Community Health Status Assessment: Nelson County
description
Transcript of Community Health Status Assessment: Nelson County
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 2010Locality (% Change 2000-2010)
Num
ber o
f Per
sons
Liv
ing
in L
ocal
ity
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 years5 to 9 years
10 to 14 years15 to 19 years20 to 24 years25 to 29 years30 to 34 years35 to 39 years40 to 44 years45 to 49 years50 to 54 years55 to 59 years60 to 64 years65 to 69 years70 to 74 years75 to 79 years80 to 84 years85 to 89 years
90 years and over
2,0001,5001,00050005001,0001,5002,000
Male Female
Age DistributionNelson County, 2000, 2010
Source: U.S. Census Bureau
< 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
Num
ber o
f Per
sons
Liv
ing
in L
ocal
ity
Racial CompositionNelson County, 2010
Source: U.S. Census Bureau
• 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%
Source: U.S. Census Bureau
Percent Change in Hispanic PopulationNelson County and Virginia, 2000-2010
Source: U.S. Census Bureau
Nelson Virginia0%
1%
2%
3%
4%
5%
6%
7%
8%
9%
2000 2010
Per
cent
of T
otal
Per
sons
Liv
ing
in L
ocal
ity th
at
is H
ispa
nic
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
Per
cent
of T
otal
Stu
dent
s E
nrol
led
in P
ublic
S
choo
ls
SSI and Disabled OASDI BeneficiariesTJHD by Locality and Virginia, 2011
Source: U.S. Social Security Administration; U.S. Census Bureau
Total Number of Beneficiaries
Total Population
Percent 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
Per
cent
of T
otal
Chi
ldre
n A
ged
19 a
nd U
n-de
r Liv
ing
in L
ocal
ity
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%
Per
cent
of S
tude
nts
in C
ohor
t**
On-Time* Graduation Rate Nelson County and Virginia, 2008-2011
Source: Virginia Department of Education
*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
Per
cent
of T
otal
Per
sons
Age
d 25
and
O
ver L
ivin
g in
Loc
ality
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.
Ann
ual I
ncom
e in
Dol
lars
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
Source: U.S. Census Bureau, Small Area Income and Poverty Estimates
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%
Nelson Virginia U.S.
Per
cent
of T
otal
Per
sons
Liv
ing
in L
ocal
ity
Percent of Children in PovertyNelson 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 2011-2%
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%
Nelson Virginia U.S.
Per
cent
of T
otal
Chi
ldre
n A
ged
18 a
nd U
nder
Liv
-in
g in
Loc
ality
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%
Nelson TJHD Virginia
Per
cent
of T
otal
Stu
dent
s E
nrol
led
in P
ublic
S
choo
ls in
Loc
ality
Percent 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
Num
ber o
f Hou
seho
lds
Enr
olle
dNumber of Households Receiving Supplemental Nutrition Assistance
Nelson County, 2001-2011
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
Num
ber o
f Hom
eles
s P
erso
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
Per
cent
of T
otal
Per
sons
in A
ge G
roup
Liv
ing
in L
ocal
ity
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%
Nelson TJHD Virginia
Per
cent
of T
otal
Per
sons
Age
d 18
to 6
4 Li
ving
in
Loc
ality
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%
Nelson TJHD Virginia
Per
cent
of P
erso
ns A
ged
Less
than
19
Yea
rs
Livi
ng in
Loc
ality
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
Virginia United States
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
Per
cent
of T
otal
Enr
ollm
ent/S
pend
ing
United StatesVirginia
Number of Primary Care ProvidersTJHD by Locality, 2011
Source: UVA Physician Directory; Martha Jefferson Hospital Physician Directory
Internal Medicine Pediatrics 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
rage
Num
ber o
f Pat
ient
s S
erve
d P
er
Mon
th
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
Per
cent
of T
otal
Ped
iatri
c M
edic
aid/
FAM
IS
Enr
olle
es L
ivin
g in
Loc
ality
Number of Licensed Mental Health Providers TJHD by Locality, 2011
Source: Mental Health America
Clinicians Practices
Psychiatrists Licensed 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
Num
ber o
f Pas
seng
ers
(by
plac
e of
orig
in)
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
Num
ber o
f Pas
seng
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
Faci
litie
s pe
r 100
,000
Per
sons
Liv
ing
in L
ocal
