergency Services Delivered by Region 10 Community Services Board by Type of Service

1996-2009

Source: Region Ten Community Services Board

1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 20090

500

1000

1500

2000

2500

3000

1453

2306

1042

629

Emergency Custody Order Evaluations Temporary Detention Orders IssuedTotal Evaluations Hospital AdmissionsWellness Recovery Center Referrals

Nu

mb

er

of

Re

gio

n T

en

Se

rvic

es

De

live

red

Source: Substance Abuse and Mental Health Services Administration

Adults with a co-occuring MH and AOD disorder

Children with a co-occurring MH and AOD disorder

0%

5%

10%

15%

20%

25%

30%

35%32.8%

7.6%

20.0%

4.6%

Virginia US

Per

cent

of

Tot

al A

dult

s/C

hild

ren

Ser

ved

thro

ugh

Sta

te M

enta

l Hea

lth

Age

ncie

sPercent of Persons Served though State Mental

Health Agencies with Co-Occurring Mental Health and Substance Abuse Disorders, Virginia and U.S., 2010

MH = Mental Health; AOD = Alcohol and Other Drug

Source: Substance Abuse and Mental Health Services Administration

Adults with a SMI and a substance abuse disorder

Children with a SMI and a substance abuse disorder

0%

5%

10%

15%

20%

25%

30%

35%31.8%

7.9%

24.4%

8.7%

Virginia US

Pe

rce

nt

of

To

tal A

du

lts/C

hild

ren

Se

rve

d

thro

ug

h S

tate

Me

nta

l He

alth

Ag

en

cie

sPercent of Persons Served though State Mental Health Agencies with Co-Occurring Severe Mental Health and

Substance Abuse Disorder, Virginia and U.S., 2010

Adults with a serious mental illness (SMI) are Persons 18 years and Over who, “at any time during a given year, had a diagnosable mental, behavioral, or emotional disorder without the benefit of treatment or other support services … that has resulted in functional impairment which substantially interferes with or limits one or more major life activities.…"

Hospital Discharge Rates for PsychosesTJHD and Virginia, 2000-2011


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 20110

100

200

300

400

500

600

700

800

677.19

418.60

586.01

563.09

TJHD VA

Ho

spita

l Dis

cha

rge

s p

er

10

0,0

00

Pe

rso

ns

Liv

ing

in L

oca

l-ity

Hospital Discharge Rates for Neurotic Disorders, Personality Disorders, and other Nonpsychotic Mental Disorders

TJHD and Virginia, 2000-2011


2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 20110

50

100

150

200

250

300

257.45

206.30199.55

140.88

TJHD VAHo

spita

l Dis

cha

rge

s p

er

10

0,0

00

Pe

rso

ns

Liv

ing

in L

oca

l-ity

Section Four: What are community members’ perceptions of health in their

communities?

Thomas Jefferson Area Community Survey

MAPP 2 Health Focus Groups

Louisa County Qualitative Data

Thomas Jefferson Area Community Survey

Thomas Jefferson Area Community Survey (TJACS)

TJHD, 2012

Source: UVA Center for Survey Research

• Conducted by the UVA Center for Survey Research (CSR)

• Conducted in January 2012• Survey of 1,098 individuals living in

Charlottesville City and Albemarle, Nelson, Fluvanna, Greene, and Louisa Counties

• Conducted through a Random Digit Dial (RDD) sample of landline and cell-phone numbers – Also included a random sample of directory-listed

landline households

Medical Doctors DentistsCounselors for

Mental Health or Substance Abuse

Urgent Care

FacilitiesHospitals

Nelson 7.7% 9.8% 17.6% 27.3% 37.6%

TJHD11.3% 13.4% 20.7% 17.9% 14.9%

19.7% Insists No Problems

Question 1: Thinking about Nelson County, which of the following

services is most difficult to get care from?


• Open-ended response: “All of them. I live in Nelson County and it would take an hour to come get me if something ever happened to me.”

