Upload
others
View
4
Download
0
Embed Size (px)
Citation preview
1
Dallas County Community Health Dashboard
Parkland Health & Hospital System
2
Model for Determining
Community Health Dashboard
3
Model for Determining
Community Health
Dashboard
Health Outcomes
Mortality
Years of Potential Life Lost
Infant Mortality
Very Low Birth Weight Births
Morbidity
Mental Health Status
Diabetes Prevalence
Health Factors
Health Risk Behaviors
Cancer Screening
Mammogram
Pap Test
Colon Cancer Screening
Vaccinations
Flu Shots for Adults 65+
Child ages 19-35 months
Violence and Injury Prevention Mortality
ED Visits for Injury
High Risk Sexual Behavior HIV/STD Rates
Teen Birth Rate
Tobacco Use
Alcohol Use
Diet and Exercise
Over Weight and Obese
Access to Clinical Care
Percent Uninsured
Percent with Personal Physician
Physician-to-Population Ratio
Non-Emergent Emergency Department Use
Quality of Clinical Care
Prevention Quality Indicators
4
Access to care
Access to Clinical Care
Percent Uninsured
Percent with Personal Physician
Physician-to-Population Ratio
Non-emergent Emergency
Department Use
Dallas County
Compared to
Healthy
People 2020
Goal
Dallas County
Compared to
8 Peer
Counties
(Quartiles)
Dallas
County
Compared to
Past Years’
Data (CI)
N/A
N/A N/A
– Doing better than the benchmark
– Same as/not significantly different from the benchmark
– Worse than the benchmark
5
Access: Percent Without Health Insurance
Ages 0-64, 2006 to 2011 Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
2008-2011 data are from US Census American Community Survey, 2008-2011. 2005 and 2006 data are
from US Census Small Area Health Insurance Estimates 2005-6, accessed from the following web site
http://www.census.gov/did/www/sahie/data/2006/tables.html
Healthy People 2020 Objective AHS 1.1
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
City of Dallas, EBRI, Special run by Ken McDonnell, EBRI and ASEC Program Director, 2004-2008
202-775-6367, 2009-11 data is from US Census American Community Survey, 2009-11
Dallas County Trend, Percent
Uninsured, Ages 0-64, 2005, 2006,
2008-2011
17
.3%
17
.9%
22
.5%
24
.6%
28
.2%
33
.4%
23
.3%
25
.9%
25
.4%
27
.6%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
2011 % Uninsured under 65 2006 % Uninsured under 65
U.S. Bexar County Harris County Tarrant County Dallas County Texas
20.0% - 34.9%
Other Peer Counties
Range, 2011
Percent with no health insurance
trend, City of Dallas, all ages
Healthy People 2020 goal is to decrease the
portion of persons without health insurance
to 0% (target based on total coverage ) Percent
Percent
Percent
29.1%
30.8%
33.2%
32.9%
31.1%
30.5%
0.0% 10.0% 20.0% 30.0% 40.0%
2005
2006
2008
2009
2010
2011
Dallas Co.
28.7%
31.0%
39.9%
42.5%
34.0%
36.1%
31.2%
32.3%
0.0% 20.0% 40.0% 60.0%
2004
2005
2006
2007
2008
2009
2010
2011
City of Dallas
6
Source: BRFSS, Texas, 2004-2011, personal email from TX Dept of State Health
Services 3.18.13
Healthy People 2020. Objective AHS 3.
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
Dallas County Trend 2004 to 2011
Access: Percent of Adults With A
Personal Doctor, 2004-2011
This indicator shows the percentage of
adults that report that they do have
someone they think of as their personal
doctor or health care provider.
BRFSS Survey Question: Do you have one person you
think of as your personal doctor or health care provider?
(response includes: Yes one or yes more than one)
Percent
Percent
Healthy People 2020 goal is to increase the
proportion of persons with a usual primary
care provider. (target based on 10% improvement)
78
.0%
79
.6%
68
.3%
72
.1%
64
.7%
72
.3%
70
.1%
72
.1%
63
.3%
69
.3%
68
.4%
72
.5%
83.9% 83.9%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
2011 2004
U.S. Median Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
69.3%
69.2%
69.4%
76.4%
73.6%
68.5%
73.8%
63.3%
0.0% 20.0% 40.0% 60.0% 80.0% 100.0%
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Discontinuity: BRFSS began surveying cell phones in
2011, not comparable with previous years’ rates
7
Sources: Texas Bureau of Primary Care, http://www.dshs.state.tx.us/chs/hprc/tables/08PCshtm for
Texas counties
http://www.countyhealthrankings.org for Texas and Other Peer Counties
http://www.gao.gov/new.items/d08472t.pdf U.S. Comparison 2005 is base year
http://www.hschange.com/CONTENT/1192/1192.pdf Center for Health System Change, State Variation
in Primary Care Physician Supply: Implications for Health Reform Medicaid Expansions. Research
Brief No. 19 • March 2011 (U.S. comparison for most recent comparison year is 2008)
Dallas County Trend 2004 to 2012
Access: Primary care physician to population
ratio (rate per 100,000), January 2012
This indicator shows the number of primary
care physicians per 100,000 population
Includes: Active primary care physicians with Texas practice
addresses and a practice type of direct patient care. Primary
Care Physicians are those physicians that indicate a primary
specialty of: Family Practice/Medicine, General Practice, Internal
Medicine, Pediatrics, Obstetrics and/or Gynecology, or Geriatrics
(Geriatrics was included for the first time in 2004).
Rate Per 100,000 Population
Rate Per 100,000 Population
Other Peer Counties
include: Maricopa, Los
Angeles, Miami-Dade, Cook
12
7.4
90
.0
10
2.9
76
.5
99
.0
79
.4
88
.2
73
.4
96
.7
79
.2
80
.9
68
.1
-
20.0
40.0
60.0
80.0
100.0
120.0
140.0
160.0
180.0
2012 2004
U.S. Median Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
*
79.2
79.5
78.9
80.7
82.7
80.2
82.3
83.9
96.7
- 20.0 40.0 60.0 80.0 100.0 120.0
2004
2005
2006
2007
2008
2009
2010
2011
2012
Dallas Co.
The data on primary care providers for peer counties are obtained from
the Health Resources and Services Administration’s Area Resource File
(ARF) for 2010. The ARF data on practicing physicians come from the
AMA Master File (2010), and the population estimates are from the U.S.
Census Bureau’s 2010 decennial census. From the County Health
Rankings website.
Other Peer Counties
Range, 2010
67.1 to 90.2
8
Sources: DFWHC ERF Information Quality Services Center Regional Data, 2010.
Dallas-Fort Worth Hospital Council Education and Research Foundation, Information
and Quality Services Center, Irving, Texas. Nov 20 2012.
Dallas County Trend in Emergency
Department Visits for Non-Emergent
Conditions, 2006-2012
Access: Non-Emergent Use of
Emergency Departments, 2006-2012
The Dallas Fort Worth Hospital Council has established an
Emergency Department data set from more than 44
hospitals in the region. The data repository has over 3.6
million emergency department visits as of 2011. Analysis
of this data was based on the New York University’s
Emergency Department Algorithm. The NYU Algorithm
defines a non-emergent ED visit as – the patient’s initial
complaint, presenting symptoms, vital signs, medical
history and age indicated that immediate medical care was
not required within 12 hours.
Percent of ED Visits
Percent of ED Visits
29
.8%
33
.1%
31
.3%
34
.7%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
2012 2006
Tarrant Co. Dallas Co.
34.7%
33.9%
33.4%
33.1%
34.1%
33.2%
31.3%
0.0% 10.0% 20.0% 30.0% 40.0%
2006
2007
2008
2009
2010
2011
2012
Dallas Co.
9
Model for Determining
Community Health
Dashboard
Health Outcomes
Mortality
Years of Potential Life Lost
Infant Mortality
Very Low Birth Weight Births
Morbidity
Mental Health Status
Diabetes Prevalence
Health Factors
Health Risk Behaviors
Cancer Screening
Mammogram
Pap Test
Colon Cancer Screening
Vaccinations
Flu Shots for Adults 65+
Child ages 19-35 months
Violence and Injury Prevention
Mortality
ED Visits for Injury
High Risk Sexual Behavior HIV/STD Rates
Teen Birth Rate
Tobacco Use
Alcohol Use
Diet and Exercise
Over Weight and Obese
Access to Clinical Care
Percent Uninsured
Percent with Personal Physician
Physician-to-Population Ratio
Non-Emergent Emergency Department Use
Quality of Clinical Care
Prevention Quality Indicators
10
Quality of care
Quality of
Clinical Care
Prevention Quality
Indicators
Preventable Hospitalizations –
Diabetes PQIs
Diabetes Short Term Comp
Diabetes Long Term Comp
Diabetes Lower Extremity
Amputations
Uncontrolled Diabetes
Preventable Hospitalizations –
Cardiovascular PQIs
Hypertension
Congestive Heart Failure
Angina w/o Procedure
Preventable Hospitalizations –
Chronic Pulmonary PQIs
Adult Asthma
COPD
Preventable Hospitalizations – Acute/Infectious Disease PQIs
Urinary Tract Infection
Bacterial Pneumonia
Dehydration
Perforated Appendix
Dallas County
Compared to Four Peer
Counties (Quartiles)
Dallas County
Compared to
Past Years’ Data – Doing better than the benchmark
– Same as/not significantly different from the benchmark
– Worse than the benchmark
11
Source: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided
5.16.13
Dallas County Trend 2007 to 2011
Potentially Preventable
Hospitalizations, Adult Asthma,
2007 - 2011
Total risk adjusted rate
per 100,000 population
30
.0
36
.2
25
.4
26
.8
32
.5
36
.2
28
.7
39
.3
28
.7
35
.7
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
2011 2007
Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
39.3
37.6
46.2
36.4
28.7
0.0 10.0 20.0 30.0 40.0 50.0
2007
2008
2009
2010
2011
Dallas Co.
The Prevention Quality Indicator (PQI) is a product of
the Agency for Health Research and Quality (AHRQ).
AHRQ has defined 13 adult PQIs that measure rates of
inappropriate hospital admissions for illnesses that
can be effectively managed with high-quality,
community-based primary care.
Risk Adjusted Rate per 100,000
12
Dallas County Trend 2007 to 2011
Potentially Preventable
Hospitalizations, Angina W/O
Procedure, 2007 - 2011
Risk Adjusted Rate per 100,000
9.2
20
.7
7.1
16
.7
13
.0
20
.4
5.8
12
.6
10
.9
21
.4
0.0
5.0
10.0
15.0
20.0
25.0
2011 2007
Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
12.6
8.9
8.7
6.6
5.8
0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0
2007
2008
2009
2010
2011
Dallas Co.
Total risk adjusted rate
per 100,000 population
Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided
5.16.13
The Prevention Quality Indicator (PQI) is a product of
the Agency for Health Research and Quality (AHRQ).
AHRQ has defined 13 adult PQIs that measure rates of
inappropriate hospital admissions for illnesses that
can be effectively managed with high-quality,
community-based primary care.
13
Dallas County Trend 2007 to 2011
Potentially Preventable
Hospitalizations, Bacterial
Pneumonia, 2007 - 2011 2
02
.9
29
3.7
24
3.4
31
6.4
26
7.6
41
3.2
23
8.8
33
7.6
26
4.7
36
3.5
0.0
50.0
100.0
150.0
200.0
250.0
300.0
350.0
400.0
450.0
2011 2007
Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
337.6
276.6
259.0
262.2
238.8
0.0 100.0 200.0 300.0 400.0
2007
2008
2009
2010
2011
Dallas Co.
Total risk adjusted rate
per 100,000 population
Risk Adjusted Rate per 100,000
Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided
5.16.13
The Prevention Quality Indicator (PQI) is a product of
the Agency for Health Research and Quality (AHRQ).
AHRQ has defined 13 adult PQIs that measure rates of
inappropriate hospital admissions for illnesses that
can be effectively managed with high-quality,
community-based primary care.
14
Dallas County Trend 2007 to 2011
Potentially Preventable Hospitalizations,
Chronic Obstructive Pulmonary Disease
(COPD), 2007 - 2011 3
54
.8
30
8.3
39
6.6
39
6.1
42
4.2
45
5.5
43
2.7
43
2.0
39
4.7
40
9.5
0.0
50.0
100.0
150.0
200.0
250.0
300.0
350.0
400.0
450.0
500.0
2011 2007
Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
432.0
458.2
452.9
454.6
432.7
0.0 100.0 200.0 300.0 400.0 500.0
2007
2008
2009
2010
2011
Dallas Co.
Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided
5.16.13
Total risk adjusted rate
per 100,000 population
Risk Adjusted Rate per 100,000
The Prevention Quality Indicator (PQI) is a product of
the Agency for Health Research and Quality (AHRQ).
AHRQ has defined 13 adult PQIs that measure rates of
inappropriate hospital admissions for illnesses that
can be effectively managed with high-quality,
community-based primary care.
15
Dallas County Trend 2007 to 2011
Potentially Preventable
Hospitalizations, Congestive Heart
Failure (CHF), 2007 - 2011 3
07
.5
42
6.7
36
6.5
45
2.8
32
6.1
36
2.3
36
9.3
44
1.8
31
6.4
40
5.0
0.0
50.0
100.0
150.0
200.0
250.0
300.0
350.0
400.0
450.0
500.0
2011 2007
Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
441.8
414.0
398.8
407.9
369.3
0.0 100.0 200.0 300.0 400.0 500.0
2007
2008
2009
2010
2011
Dallas Co.
Total risk adjusted rate
per 100,000 population
Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided
5.16.13
Risk Adjusted Rate per 100,000
The Prevention Quality Indicator (PQI) is a product of
the Agency for Health Research and Quality (AHRQ).
AHRQ has defined 13 adult PQIs that measure rates of
inappropriate hospital admissions for illnesses that
can be effectively managed with high-quality,
community-based primary care.
16
Dallas County Trend 2007 to 2011
Potentially Preventable
Hospitalizations, Dehydration,
2007 - 2011 11
5.4
15
9.5
95
.8
15
4.5
12
4.9
13
8.9
12
5.7
15
6.5
11
9.2
15
9.4
0.0
20.0
40.0
60.0
80.0
100.0
120.0
140.0
160.0
180.0
2011 2007
Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
156.5
140.1
122.2
119.9
125.7
0.0 50.0 100.0 150.0 200.0
2007
2008
2009
2010
2011
Dallas Co.
Total risk adjusted rate
per 100,000 population
Risk Adjusted Rate per 100,000
Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided
5.16.13
The Prevention Quality Indicator (PQI) is a product of
the Agency for Health Research and Quality (AHRQ).
AHRQ has defined 13 adult PQIs that measure rates of
inappropriate hospital admissions for illnesses that
can be effectively managed with high-quality,
community-based primary care.
17
Dallas County Trend 2007 to 2011
Potentially Preventable
Hospitalizations, Diabetes Long-
Term Complications, 2007 - 2011 1
79
.5
16
4.9
14
6.3
13
4.3
12
4.7
11
6.8
15
3.9
15
4.8
12
8.6
12
9.6
0.0
20.0
40.0
60.0
80.0
100.0
120.0
140.0
160.0
180.0
200.0
2011 2007
Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
154.8
141.0
142.2
159.4
153.9
0.0 50.0 100.0 150.0 200.0
2007
2008
2009
2010
2011
Dallas Co.
Risk Adjusted Rate per 100,000
Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided
5.16.13
Total risk adjusted rate
per 100,000 population
The Prevention Quality Indicator (PQI) is a product of
Agency for Health Research and Quality (AHRQ). AHRQ
has defined 13 adult PQIs that measure rates of
inappropriate hospital admissions for illnesses that
can be effectively managed with high-quality,
community-based primary care.
18
Dallas County Trend 2007 to 2011
Potentially Preventable
Hospitalizations, Diabetes Short-
Term Complications, 2007 - 2011 6
5.6
41
.2
49
.9
44
.6
73
.6
50
.8
66
.1
49
.9
53
.3
43
.4
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
2011 2007
Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
49.9
54.2
55.3
60.1
66.1
0.0 20.0 40.0 60.0 80.0
2007
2008
2009
2010
2011
Dallas Co.
Risk Adjusted Rate per 100,000
Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided
5.16.13
Total risk adjusted rate
per 100,000 population
The Prevention Quality Indicator (PQI) is a product of
Agency for Health Research and Quality (AHRQ). AHRQ
has defined 13 adult PQIs that measure rates of
inappropriate hospital admissions for illnesses that
can be effectively managed with high-quality,
community-based primary care.
19
Dallas County Trend 2007 to 2011
Potentially Preventable
Hospitalizations, Lower Extremity
Amputations for Patients with
Diabetes, 2007 - 2011 3
2.5
32
.3
21
.2
22
.4
20
.5
22
.5
22
.6
24
.8
21
.1
23
.2
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
2011 2007
Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
24.8
22.0
24.8
27.0
22.6
0.0 5.0 10.0 15.0 20.0 25.0 30.0
2007
2008
2009
2010
2011
Dallas Co.
Risk Adjusted Rate per 100,000 Total risk adjusted rate
per 100,000 population
Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided
5.16.13
The Prevention Quality Indicator (PQI) is a product of
the Agency for Health Research and Quality (AHRQ).
AHRQ has defined 13 adult PQIs that measure rates of
inappropriate hospital admissions for illnesses that
can be effectively managed with high-quality,
community-based primary care.
20
Dallas County Trend 2007 to 2011
Potentially Preventable
Hospitalizations, Uncontrolled
Diabetes, 2007 - 2011 2
3.9
26
.5
13
.8
16
.5
13
.0
12
.8
17
.2
16
.5
16
.2
19
.9
0.0
5.0
10.0
15.0
20.0
25.0
30.0
2011 2007
Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
16.5
17.5
17.6
20.2
17.2
0.0 5.0 10.0 15.0 20.0 25.0
2007
2008
2009
2010
2011
Dallas Co.
Risk Adjusted Rate per 100,000
Total risk adjusted rate
per 100,000 population
Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided
5.16.13
The Prevention Quality Indicator (PQI) is a product of
the Agency for Health Research and Quality (AHRQ).
AHRQ has defined 13 adult PQIs that measure rates of
inappropriate hospital admissions for illnesses that
can be effectively managed with high-quality,
community-based primary care.
21
Dallas County Trend 2007 to 2011
Potentially Preventable
Hospitalizations, Hypertension,
2007 - 2011 8
7.3
66
.8
64
.9
74
.3
68
.4
66
.1
75
.7
85
.1
61
.6
64
.1
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
2011 2007
Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
85.1
75.3
78.4
79.0
75.7
0.0 20.0 40.0 60.0 80.0 100.0
2007
2008
2009
2010
2011
Dallas Co.
Risk Adjusted Rate per 100,000
Total risk adjusted rate
per 100,000 population
Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided
5.16.13
The Prevention Quality Indicator (PQI) is a product of
the Agency for Health Research and Quality (AHRQ).
AHRQ has defined 13 adult PQIs that measure rates of
inappropriate hospital admissions for illnesses that
can be effectively managed with high-quality,
community-based primary care.
22
Dallas County Trend 2007 to 2011
Potentially Preventable
Hospitalizations, Urinary Tract
Infections, 2007 - 2011 1
99
.9
18
4.1
23
4.7
22
5.6
22
2.2
21
2.0
21
4.9
21
7.5
21
6.0
21
2.6
0.0
50.0
100.0
150.0
200.0
250.0
2011 2007
Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
217.5
200.3
209.2
222.4
214.9
0.0 50.0 100.0 150.0 200.0 250.0
2007
2008
2009
2010
2011
Dallas Co.
Total risk adjusted rate
per 100,000 population Risk Adjusted Rate per 100,000
Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided
5.16.13
The Prevention Quality Indicator (PQI) is a product of
the Agency for Health Research and Quality (AHRQ).
AHRQ has defined 13 adult PQIs that measure rates of
inappropriate hospital admissions for illnesses that
can be effectively managed with high-quality,
community-based primary care.
23
Dallas County Trend 2007 to 2011
Potentially Preventable
Hospitalizations, Perforated
Appendix, 2007 - 2011 2
6.9
31
.6
32
.5
28
.7
28
.7
28
.3
31
.9
31
.6
30
.0
29
.0
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
2011 2007
Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
31.6
30.5
29.2
31.3
31.9
0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0
2007
2008
2009
2010
2011
Dallas Co.
Total risk adjusted rate
per 100,000 population Risk Adjusted Rate per 100,000
Sources: Dallas Fort Worth Hospital Council Foundation, Data Initiative, Greg Shelton, data provided
5.16.13
The Prevention Quality Indicator (PQI) is a product of
the Agency for Health Research and Quality (AHRQ).