Problems with cost, insurance

or Medicaid

Distance or Transportation

Not enough doctors, dentists or counselors

Language or cultural

difficulties

Nelson 45.2% 41.8% 6.7% 6.3%

TJHD 59.4% 20.4% 11.0% 2.2%

Question 2: Thinking about Nelson County, what is the biggest

difficulty people have in getting health services?


• Open-ended response: “People in Nelson County have a lack of education to reach out and use resources which are available. It's an old cultural thing – people don't have perspective or don't care and are uneducated.”

SmokingWeight and

obesityAlcohol/ drug use

Infant Death

Mental Health

Nelson 3.8% 43.1% 40.7% 0.0% 12.4%

TJHD 7.8% 36.0% 32.7% 3.1% 20.3%

Question 3: Which of the following public health concerns is the most

important for Nelson County to give more attention to?


MAPP 2 Health Focus Groups

Focus Group DemographicsNelson County, 2012

Number Percent

Attendees 15 100.0%

Gender

Male 1 6.7%

Female 14 93.3%

Race

White 11 73.3%

Other 4 26.7%

Ethnicity

Hispanic or Latino 0 0.0%

Not Hispanic or Latino 15 100.0%

Age

18-27 0 0.0%

28-37 0 0.0%

38-47 1 6.7%

48-57 1 6.7%

58-67 6 40.0%

68-77 7 46.7%

Unknown 0 0.0%


Number Percent

Marital Status

Married 6 40.0%

Widowed 2 13.3%

Divorced 4 26.7%

Never Married 2 13.3%

No Answer 1 6.7%

Employment status

Employed 7 46.7%

Retired 4 26.7%

Unemployed 3 20.0%

Disabled/ Unable to Work 1 6.7%

No Answer 0 0.0%


Number Percent

Education Completed

Less than eighth grade 1 6.7%

High school diploma or GED 2 13.3%

College degree (4 years or less of college) 8 53.3%

Advanced degree 4 26.7%

No Answer 0 0.0%

Income

< $15,000 5 33.3%

$15,000–$29,000 2 13.3%

$30,000–$44,000 0 0.0%

$45,000–$59,000 1 6.7%

$60,000–$74,000 2 13.3%

$75,000–$89,000 1 6.7%

>$90,000 1 6.7%

No answer 3 20.0%

Focus Group Health Care CharacteristicsNelson County, 2012

Number Percent

Medical Insurance

None 2 13.3%

Medicare 7 46.7%

Medicaid 4 26.7%

Private 3 20.0%

Employment-based 3 20.0%

Other 2 13.3%

No Answer 0 0.0%

On average, how many times each month do you use health care services (doctor, dentist, hospital, etc)?

1- 4 9 60.0%

5-9 1 6.7%

10-14 0 0.0%

15 or more 0 0.0%

Other: 1-4/year 5 33.3%

Never 0 0.0%

No Answer 0 0.0%

Focus Group Health Care CharacteristicsNelson County, 2012

Number Percent

Do you have any of the following conditions? Check all that apply:

Smoking 1 6.7%

Diabetes 3 20.0%

Heart Disease 0 0.0%

Cancer 1 6.7%

Asthma 1 6.7%

High Blood Pressure 5 33.3%

Other 2 13.3%

Nelson County Focus Group Results2012

• Weight and Obesity– This issue can be ameliorated through education

• Nutritional education has helped before• Participants only knew of one rural health class

available to the community

– Poverty contributes to this problem – people purchase foods that are cheaper rather than healthier

– A lack of walking trails/sidewalks is a barrier to becoming fit within the community


• Transportation– Participants reported being unable to use resources

offered, mainly due to limits to their use • e.g., solely for medical appointments, always booked, not

enough time, and not enough volunteers

– One solution suggested was a more informal system in which community residents would be able to carpool, and those with cars could offer to take those without


• Alcohol and Drug Use– It is a cultural issue: parents are enabling their

children – making it a generational problem – and alcoholism is culturally engrained in the population

– The problem may be due to a lack of activities available for community members to be involved in

– Though people are more educated about the issue, drinking and driving is a major concern in the community

Documents

Community Health Status Assessment: Nelson County Mobilizing for Action through Planning and Partnerships A Compilation of Data that Reflects the Community’s