AHRQ has defined 13 adult PQIs that measure rates of
inappropriate hospital admissions for illnesses that
can be effectively managed with high-quality,
community-based primary care.
24
Model for Determining
Community Health
Dashboard
Health Outcomes
Mortality
Years of Potential Life Lost
Infant Mortality
Very Low Birth Weight Births
Morbidity
Mental Health Status
Diabetes Prevalence
Health Factors
Health Risk Behaviors
Cancer Screening
Mammogram
Pap Test
Colon Cancer Screening
Vaccinations
Flu Shots for Adults 65+
Child ages 19-35 months
Violence and Injury Prevention Mortality
ED Visits for Injury
High Risk Sexual Behavior HIV/STD Rates
Teen Birth Rate
Tobacco Use
Alcohol Use
Diet and Exercise
Over Weight and Obese
Access to Clinical Care
Percent Uninsured
Percent with Personal Physician
Physician-to-Population Ratio
Non-Emergent Emergency Department Use
Quality of Clinical Care
Prevention Quality Indicators
25
Health Risk Behaviors –
Cancer Screening
Cancer Screening
Mammogram
Pap Test
Colon Cancer Screening
Dallas County
Compared to
Healthy People
2020 Goal
Dallas County
Compared to 8
Peer Counties
(Quartiles)
Dallas County
Compared to
Past Years’ Data
(CI)
N/A
N/A
– Doing better than the benchmark
– Same as/not significantly different from the
benchmark
– Worse than the benchmark
26
Source: CDC BRFSS, 2004 - 2010, Texas 2010 data provided by Anna Vincent, Research
Specialist, Texas Dept. of State Health Services, via email 7.15.11
Healthy People 2020 Objective C-15
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
Dallas County Trend 2004 to 2010
Screenings: Percent of women aged
18 and over who have had a Pap test
within the past three years, 2010
Healthy People 2020 goal is to increase the
proportion of women who receive a cervical
cancer screening based on the most recent
guidelines. Baseline for the United States for
this measure is 84.5% of women aged 21 to 65
years received a cervical cancer screening
based on the most recent guidelines in 2008. (target based on 10% improvement or an increase to in
screening rates to 93.0%)
Percent Percent
Other Peer Counties
include: Maricopa, Los
Angeles, Miami-Dade, Cook 8
1.1
%
86
.0%
78
.2%
83
.0%
77
.2%
83
.1%
84
.5%
87
.5%
76
.7%
86
.5%
79
.4%
82
.2%
93.0% 93.0%
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
2010 2004
U.S. Median Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
86.5%
91.4%
85.6%
76.7%
0.0% 20.0% 40.0% 60.0% 80.0% 100.0%
2004
2006
2008
2010
Dallas Co.
Other Peer Counties
Range
74.5% – 82.8%
27
Screenings: Percent of women aged 40+
who have had a mammogram within the
past two years, 2010
75
.6%
74
.9%
71
.9%
73
.5%
70
.9%
69
.8%
76
.9%
74
.6%
75
.4%
64
.3%
70
.1%
67
.8%
81.1%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
2010 2004
U.S. Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
64.3%
78.3%
77.3%
75.4%
0.0% 20.0% 40.0% 60.0% 80.0% 100.0%
2004
2006
2008
2010
Dallas County
Percent
Healthy People 2020 goal is to increase the
proportion of women who receive breast
cancer screening based on the most recent
guidelines. Baseline for the United States
for this measure is 73.7% of females 50 to
74 years of age received a breast cancer
screening based on the most recent
guidelines in 2008. (target based on 10%
improvement to a target of 81.1%) Source: CDC BRFSS, 2004 - 2010, Texas 2010 data provided by Anna Vincent, Research
Specialist, Texas Dept. of State Health Services, via email 7.15.11
Healthy People 2020 Objective C-17
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
Other Peer Counties include:
Maricopa, Los Angeles, Miami-Dade,
Cook
Other Peer Counties
Range
74.3% – 81.3%
Dallas County Trend 2004 to 2010
28
Dallas County Trend 2002 to 2010
Screenings: Percent of adults age 50 and
over who have ever had a sigmoidoscopy
or colonoscopy, 2010
Per cent
Percent
Other Peer Counties
include: Maricopa, Los
Angeles, Miami-Dade, Cook
65
.3%
53
.5%
70
.5%
59
.6%
60
.2%
48
.8%
69
.5%
48
.2%
60
.8%
47
.6%
61
.6%
48
.4%
70.5%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
2010 2004
U.S. Median Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
*
46.3%
47.6%
60.4%
56.0%
60.8%
0.0% 20.0% 40.0% 60.0% 80.0%
2002
2004
2006
2008
2010
Dallas Co.
Other Peer Counties Range
56.3% – 71.4%
Healthy People 2020 goal is to increase the
proportion of adults aged 50-74 who
receive colorectal cancer screening based
on the most recent guidelines. Baseline for
the United States for this measure is 54.2%
of adults 50 to 74 years of age received a
colonoscopy or sigmoidoscopy based on
the most recent guidelines in 2008. (target
based modeling/projection) Source: CDC BRFSS, 2004 - 2010, Texas 2010 data provided by Anna Vincent, Research
Specialist, Texas Dept. of State Health Services, via email 7.15.11
Healthy People 2020 Objective C-16
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
29
Health Risk Behaviors –
Vaccinations
Vaccinations
Adult
Child age 19-35 months
Dallas County
Compared to
Healthy People
2020 Goal
Dallas County
Compared to 8
Peer Counties
(Quartiles)
Dallas County
Compared to
Past Years’ Data
(CI)
– Doing better than the benchmark
– Same as/not significantly different from the
benchmark
– Worse than the benchmark
30
Immunization: Vaccinations for children
ages 19 to 35 months
77
.0%
73
.7%
71
.7%
71
.4%
73
.7%
63
.1%
76
.3%
69
.7%
80.0% 80.0%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
2011 2001
U.S. Median Bexar Co. Dallas Co.
Texas Healthy People 2020No peer county data available for the 2011 survey. The
only peer county available in 2010 was Los Angeles
County at 80.0% immunized in this age group.
Dallas County Trend for percent of
children receiving the appropriate
vaccinations for ages 19 to 35 months,
2001-2011
Source: Centers for Disease Control and Prevention, National Immunization Survey, 2001, 2002,
2004-2011.
http://www.cdc.gov/vaccines/stats-surv/nis/default.htm#nis
Percent
Percent
Healthy People 2020 Objective IID-8
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
Healthy People 2020 goal is to increase the proportion of
children aged 19 to 35 months who receive the recommended
doses of DTaP, polio, MMR, Hib, hepatitis B and varicella.
(Target based on consistency with national programs)
Vaccine recommendations based on the
4:3:1:3:3:1 schedule and at the
appropriate age.
63.1%
68.0%
67.1%
72.8%
73.3%
71.9%
74.2%
73.5%
72.6%
73.7%
0.0% 20.0% 40.0% 60.0% 80.0% 100.0%
2001
2002
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
31
Immunization: Adults aged 65+ who
have had a flu shot/nasal vaccine
within the past year, 2011
60
.2%
67
.3%
61
.8%
65
.5%
56
.8%
58
.2%
62
.0%
60
.5%
63
.4%
59
.7%
59
.1%
61
.4%
90.0% 90.0%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
2011 2001/2002
US Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
59.7%
71.4%
63.6%
72.8%
68.9%
70.3%
65.1%
63.4%
0.0% 20.0% 40.0% 60.0% 80.0% 100.0%
2001/2
2003/4
2005/6
2007
2008
2009
2010
2011
Dallas County Trend for Adults aged
65+ who have had a flu shot within
the past 12 months Percent
Healthy People 2020 goal is to increase the
proportion of adults who are vaccinated annually
against influenza. (Target based on better than best,
retention of Healthy People 2010 target)
Other Peer
Counties Range
Percent
Source: CDC BRFSS, 2001/2002 combined, 2003/2004 combined, 2005/2006 combined, 2007-11. Years were combined to ensure a sufficient
sample size. Data for Other Peer Counties is 2010, before implementation of cell phone sampling procedures.. Texas 2010-11 data provided
by Anna Vincent, Research Specialist, Texas Dept. of State Health Services, via email 3.18.13
Healthy People 2020 Objective IID-12.7 http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
Other Peer Counties include:
Maricopa, Los Angeles, Cook,
Miami/Dade.
49.3% - 70.7%
Discontinuity: BRFSS began surveying cell
phones in 2011, not comparable with
previous years’ rates. Also in 2011, the
question was changed to include nasal
inoculation as well as injected vaccine.
32
Violence Mortality and ED Visits for Injury
All Unintentional Injuries Death Rate
Motor Vehicle Crash Death Rate
Falls Death Rate
Falls Death Rate Age 65+
Unintentional Poisoning Death Rate
Suicide Death Rate
Homicide Death Rate
ED Visits for Injuries
Health Risk Behaviors – Violence
and Injury Prevention Dallas County
Compared to
Healthy People
2020 Goal
Dallas County
Compared to
8 Peer
Counties
Dallas County
Compared to
Past Years’
Data (CI)
N/A N/A
– Doing better than the benchmark
– Same as/not significantly different from the benchmark
– Worse than the benchmark
33
Injuries: Age-Adjusted Unintentional
Injury Death Rate, per 100,000 population
38
.2
35
.7
43
.2
30
.9
35
.4
38
.1
29
.2
33
.3
35
.1
35
.1
39
.0
39
.3
36.0 36.0
0.0
10.0
20.0
30.0
40.0
50.0
2010 2001U.S. Median Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
Other Peer
Counties Range
Other Peer Counties include: Maricopa, Los
Angeles, Miami-Dade, Cook
Dallas County Trend in Unintentional
Injury Death Rates, 2001 to 2011
20.2 – 44.1
Rate Per 100,000
Rate Per 100,000
Source: Texas Department of State Health Services website query system and special run by Lyudmila Baskin,
Ph.D, Research Specialist, Texas Dept of State Health Services
Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File 1999-
2007. CDC WONDER On-line Database, compiled from Compressed Mortality File 1999-2007 Series 20 No. 2M, 2010.
Accessed at http://wonder.cdc.gov/cmf-icd10.html on Jul 15, 2011 6:32:01 PM
Healthy People 2020 Objective IVP-11
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
U.S. 2009 data source: National Vital Statists Reports, Deaths: Preliminary data for 2009, March 2011 Vol. 59., No.4.
pp. 41-43
Healthy People 2020 goal is to reduce deaths caused
by unintentional injuries (Target based on 10 percent
improvement)
35.1
34.3
34.1
36.1
35.1
34.0
35.8
36.0
35.3
35.1
32.1
- 10.0 20.0 30.0 40.0
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Includes all unintentional injuries, including
motor vehicle accidents, falls, poisoning,
drowning/submersion, and others. Does
not include homicide and suicide. ICD10
codes for unintentional injury deaths
include: (V01-X59, Y85-Y86).
34
Injuries: Age-Adjusted Motor Vehicle
Crash Death Rate, per 100,000 population
11
.7
15
.3
11
.6
11
.7
10
.7
16
.1
10
.3
13
.9
10
.9
16
.3
14
.3
18
.7
12.4 12.4
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
20.0
2010 2001
U.S. Median Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
Other Peer
Counties Range
Other Peer Counties include: Maricopa,
Los Angeles, Miami-Dade, Cook
Dallas County Trend in Motor Vehicle
Crash Death Rates, 2001-2011
6.1 – 10.9
Source: Texas Department of State Health Services website query system and special run by Lyudmila
Baskin, Ph.D, Research Specialist, Texas Dept of State Health Services
Rate Per 100,000
Rate Per 100,000
Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File 1999-2007.
CDC WONDER On-line Database, compiled from Compressed Mortality File 1999-2007 Series 20 No. 2M, 2010.
Accessed at http://wonder.cdc.gov/cmf-icd10.html on Jul 15, 2011 6:32:01 PM
Healthy People 2020 Objective IIVP 13.1
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
U.S. 2009 data source: National Vital Statists Reports, Deaths: Preliminary data for 2009, March 2011 Vol. 59., No.4. pp.
41-43
Healthy People 2020 goal is to reduce
deaths caused by motor vehicle crashes
(Target based on 10% improvement)
16.3
14.1
13.6
14.4
11.5
11.0
11.7
12.2
8.0
10.9
8.4
0.0 5.0 10.0 15.0 20.0
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
ICD10 Codes for Motor Vehicle Crashes
Includes V02-V04, V09.0, V09.2, V12-V14,
V19.0-V19.2, V19.4-V19.6, V20-V79, V80.3-
V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86,
V87.0-V87.8, V88.0-V88.8, V89.0, V89.2
35
Injuries: Age-Adjusted Falls Death Rate,
per 100,000 population
7.5
5.3
15
.1
7.3
9.0
4.3
4.3
4.2
8.9
5.2
7.4
4.6
7.0 7.0
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
2010 2001
U.S. Median Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
Other Peer
Counties Range
Other Peer Counties include: Maricopa, Los
Angeles, Miami-Dade, Cook
Dallas County Falls Death Rates,
2001-2011
4.3 – 13.7
Rate Per 100,000
Rate Per 100,000
Healthy People 2020 goal prevent an
increase in the rate of fall-related deaths
(Target is to maintain the baseline rate)
5.2
4.8
6.4
7.4
6.6
7.3
8.4
7.9
10.2
8.9
6.5
0.0 2.0 4.0 6.0 8.0 10.0 12.0
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Includes falls deaths. ICD 10 W00-W19
Source: Texas Department of State Health Services website query system and special run by Lyudmila
Baskin, Ph.D, Research Specialist, Texas Dept of State Health Services
Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File 1999-2007. CDC
WONDER On-line Database, compiled from Compressed Mortality File 1999-2007 Series 20 No. 2M, 2010.
Accessed at http://wonder.cdc.gov/cmf-icd10.html on Jul 15, 2011 6:32:01 PM
Healthy People 2020 Objective IIVP 23.1 http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
U.S. 2009 data source: National Vital Statists Reports, Deaths: Preliminary data for 2009, March 2011 Vol. 59., No.4. pp. 41-43
36
Injuries: Age Specific Fall Death Rates,
per 100,000 population for age 65
45
.2
33
10
5.6
46
.2
63
.2
21
.9
24
.7
23
.4
59
.3
30
.8
49
.5
25
.9
45.3 45.3
0
20
40
60
80
100
120
2010 2001
U.S. Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
30.8
28.4
38.8
45.1
42.4
44.1
58.5
51.2
65.8
59.3
43.9
0 20 40 60 80
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Dallas County Trend in Age-
Specific Falls Death Rates, 2001-
2011, age 65 and over
Other Peer Counties
Range Rate per 100,000 population
age 65 and over
Healthy People 2020 to prevent
an increase in the rate of fall-
related deaths (Target is to maintain
the baseline rate)
Source: Texas Department of State Health Services website query system and special run by Lyudmila Baskin, Ph.D,
Research Specialist, Texas Dept of State Health Services
Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File 1999-2007. CDC WONDER
On-line Database, compiled from Compressed Mortality File 1999-2007 Series 20 No. 2M, 2010.
Accessed at http://wonder.cdc.gov/cmf-icd10.html on Jul 15, 2011 6:32:01 PM
Healthy People 2020 Objective IVP-23.2 http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
U.S. 2009 data source: National Vital Statists Reports, Deaths: Preliminary data for 2009, March 2011 Vol. 59., No.4. pp. 41-43
Other Peer Counties include:
Maricopa, Los Angeles,
Miami-Dade, Cook
Includes falls deaths. ICD 10 W00-W19
26.3 – 98.3
37
Injuries: Age-Adjusted Unintentional
Poisoning Death Rate, per 100,000
population 9
.9
9.9
10
.4
5.1
9.8
7.3
6.8
5.6
7.9
5.4
8.7
5.1
13.1 13.1
0
2
4
6
8
10
12
14
2010 2001
U.S. Median Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
Other Peer
Counties Range
Other Peer Counties include: Maricopa, Los
Angeles, Miami-Dade, Cook
Dallas County Trend in Poisoning
Death Rates, 2001-2011
3.4– 13.3
Rate Per 100,000
Rate Per 100,000
Healthy People 2020 goal is to Prevent an
increase in the rate of poisoning deaths
((Target is to maintain the baseline rate)
5.4
6.7
5.7
6.4
7.8
7.1
9.2
8.4
8.4
7.9
9.1
0 2 4 6 8 10
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Includes all unintentional
poisoning deaths. ICD 10 X40-
X49
Source: Texas Department of State Health Services website query system and special run by Lyudmila Baskin, Ph.D,
Research Specialist, Texas Dept of State Health Services Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File 1999-2007. CDC WONDER
On-line Database, compiled from Compressed Mortality File 1999-2007 Series 20 No. 2M, 2010.
Accessed at http://wonder.cdc.gov/cmf-icd10.html on Jul 15, 2011 6:32:01 PM
Healthy People 2020 Objective IVP-9.1 http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
U.S. 2009 data source: National Vital Statists Reports, Deaths: Preliminary data for 2009, March 2011 Vol. 59., No.4. pp. 41-43
38
Injuries: Age-Adjusted Suicide Death Rate,
per 100,000 population
11
.7
10
.7
10
.9
10
.8
11
.0
10
.3
10
.5
9.9
11
.1
10
.8
11
.7
10
.8
10.2 10.2
0
2
4
6
8
10
12
14
16
2010 2001
U.S. Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
Other Peer Counties
Range
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
7.4 – 14.9
Includes all Suicides deaths. ICD 10 X60-x84, Y87.0
Dallas County Trend in Suicide
Death Rates, 2001-2011
Rate per 100,000
Rate per 100,000
Healthy People 2020 goal is to reduce
deaths the suicide rate (Target based on
10 percent improvement)
10.8
10.7
10.3
9.5
9.7
9.0
10.4
9.6
10.6
11.1
9.3
0 2 4 6 8 10 12
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Source: Texas Department of State Health Services website query system and special run by Lyudmila Baskin, Ph.D,
Research Specialist, Texas Dept of State Health Services Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File 1999-2007. CDC WONDER
On-line Database, compiled from Compressed Mortality File 1999-2007 Series 20 No. 2M, 2010.
Accessed at http://wonder.cdc.gov/cmf-icd10.html on Jul 15, 2011 6:32:01 PM
Healthy People 2020 Objective MHMD-1 http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
U.S. 2009 data source: National Vital Statists Reports, Deaths: Preliminary data for 2009, March 2011 Vol. 59., No.4. pp. 41-43
39
Injuries: Age-Adjusted Homicide Death
Rate, per 100,000 population
5.5
6.0
6.1
7.7
8.8
8.7
5.8
6.5
7.4
12
.4
5.4
6.4
5.5 5.5
0
2
4
6
8
10
12
14
2010 2001
U.S. Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
Other Peer Counties
Range
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
6.3 – 10.3
Includes all homicide deaths. ICD 10 X85-Y09, Y87.1
Dallas County Trend in Homicide
Death Rates, 2001-2011
Rate per 100,000
Rate per 100,000
Healthy People 2020 goal is to reduce
homicides (Target based on 10 percent
improvement)
12.4
10.8
10.5
11.3
10.0
9.3
10.1
9.0
8.5
7.4
6.7
0 5 10 15
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Source: Texas Department of State Health Services website query system and special run by Lyudmila Baskin, Ph.D,
Research Specialist, Texas Dept of State Health Services Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File 1999-2007. CDC WONDER
On-line Database, compiled from Compressed Mortality File 1999-2007 Series 20 No. 2M, 2010.
Accessed at http://wonder.cdc.gov/cmf-icd10.html on Jul 15, 2011 6:32:01 PM
Healthy People 2020 Objective IVP 29 http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
U.S. 2009 data source: National Vital Statists Reports, Deaths: Preliminary data for 2009, March 2011 Vol. 59., No.4. pp. 41-43
40
Sources: DFWHC ERF Information Quality Services Center Regional Data, 2010.
Dallas-Fort Worth Hospital Council Education and Research Foundation, Information
and Quality Services Center, Irving, Texas. Nov 20 2012. Denominator population
data from US Census Bureau, American Community Survey, 2011
Dallas County Trend in Emergency
Department Visits for Injuries, 2006-2012
Injuries: Emergency Department
Visits for Injuries, 2006-2012
The Dallas Fort Worth Hospital Council has established an
Emergency Department data set from more than 44
hospitals in the region. The data repository has over 3.6
million emergency department visits as of 2011.
Injury-Related ED Visits per 1,000 population
Rate per 1,000 population
72
.8
61
.3
65
.9
48
.0
-
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
2012 2008
Tarrant Co. Dallas Co.
54.1
53.5
48.0
48.4
58.5
60.8
65.9
- 10.0 20.0 30.0 40.0 50.0 60.0 70.0
2006
2007
2008
2009
2010
2011
2012
Dallas Co.
Health Risk Behaviors – High
Risk Sexual Behaviors
High Risk Sexual
Behavior
HIV/STD Rates
HIV Incidence
Chlamydia Incidence
Gonorrhea Incidence
Primary/ Secondary
Syphilis
Teen Birth Rates
Dallas
County
Compared
to Healthy
People
2020 Goal
Dallas
County
Compared
to 8 Peer
Counties
(Quartiles)
Dallas
County
Compared
to Past
Years’
Data (CI)
N/A
N/A
N/A
N/A
N/A
41
– Doing better than the benchmark
– Same as/not significantly different from the benchmark
– Worse than the benchmark
42
STD/HIV: Annual HIV Cases and
Rates, 2003-2011
36
1
31
6
1,2
34
1,1
42
22
7
19
8
88
3
1,0
81
4,4
02
4,5
12
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
5,000
2011 2004
Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
Email from Ed Weckerly Epidemiologist TB/HIV/STD Epidemiology and Surveillance, MC 1873
7/20/11
The Texas HIV Surveillance Report 2011, Texas Department of State Health Services,
http://www.dshs.state.tx.us/hivstd/reports/default.shtm
Dallas County Trend for Rate of
New HIV Cases, 2003 to 2011
Cases per 100,000
Number of New Cases
46.0
46.2
44.3
35.5
34.2
32.7
34.4
38.3
34.8
0.0 10.0 20.0 30.0 40.0 50.0
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
34,247 new cases of HIV in 2009 in the
U.S.
43
STD/HIV: Chlamydia Cases per
100,000 population 2003-2011
40
9.2
31
6.5
71
2.2
46
8.8
51
4.8
33
0.7
42
2.2
29
5.2
68
4.8
37
2.8
47
3.0
31
2.1
0
100
200
300
400
500
600
700
800
2011 2004
U.S. Median (2009) Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
Other Peer Counties
Range
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook (2009 data)
Source: The Texas STD Surveillance Report 2011, Texas Department of State Health Services,
http://www.dshs.state.tx.us/hivstd/reports/default.shtm
Dallas County Trend 2003 to 2011
346.8 - 671.1
Cases per 100,000 Cases per 100,000
Healthy People 2020, STD-3.1 to 4.2. No overall target is available, all targets are age- and gender-
specific.
http://wonder.cdc.gov/controller/datarequest/D42
420.9
372.8
426.7
364.5
517.0
565.1
580.7
654.4
684.8
0.0 200.0 400.0 600.0 800.0
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
44
STD/HIV: Gonorrhea Rate per
100,000 population 2003-2011
99
.1
11
2.4
20
8.9
13
8.3
13
7.3
12
8.1
11
6.8
14
1.9
20
9.0
18
1.5
11
7.8
10
8.2
0.0
50.0
100.0
150.0
200.0
250.0
2011 2004
U.S. Rate (2009) Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
Other Peer Counties Range Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook (2009 data) Dallas County Trend 2003 to 2011
57.1 to 251.8
Cases per 100,000
Cases per 100,000
205.8
181.5
219.0
198.7
260.4
212.3
183.2
211.7
209.0
0.0 100.0 200.0 300.0
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Healthy People 2020, STD-3.1 to 4.2. No overall target is available, all targets are age- and gender-
specific.
http://wonder.cdc.gov/controller/datarequest/D42
Source: The Texas STD Surveillance Report 2011, Texas Department of State Health Services,
http://www.dshs.state.tx.us/hivstd/reports/default.shtm
45
STD/HIV: Syphilis Primary and Secondary
Rate per 100,000 population, 2003-2011
4.6
2.7
11
.1
7.3
6.5
5.8
6.6
4.2
7.1
8.0
4.5
3.7
0.0
5.0
10.0
15.0
20.0
25.0
30.0
2011 2004
U.S. Rate (2008) Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
Other Peer Counties Range Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook (2010 data) Dallas County Trend for Syphilis
Rate, 2003 to 2011
3.9 – 25.5
Cases per 100,000
Cases per 100,000
7.3
8.0
7.5
8.9
6.6
9.0
12.1
7.5
7.1
0.0 5.0 10.0 15.0
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Healthy People 2020, STD-3.1 to 4.2. No overall target is available, all targets are age- and gender-
specific.
http://wonder.cdc.gov/controller/datarequest/D42
Source: The Texas STD Surveillance Report 2011, Texas Department of State Health Services,
http://www.dshs.state.tx.us/hivstd/reports/default.shtm
46
Teen Births: Teen Birth Rate, 2003 to 2010
(Number of births per 1,000 women ages
15 to 19) 3
4.3
45
.3
51
.76
67
.90
52
.1
63
.5
46
.5
62
.6
52
.3
76
.5
52
.2
67
.4
0
10
20
30
40
50
60
70
80
90
2010 2003
U.S. Rate Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
(Other Peer Counties Range) Other Peer Counties include:
Maricopa, Los Angeles, Miami-Dade, Cook
Dallas County Trend for Teen
Birth Rate, 2003 to 2011
27.1 – 39.5
Cases per 1,000 women
Cases per 1,000
The Healthy People 2020 national health
target is to reduce pregnancies among
adolescent females ages 15-17 from 40.2
per 1,000 in 2005 to 36.2 per 1,000 in 2020
Healthy People 2020, FP 8.1 Source: CDC Wonder 2003, 2010
American Community Survey Population Estimates 2003-2011, Females 15 to 19
Rate for 2011 from email correspondence with Lyudmila Baskin, Ph.D. Research Specialist, Texas Department
of State Health Services
Peer County Data Source: CDC Wonder.
76.5
78.5
77.1
78.0
78.0
73.4
68.6
58.3
52.3
0 20 40 60 80 100
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Health Risk Behaviors –
Other High Risk Behaviors
Health Risks
Alcohol Use Binge Drinking
Diet and Exercise
Overweight and Obese
Recommended Physical Activity
Frequency of Five Fruits/
Vegetables per Day
Tobacco Use Current
Smokers
Dallas
County
Compared to
Healthy
People 2020
Goal
Dallas
County
Compared
to 8 Peer
Counties
(Quartiles)
Dallas
County
Compared
to Past
Years’ Data
(CI)
N/A
47
– Doing better than the benchmark
– Same as/not significantly different from the benchmark
– Worse than the benchmark
48
Diet and Exercise: Adults* with 30+ minutes of moderate
physical activity five or more days per week, or vigorous
physical activity for 20+ minutes three or more days per week
51
.4%
49
.1%
47
.2%
48
.7%
49
.1%
43
.0%
47
.9%
48
.8%
43
.3%
38
.8%
48
.2%
46
.7%
47.9% 47.9%
0%
10%
20%
30%
40%
50%
60%
2011 2005
U.S. Median Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
Other Peer Counties
Range
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
Dallas County Trend for Physical
Activity, 2003 to 2011
Healthy People 2020 goal is to increase the proportion
of adults who engage in aerobic physical activity of at
least moderate intensity for at least 150 minutes/week
or 75 minutes/week of vigorous intensity, or an
equivalent combination (Target set at 10 percent improvement)
39.3 – 50.0
Percent Percent
Source: CDC BRFSS, 2003, 2005, 2007, 2009 and 2011
Healthy People 2020 Objective PA 2.1
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
44.2%
38.8%
44.7%
42.6%
43.3%
0% 10% 20% 30% 40% 50%
2003
2005
2007
2009
2011
Dallas Co.
*Adults are described as 18 and over
Discontinuity: BRFSS began
surveying cell phones in 2011, not
comparable with previous years’ rates
49
Overweight and Obese: Adults* with a BMI
Greater Than 25 and Greater Than 30, 2006 to 2011
63
.3%
61
.6%
66
.3%
68
.3%
65
.0%
52
.7%
65
.4%
65
.5%
63
.8%
63
.0%
65
.8%
62
.4%
66.1% 66.1%
0%
10%
20%
30%
40%
50%
60%
70%
80%
2011 2006
U.S. Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
Dallas County Trend for
Overweight or Obese, 2006 -
2011
63.0%
57.3%
71.3%
60.3%
59.3%
63.8%
0% 20% 40% 60% 80%
2006
2007
2008
2009
2010
2011
Dallas Co.
Percent
Percent
61.3% – 66.4%
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
Other Peer Counties
Range
*Adults are defined as ages 18 and over
Source: CDC BRFSS, 2003, 2005, 2007, 2009 and 2011
Healthy People 2020 Objective NWS-8
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=29
Healthy People 2020 goal is to increase
the proportion of adults who are at a
healthy weight. Baseline and target are
for adults over the age of 20. The data
source available here is for adults over
the age of 18. (Target is a 10% increase.
Baseline is at 30.8% of adults 20 and over at a
healthy weight . The target is to increase to 33.9%
of adults 20 and over at a healthy weight.)
Discontinuity: BRFSS began
surveying cell phones in 2011, not
comparable with previous years’ rates
50
Diet and Exercise: Adults* who have
consumed fruits or vegetables 5 or more
times per day, 2003-2011
18
.1%
23
.2%
18
.1%
21
.8%
21
.3%
23
.6%
21
.7%
21
.8%
16
.8%
20
.1%
18
.1%
22
.6%
0%
5%
10%
15%
20%
25%
30%
2011 2005
U.S. Median Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
Other Peer Counties
Range
Other Peer Counties include:
Maricopa, Los Angeles,
Miami-Dade, Cook
Dallas County Trend for Fruit and
Vegetable Consumption, 2003 to
2011
22.1% – 26.5%
Percent
Percent
Source: CDC BRFSS, 2003, 2005, 2007, 2009 and 2011
25.5%
20.1%
25.5%
23.3%
16.8%
0% 20% 40%
2003
2005
2007
2009
2011
Dallas Co.
*Adults are described as 18 and over
Healthy People 2020 goal is to
increase contribution of total
vegetables to the diets of the
population aged 2 years and older. (Target is 1.1 cup equivalents per 1,000
calories)
Discontinuity: BRFSS began
surveying cell phones in 2011, not
comparable with previous years’ rates
51
Alcohol Use: Binge Drinkers (Males over the age of 18
who have had 5 or more drinks on one occasion; females
who have had 4 or more drinks on one occasion)
18
.3%
15
.1%
21
.7%
17
.5%
19
.1%
18
.2%
20
.7%
10
.5%
17
.1%
16
.5%
18
.9%
15
.7%
24.3% 24.3%
0%
5%
10%
15%
20%
25%
30%
2011 2004
U.S. Median Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
Other Peer Counties
Range
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
Dallas County Trend for Binge
Drinking, 2004 to 2011
11.6%-18.8%
Percent
Percent
16.5%
10.6%
14.9%
17.2%
15.0%
8.7%
10.9%
17.1%
0% 5% 10% 15% 20%
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
*Adults are described as 18 and over
Healthy People 2020 goal is to reduce the
proportion of adults that engaged in binge drinking
during past month (Target set at 10% improvement)
Source: CDC BRFSS, 2004 – 2011
Healthy People 2020 Objective TU 1.1
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
Discontinuity: BRFSS began
surveying cell phones in 2011, not
comparable with previous years’ rates
52
Tobacco Use: Adults* who are Current
Smokers (Do you now smoke cigarettes every day,
some days, or not at all) 2
0.1
%
20
.9%
16
.8%
19
.0%
18
.2%
17
.1%
18
.9%
19
.7%
18
.9%
20
.8%
19
.2%
20
.5%
12.0% 12.0%
0%
5%
10%
15%
20%
25%
2011 2004
U.S. Median Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
Other Peer Counties
Range
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
Dallas County Trend for Rate of
Current Smokers, 2004 to 2011
10.2% - 18.3%
Percent
Percent
Source: CDC BRFSS, 2004 – 2011
Healthy People 2020 Objective TU 1.1
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
20.8%
16.7%
12.5%
15.8%
18.6%
22.4%
15.8%
18.9%
0% 5% 10% 15% 20% 25%
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
*Adults are described as 18 and over
Healthy People 2020 goal is to reduce tobacco use
by adults (Target set at 2010 goal)
Discontinuity: BRFSS began
surveying cell phones in 2011, not
comparable with previous years’ rates
53
Model for Determining
Community Health
Dashboard
Health Outcomes
Mortality
Years of Potential Life Lost
Infant Mortality
Very Low Birth Weight Births
Morbidity
Mental Health Status
Diabetes Prevalence
Health Factors
Health Risk Behaviors
Cancer Screening
Mammogram
Pap Test
Colon Cancer Screening
Vaccinations
Flu Shots for Adults 65+
Child ages 19-35 months
Violence and Injury Prevention Mortality
ED Visits for Injury
High Risk Sexual Behavior HIV/STD Rates
Teen Birth Rate
Tobacco Use
Alcohol Use
Diet and Exercise
Over Weight and Obese
Access to Clinical Care
Percent Uninsured
Percent with Personal Physician
Physician-to-Population Ratio
Non-Emergent Emergency Department Use
Quality of Clinical Care
Prevention Quality Indicators
54
Health Outcomes
Mortality
Heart Disease Death Rate
Cancer Death Rate
Stroke Death Rate
COPD Death Rate
Diabetes Death Rate
Diabetes Prevalence
Health Outcomes –
Mortality Dallas County
Compared to
Healthy
People 2020
Goal
Dallas County
Compared to
8 Peer
Counties
(Quartiles)
Dallas
County
Compared to
Past Years’
Data (CI)
N/A
N/A
N/A
– Doing better than the benchmark
– Same as/not significantly different from the benchmark
– Worse than the benchmark
55
Health Outcomes
Years of Potential Life Lost
Infant Mortality
Very Low Birth Weight Births
Notifiable Communicable
Diseases
Campylobacteriosis
Aseptic Meningitis
Pertussis
Salmonellosis
General Health Status
Mental Health Status
Health Outcomes – Other
Outcomes Dallas
County
Compared to
Healthy
People 2020
Goal
Dallas
County
Compared
to 8 Peer
Counties
(Quartiles)
Dallas
County
Compared to
Past Years’
Data (CI)
N/A
N/A
N/A
N/A
N/A
N/A
– Doing better than the benchmark
– Same as/not significantly different from the benchmark
– Worse than the benchmark
56
Mortality: Deaths due to Heart Disease
2001-2010 (age adjusted rates per 100,000)
17
9.1
27
3.9
17
2.2
24
5.6
17
5.0
27
1.0
18
3.5
26
7.9
18
0.0
26
3.1
18
1.1
25
7.1
100.8 100.8
0.0
50.0
100.0
150.0
200.0
250.0
300.0
2010 2001
U.S. Median Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
Other Peer Counties Range
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
Dallas County Trend 2001 to 2011
141.5 – 192.7
Deaths per 100,000 Deaths per 100,000
Source: Texas Department of State Health Services website query system and special run by Lyudmila
Baskin, Ph.D, Research Specialist, Texas Dept of State Health Services
Healthy People 2020 Objective HDS-2
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
263.1
260.4
244.4
229.2
225.6
206.7
205.2
195.3
198.0
180.0
179.1
0.0 100.0 200.0 300.0
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Healthy People 2020 goal is to reduce coronary
heart disease deaths (Target set at 20 percent improvement)
Centers for Disease Control and Prevention,
National Center for Health Statistics. Multiple
Cause of Death File 2001-2010. CDC WONDER
On-line Database, compiled from Multiple Cause
of Death File 2001-2010. Accessed at
http://wonder.cdc.gov/mortsql.html
ICD10 (l00-l09,l11,l13,l20-l51)
57
Mortality: Deaths due to Cancer
2001-2010 (age adjusted rates per 100,000)
17
2.8
19
6.0
15
9.9
17
5.4
16
2.4
19
8.2
17
2.6
19
2.0
17
2.7
20
2.4
16
5.9
19
1.7
160.6 160.6
0
25
50
75
100
125
150
175
200
225
2010 2001
U.S. Median Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
Other Peer Counties Range
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
Dallas County Trend 2001 to 2011
143.3 – 181.0
Deaths per 100,000 Deaths per 100,000
202.4
195.0
191.5
187.6
192.0
187.5
180.8
176.6
179.3
172.7
168.8
0 50 100 150 200 250
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Healthy People 2020 goal is to reduce the overall
cancer death rate. (target set at 10% improvement)
ICD10 (C00-C97)
Source: Texas Department of State Health Services website query system and special run by Lyudmila
Baskin, Ph.D, Research Specialist, Texas Dept of State Health Services
Healthy People 2020 Objective C-1
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
Centers for Disease Control and Prevention,
National Center for Health Statistics. Multiple
Cause of Death File 2001-2010. CDC WONDER On-
line Database, compiled from Multiple Cause of
Death File 2001-2010. Accessed at
http://wonder.cdc.gov/mortsql.html
58
Mortality: Deaths due to Stroke
2001-2010 (age adjusted rates per 100,000)
39
.1
57
.8
44
.9
63
.3
43
.3
74
.7
51
.7
80
.5
48
.6
64
.8
44
.4
64
.4
33.8
33.8
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
2010 2001
U.S. Median Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
Other Peer Counties Range
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
Dallas County Trend 2001 to 2011
28.8 – 37.7
Deaths per 100,000 Deaths per 100,000
Source: Texas Department of State Health Services website query system and special run by Lyudmila
Baskin, Ph.D, Research Specialist, Texas Dept of State Health Services
Healthy People 2020 Objective HDS-3
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
64.8
60.8
61.7
63.0
55.9
54.9
50.6
55.2
50.2
48.6
43.2
0 20 40 60 80
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Healthy People 2020 goal is to reduce stroke
deaths (Target set at 20 percent improvement)
Centers for Disease Control and Prevention,
National Center for Health Statistics. Multiple
Cause of Death File 2001-2010. CDC WONDER
On-line Database, compiled from Multiple
Cause of Death File 2001-2010. Accessed at
http://wonder.cdc.gov/mortsql.html
(ICD10 I60-I69)
59
Mortality: Deaths due to Chronic Lower
Respiratory Disease (COPD), 2001-2010 (age adjusted rates per 100,000)
42
.2
43
.7
36
.1
39
.2
33
.4
40
.1
48
.7
50
.2
41
.7
44
.9
43
.0
46
.4
50.1 50.1
0
10
20
30
40
50
60
2010 2001
U.S. Median Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
Other Peer Counties Range
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
Dallas County Trend 2001 to 2011
29.7 – 40.4
Deaths per 100,000 Deaths per 100,000
44.9
42.5
40.6
38.9
40.8
38.8
39.4
42.2
42.6
41.7
39.9
34 36 38 40 42 44 46
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Healthy People 2020 goal is to reduce COPD
deaths (Target set at the smallest improvement that results in a
statistically significant difference when tested against the baseline
value)
Centers for Disease Control and Prevention,
National Center for Health Statistics. Multiple
Cause of Death File 2001-2010. CDC WONDER On-
line Database, compiled from Multiple Cause of
Death File 2001-2010. Accessed at
http://wonder.cdc.gov/mortsql.html
(ICD10 J40-J47)
Source: Texas Department of State Health Services website query system and special run by Lyudmila
Baskin, Ph.D, Research Specialist, Texas Dept of State Health Services
Healthy People 2020 Objective RD-11
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
60
Mortality: Deaths due to Diabetes
2001-2010 (age adjusted rates per 100,000)
20
.8
25
.3
24
.7
42
.7
19
.6
29
.4
20
.5
28
.5
19
.4
22
.7
21
.6
31
.7
0
5
10
15
20
25
30
35
40
45
2010 2001
U.S. Median Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
Other Peer Counties
Range
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
Dallas County Trend 2001 to 2011
19.0 – 23.4
Deaths per 100,000 Deaths per 100,000
22.7
26.6
21.7
22.9
24.7
24.0
24.3
23.8
22.8
19.4
20.9
0 5 10 15 20 25 30
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Healthy People 2020 goal is to reduce deaths that were
related to diabetes to 65.8 age adjusted deaths per
100,000. This measure encompasses a broader range of
deaths than included here. (Target set at 10% improvement)
Centers for Disease Control and Prevention,
National Center for Health Statistics. Multiple
Cause of Death File 2001-2010. CDC WONDER
On-line Database, compiled from Multiple Cause
of Death File 2001-2010. Accessed at
http://wonder.cdc.gov/mortsql.html
(ICD10 E10-E14)
Source: Texas Department of State Health Services website query system and special run by Lyudmila
Baskin, Ph.D, Research Specialist, Texas Dept of State Health Services
Healthy People 2020 Objective D-3
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
61
Estimated Diabetes Prevalence
(Diagnosed and Undiagnosed), 2010
.
Percent of Population 18
and Older with Diabetes 11
.3%
11
.7%
8.8
%
11
.8%
9.0
%
10
.3%
7.9
%
11
.7%
8.8
%
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
2010 2004
US Bexar Co. Harris Co. Tarrant Co. Dallas Co.
Source: US Diabetes Index, National Minority Quality Forum and Centers for Disease Control and Prevention, 2013; based on NHANES
population prevalence estimates, 2010, http://maps.z-atlas.com/DiabetesSampleIndex/ . Denominator population data 2010 from
Nielson/Claritas, Inc. Pop Facts. Mid 2010 version. US prevalence estimates from CDC http://www.cdc.gov/diabetes/pubs/estimates11.htm#2
7.33%
7.61%
8.43%
8.82%
9.59%
9.23%
11.18%
11.16%
10.66%
11.78%
0 0 0 0
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Dallas Co.
Dallas County Trend in
Incidence Rates, 2001 - 2010
Percent of the Population 18 and Older
Other Peer Counties
Range
8.9 – 13.7
62
Mortality: Infant Mortality Rate
2001 to 2010 6
.1
6.8
6.5
6.2
6.3
5.4
7.5
7.4
7.6
7.6
6.1
6.0
6.0 6.0
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
9.0
2010 2001
U.S. Median Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
Other Peer Counties Range
Other Peer Counties include: Maricopa,
Los Angeles, Miami-Dade, Cook
Dallas County Trend 2001 to 2011
4.4 – 7.2
Deaths per 1,000 live births
Deaths per 1,000 Live Births
Source: Texas Department of State Health Services website query system and special run by Lyudmila
Baskin, Ph.D, Research Specialist, Texas Dept of State Health Services
http://www.cdc.gov/nchs/data/nvsr/nvsr58/nvsr58_17.pdf
http://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_04.pdf
Healthy People 2020 Objective MCH-1.3
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
6.3
6.6
8.0
6.7
7.1
7.6
7.2
6.7
7.3
7.6
7.1
0 2 4 6 8 10
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Healthy People 2020 goal is to reduction in
infant deaths (Target based on 10% improvement)
Source: Infant Mortality Report: California Department of Public
Health, Center for Health Statistics, OHIR Vital Statistics Section,
1999-2008
Maricopa County health Status Report 2005-2009 page 26.
Illinois Department of Public Health
http://www.idph.state.il.us/health/infant/infmort0608.htm
http://www.flpublichealth.com/VSBOOK/viewreport.aspx?CEID=71
54&Year=2009 Interactive Florida Vital Statistics Annual Report
This indicator shows the mortality rate in deaths
per 1,000 live births for infants within their first year
of life.
63
Low Birth Weight Births: Percent of Births
that are Very Low Birth Weight, <1,500
grams, 2001 to 2010 1
.4%
1.4
%
1.7
%
1.4
%
1.6
%
1.4
%
1.6
%
1.3
%
1.6
%
1.4
%
1.4
%
1.3
%
1.4%
0.0%
0.2%
0.4%
0.6%
0.8%
1.0%
1.2%
1.4%
1.6%
1.8%
2.0%
2010 2001
U.S. Median Bexar Co. Harris Co.
Tarrant Co. Dallas Co. Texas
Healthy People 2020
Other Peer Counties Range
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
Dallas County Trend 2001 to 2011
1.0% – 1.8%
Percent of Births
Percent of Births
Texas Dept of State Health Services, Query System 2001-2010 Very low birth weight births. Email
from Lyudmila Baskin, Ph.D., Research Scientist, TDSHS; CDC Wonder2010; Healthy People
2020 Objective MCH-8.2
http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1
http://www.mchb.hrsa.gov/chusa10/hstat/hsi/pages/203vlbw.html for U.S. data
1.4%
1.5%
1.5%
1.6%
1.6%
1.7%
1.7%
1.6%
1.7%
1.6%
1.7%
0.0% 0.5% 1.0% 1.5% 2.0%
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Healthy People 2020 goal is to reduce low
birth weight (LBW) and very low birth
weight (VLBW) (Target set 5% reduction)
Centers for Disease Control and Prevention,
National Center for Health Statistic, Beyond 20/20
WDS; http:///205.207.175.93/vitalstats/table
viewer/tablevies.aspx
64
Rate of Years of Potential Life Lost
6,9
84
6,9
98
6,8
51
7,3
07
6,6
34
7,4
05
6,6
72
6,9
63
6,9
06
7,4
96
6,8
02
7,3
27
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
2010 2002
U.S. Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
Other Peer Counties Range
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
Trend in Dallas County YPLL
Rate, 2002 to 2010
6,009 – 7,533
Source: Texas Department of State Health Services website query system and special run by Lyudmila
Baskin, Ph.D, Research Specialist, Texas Dept of State Health Services. Deaths 2002-2010
http://soupfin.tdh.state.tx.us/death10.htm DSHS's deaths website, American Community Survey 2002-2011,
http://www.cdc.gov/nchs/data/hus/hus06.pdf, Comparison counties http://www.countyhealthrankings.org/
7,496
7,591
7,253
7,420
7,038
6,735
6,906
6,851
0 2,000 4,000 6,000 8,000
2002
2004
2006
2007
2008
2009
2010
2011
Dallas Co.
This indicator shows the years of life lost
due to deaths under age 75, per 100,000
population.
Premature death is represented by the years of
potential life lost before age 75 (YPLL-75). Every
death occurring before the age of 75 contributes to
the total number of years of potential life lost. For
example, a person dying at age 25 contributes 50
years of life lost, whereas a person who dies at age
65 contributes 10 years of life lost to a county’s YPLL.
65
Notifiable Communicable Disease Incidence:
Campylobacteriosis Rate 2004-2010
13
.0
12
.9
10
.5
4.9
3.9
6.1
3.8
5.4
5.9
8.0
0
2
4
6
8
10
12
14
2010 2004
U.S. Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
Source: 2004 and 2010 data from Texas Department of State Health Services, Infectious
Disease Control Unit personal communication; other years from Dallas County Health and
Human Services web site. http://www.dallascounty.org/department/hhs/epistats.html
US data 2009 CDC Foodnet http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5914a2.htm
Campylobacteriosis is an infectious disease
caused by bacteria of the genus Campylobacter.
Most people who become ill with
campylobacteriosis get diarrhea, cramping,
abdominal pain, and fever within two to five days
after exposure to the organism. The diarrhea
may be bloody and can be accompanied by
nausea and vomiting. The illness typically lasts
one week. Some infected persons do not have
any symptoms. In persons with compromised
immune systems, Campylobacter occasionally
spreads to the bloodstream and causes a
serious life-threatening infection.
Cases per 100,000
Dallas County Trend in
Incidence Rates, 2003 - 2010
5.3
5.9
4.2
5.2
8.5
6.1
8.5
5.5
0 2 4 6 8 10
2003
2004
2005
2006
2007
2008
2009
2010
Dallas Co.
Cases per 100,000
66
Notifiable Communicable Disease Incidence:
Aseptic Meningitis Rate 2004-2010
0.9
11
.4
4.8
12
.3
12
.1
20
.7
10
.4
11
.3
6.6
11
.5
0
5
10
15
20
25
2010 2004
Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
Dallas County Trend in
Incidence Rates, 2003 - 2010
Source: 2004 and 2010 data from Texas Department of State Health Services, Infectious
Disease Control Unit personal communication; other years from Dallas County Health
and Human Services web site.
http://www.dallascounty.org/department/hhservices/services/communicable/documents/
ReportableConditions2003-07Annual.pdf
21.6
11.3
22.0
14.9
12.7
11.4
10.5
10.4
0 5 10 15 20 25
2003
2004
2005
2006
2007
2008
2009
2010
Dallas Co.
Aseptic meningitis is a common, rarely
fatal condition usually caused by certain
viruses. Meningitis means inflammation
of the membranes covering the brain and
spinal cord. Community rates of aseptic
meningitis may contain some mild cases
of West Nile Virus infection and other
mosquito-borne diseases that go
undetected by clinicians in the absence of
an outbreak.
Cases per 100,000
Cases per 100,000
67
Notifiable Communicable Disease Incidence:
Pertussis Rate 2004-2010
1.4
3.8
2.2
1.9
15
.6
3.9
5.9
11
.4
11
.3
5.4
0
2
4
6
8
10
12
14
16
18
2010 2004
Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
Dallas County Trend in
Incidence Rates, 2003 - 2010
Source: 2004 and 2010 data from Texas Department of State Health Services, Infectious
Disease Control Unit personal communication; other years from Dallas County Health
and Human Services web site.
http://www.dallascounty.org/department/hhservices/services/communicable/documents/
ReportableConditions2003-07Annual.pdf
21.6
11.4
22.0
14.9
12.7
8.0
6.9
5.9
0 5 10 15 20 25
2003
2004
2005
2006
2007
2008
2009
2010
Dallas Co.
Pertussis is a highly contagious bacterial
disease that causes uncontrollable, violent
coughing. This is a vaccine preventable
disease, and almost all cases are in
unvaccinated or incompletely vaccinated
patients. Pertussis can be deadly in
infants and unvaccinated children.
Cases per 100,000
Cases per 100,000
68
Notifiable Communicable Disease Incidence:
Salmonellosis Rate 2004-2010
15
.5
11
.7
14
.6
11
.3
20
.0
6.4
14
.9
8.1
19
.6
12
.2
0
5
10
15
20
25
2010 2004
Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
Dallas County Trend in
Incidence Rates, 2003 - 2010
Source: 2004 and 2008 data from Texas Department of State Health Services, Infectious
Disease Control Unit personal communication; other years from Dallas County Health
and Human Services web site.
http://www.dallascounty.org/department/hhservices/services/communicable/documents/
ReportableConditions2003-07Annual.pdf
7.3
8.1
8.6
7.7
10.1
13.9
11.3
14.9
0 5 10 15 20
2003
2004
2005
2006
2007
2008
2009
2010
Dallas Co.
Salmonellosis is a type of food poisoning
caused by the Salmonella bacterium.
Children are the most likely to get
salmonellosis, while young children, older
adults and people with impaired immune
systems are the most likely to have
severe infections.
Cases per 100,000
Cases per 100,000
69
Source: Texas Department of State Health Services, BRFSS program,
2009-2010, personal email from TX Dept of State Health Services 3.18.13
Outcomes: Percent of Adults Rating
Current Mental Health Not Good on
Five or More Days Out of Past 30 Days,
2003/2004 Combined to 2011
BRFSS Survey Question: Now thinking about your mental
health, which includes stress, depression, and problems
with emotions, for how many days during the past 30 days
was your mental health was not good?
Percent No Healthy People 2020 goal for this indicator
21
.8%
20
.8%
23
.1%
21
.5%
19
.5%
20
.2%
19
.2%
21
.1%
18
.5%
20
.8%
19
.8%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
2011 2003-2004
U.S. Median Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
18.5%
18.0%
17.6%
20.4%
21.1%
0 0 0 0 0 0
2003/2004
2005/2006
2007/2008
2009/2010
2011
Dallas Co.
Discontinuity: BRFSS began
surveying cell phones in 2011, not
comparable with previous years’ rates
70
Demographics: The demographic composition of Dallas taken in the context of the state and the nation, profoundly influences the service size, scope and priorities for Parkland Health & Hospital System. This section examines the significant demographic drivers outlined below:
Market Demographic Characteristics
•Population size and growth trends
•Population age distribution and trends
•Population ethnic composition and trends
•Per capita income and trends
•Poverty and unemployment trends
•Population educational attainment and trends
71
General Dallas County Demographic
Trends
2011 Estimated Population by
Age and Sex Female %* Male %**
0-4 96,361 7.9% 101,681 8.5%
5-14 179,305 14.7% 185,419 15.5%
15-17 51,230 4.2% 53,831 4.5%
18-24 115,877 9.5% 122,018 10.2%
25-44 367,148 30.1% 369,642 30.9%
45-64 285,424 23.4% 272,745 22.8%
65 years and up 125,635 10.3% 89,719 7.5%
Total 1,220,982 100.0% 1,195,056 100.0%
*: % of female population in Dallas County
**: % of male population in Dallas County
Population Trend by Age 2000 2010 2011
% change
2000-2011
0-4 181,951 192,838 198,113 8.9%
5-14 340,788 356,914 364,818 7.1%
15-44 1,098,009 1,068,802 1,079,958 -1.6%
45-64 419,279 541,613 558,099 33.1%
65 and up 178,872 207,972 215,025 20.2%
Total 2,218,899 2,368,139 2,416,014 8.9%
Ethnicity 2011 Population
% of the
Total
Population
White 789,297 32.67%
African American 514,297 21.29%
Asian 123,214 5.10%
American Indians 4,653 0.19%
Two or More 40,018 1.66%
Other 4,476 0.18%
Hispanic 939,984 38.91%
Total 2,416,014 100.0%
Household Income 2011 County
less than $25,000 25.6%
$25,000 to $74,999 45.1%
$75,000 to $99,999 10.3%
$100,000 and over 18.9%
Totals 100.0%
The Texas population has grown at a rate substantially outpacing that of the United States. Also growing at a very fast pace,
Dallas County has expanded by over 32%, or more than 600,000 thousand people, from 1990 to 2012.
The Dallas-Fort Worth area is one of the largest in the nation. Dallas-Fort Worth, the fourth largest metro area in the country,
grew by 23.5% in the past decade. Dallas County is the 9th largest county in the country, growing by 10.6% from 2000 to 2012.
The city of Dallas is the 9th largest city in the country, but only grew by 4.4% from 2000 to 2012.
Sources: U.S. Census 2000, 2010 and 2011.
72
Per Capita Income Trends 2006 and 2011
$2
6,7
08
$2
5,2
67
$2
3,1
71
$2
0,8
18
$2
6,5
43
$2
4,3
03
$2
6,4
89
$2
5,3
98
$2
5,2
67
$2
4,2
71
$2
4,6
82
$2
2,5
01
$0
$5,000
$10,000
$15,000
$20,000
$25,000
$30,000
2011 2006
U.S. Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
Dallas County Trend in Per
Capita Income, 2006 - 2011
Source: U.S. Census Bureau, American Community Survey, 2006-2011
$24,271
$25,769
$26,147
$24,915
$24,722
$25,267
$0 $10,000 $20,000 $30,000
2006
2007
2008
2009
2010
2011
Dallas Co.
Per Capita Income
Per capita income
$21,966 – $28,043
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
Other Peer Counties
Range
73
Percent of the population living below 200%
of the federal poverty level 2006 and 2011
35
.2%
31
.2%
40
.9%
39
.3%
41
.3%
39
.5%
36
.3%
31
.1%
44
.5%
39
.9%
39
.7%
38
.3%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
2011 2006
U.S. Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
Dallas County Trend for those with
Living below 200% of the Federal
Poverty Level, 2006 - 2011
Source: U.S. Census Bureau, American Community Survey, 2006-2011
39.9%
40.0%
41.9%
42.9%
43.6%
44.5%
0% 10% 20% 30% 40% 50%
2006
2007
2008
2009
2010
2011
Dallas Co.
Percent
Percent
37.1%– 46.0%
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
Other Peer Counties
Range
74
Percent of the children under the age of 6
living below the poverty level 2006 and 2011
25
.6%
20
.7%
28
.1%
27
.9%
32
.5%
25
.0%
28
.0%
18
.9%
33
.5%
26
.8%
29
.6%
26
.8%
0%
5%
10%
15%
20%
25%
30%
35%
40%
2011 2006
U.S. Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
Dallas County Trend for children
under the age of 6 living below
the Federal Poverty Level, 2005 -
2011
Source: U.S. Census Bureau, American Community Survey, 2005-2011
28.8%
26.8%
29.6%
30.7%
31.6%
31.4%
33.5%
0% 10% 20% 30% 40%
2005
2006
2007
2008
2009
2010
2011
Dallas Co.
Percent
Percent
26.6% – 29.2%
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
Other Peer Counties
Range
75
Sources: Bureau of Labor Statistics http://www.bls.gov/lau/#tables and http://www.bls.gov/cps/cpsaat1.pdf ;
U.S. Census Bureau, American Community Survey 2005-2011
Dallas County Trend 2005 to Sept 2012
Access: Percent of Unemployment in the
Civilian Labor Force
This indicator shows the percent of the
civilian population unemployed
Historical data represents annual averages
Percent of the civilian population
Percent
Other Peer Counties
include: Maricopa, Los
Angeles, Miami-Dade, Cook
7.9
5.1
6.4
5.1
6.7
5.7
6.6
5.1
6.7
5.6
6.6
5.4
-
2.0
4.0
6.0
8.0
10.0
2012 2005
U.S. Median Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
5.6
5.2
4.6
5.5
8.2
8.8
9.3
6.7
- 2.0 4.0 6.0 8.0 10.0
2005
2006
2007
2008
2009
2010
2011
2012
Dallas Co.
Other Peer Counties
Range, Sept 2012
6.9% to 9.7%
76
Percent of the population over the age of 25
with no high school diploma 2006 and 2011
14
.1%
15
.9%
17
.8%
19
.6%
21
.4%
23
.5%
15
.7%
16
.9%
23
.2%
25
.5%
18
.9%
21
.2%
0%
5%
10%
15%
20%
25%
30%
2011 2006
U.S. Bexar Co. Harris Co. Tarrant Co. Dallas Co. Texas
Dallas County Trend for those with
no high school diploma, 2006 - 2011
Source: U.S. Census Bureau, American Community Survey, 2006-2011
25.5%
25.5%
25.9%
25.1%
22.7%
23.2%
0% 5% 10% 15% 20% 25% 30%
2006
2007
2008
2009
2010
2011
Dallas Co.
Percent
Percent
13.7 % – 23.7%
Other Peer Counties include:
Maricopa, Los Angeles, Miami-
Dade, Cook
Other Peer Counties
Range
77
Assumptions
Green – Doing better than the benchmark
Yellow – Same as/not significantly different from the benchmark
Red – Worse than the benchmark
Healthy People 2010 benchmark – higher, lower or same
Peer County Comparison benchmark – if Dallas County is in first or second
quartile, green; third quartile, yellow; fourth quartile, red (method used for
county rankings by Health Matters).
Dallas County Trend benchmark – if only 1-3 years of previous Dallas County data
are available, calculate percent difference from earliest year’s data to most
recent, assign red/yellow/green for worse/same/better; if 4 or more years of
previous Dallas County data are available, calculate 95% Confidence Interval
(see next page for notes about this procedure) and assign green for statistically
significantly better, red for statistically significantly worse, or yellow for no
significant difference. For BRFSS questions, latest year’s data and 95%
Confidence Interval was compared with that of the most recent previous year,
and if the 95% Confidence Intervals overlapped, the Trend was considered not
significantly different. If the Confidence Intervals did not overlap, the trend was
significantly higher or lower.
78
Assumptions
Confidence Intervals
For common events (such as ED visits for Injuries, non-emergent ED visits, percent
of population under 200% FPL) 95% Confidence Intervals were calculated on
previous years’ data using a binomial approach.
For uncommon events (rates less than 5%), which includes many of the measures
in this Dashboard, 95% Confidence Intervals were calculated on previous years’
data using a Poisson formula. This approach does not use population size.
For survey data, such as BRFSS data, where possible the 95% Confidence Interval
of the most recent year’s survey was compared with the 95% Confidence
Interval of the previous year’s survey, to determine whether there was
significant change. Because BRFSS surveys include a fairly small percentage
of the Dallas County population, these 95% CI’s are fairly wide, and few show
statistically significant improvement from one year to the next for Dallas County
data.
79
Notes: Age Adjusted Death
Rates
• Age Adjusted Death Rates: Death rates that control for the effects in population age
distributions. The centers for Disease Control and Prevention established the
standard population weights for direct age adjustments. The need for age
adjustment becomes particularly important when cause-specific mortality is of
interest. Unadjusted rates for chronic diseases (cardiovascular diseases, cancers,
or chronic lower respiratory diseases) may appear to be higher for older
populations when compared to a younger population. With age-adjustment those
differences may be reduced or even reversed. A mechanism for adjusting the age
structure differences is needed to determine if there really are mortality differences
between two populations. By applying age-specific mortality rates to a standard
population, direct standardization controls for differences in population
composition. Mortality trends can be more accurately compared along geographic,
temporal, or race/ethnicity lines, etc. In short, standardization lets us look at what
the death rate would be in one population if that population had the same age
structure as the standard population. Beginning with 1999 events, the United States
year 2000 population is used as the standard for age-adjusting.