-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 ProgramsNumber 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 HomesNumber 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 - - - - -
Source: Virginia Department of Social Services
Licensed Child Care FacilitiesTJHD by Locality, 2012
Fluvanna
GreeneLouisa
Nelson
Charlottesville &
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
Rep
orte
d G
roup
A O
ffens
es*
per 1
00,0
00
Per
sons
Liv
ing
in L
ocal
ityReported 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
Source: Virginia Department of Education
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
3.785.54
15.47
2.74
6.53
2.64
5.20
0.362.57
1.00 1.58
6.08
12.73
3.465.03
2.47
6.67
0.35
5.14
0.96 1.45
4.82
Nelson TJHD Virginia
Inci
dent
s pe
r 1,0
00 S
tude
nts
Enr
olle
d in
P
ublic
Sch
ools
in L
ocal
ity
Founded Child Abuse and Neglect Rates
TJHD and Virginia, 2000-2011
Source: Virginia Department of Social Services
*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
Foun
ded
Chi
ld A
buse
and
Neg
lect
Rep
orts
per
1,
000
Chi
ldre
n A
ged
0-17
Liv
ing
in L
ocal
ity
Reported Adult Abuse and Neglect Rates, TJHD and Virginia, 2008-2011
Source: Virginia Department of Social Services
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
Adu
lt P
rote
ctiv
e S
ervi
ce R
epor
ts p
er 1
,000
A
dults
Age
d 18
and
Ove
r Liv
ing
in L
ocal
ity
Drug/Narcotic Arrest RatesNelson County, TJHD, and Virginia, 2000-2011
Source: Department of State Police, Virginia Uniform Crime Reporting Program
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
Nelson TJHD Virginia
Dru
g/N
arco
tic A
rres
ts p
er 1
00,0
00 P
erso
ns L
iv-
ing
in L
ocal
ity
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
50100150200250300350400450500550600650700750800850900
188.2
120.2
TJHD 348.4
251.9
Virginia 352.0 368.0
Nelson TJHD Virginia
DU
I Arr
ests
per
100
,000
Per
sons
Liv
ing
in L
ocal
ity
Source: Department of State Police, Virginia Uniform Crime Reporting Program
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
Source: Environmental Protection Agency
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
Per
cent
of T
otal
Stre
ams
in W
ater
shed
Watersheds that Drain IntoNelson County
Source: Environmental Protection Agency
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 22901 22931 (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 4 1 23 3
30
119 6 3 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
Num
ber o
f Tes
ts R
etur
ning
Pos
itive
(bar
s)
Num
ber o
f Chi
ldre
n <7
2 M
onth
s of
Age
Tes
ted
(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
Per
cent
of A
dults
Age
d 20
and
Ove
r Liv
ing
in
Loca
lity
Healthy People 2020
Source: Virginia Department of Health, Virginia Behavioral Risk Factor Surveillance Survey
Tobacco Facts Virginia, 2012
Virginia United States
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
imat
ed p
erce
nt o
f adu
lts a
ged
20 a
nd o
ver r
epor
ting
no
leis
ure
time
phys
ical
act
ivity
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
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Obesity Trends Among U.S. Adults1990
Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System
No Data <10% 10%–14% 15%–19%
Obesity Trends Among U.S. Adults1995
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System
No Data <10% 10%–14% 15%–19% ≥20%
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends Among U.S. Adults2000
Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends Among U.S. Adults2005
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends Among U.S. Adults2010
Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System
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
Per
cent
of A
dults
Age
d 20
and
Ove
r Liv
ing
in L
ocal
-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
Per
cent
of F
ifth
and
Tent
h G
rade
rs E
nrol
led
in
Pub
lic S
choo
ls in
Loc
ality
Seat Belt UsageVirginia, 1987-2011
Source: Virginia Department of Motor Vehicles, Highway Safety Office
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
0%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
Per
cent
of D
river
s an
d P
asse
nger
s U
sing
Sea
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
Num
ber o
f Hos
pita
lizat
ions
from
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
Per
cent
of K
inde
rgar
tene
rs E
nrol
led
in R
e-po
rting
Sch
ools
*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
Per
cent
of S
ixth
Gra
ders
Enr
olle
d in
Rep
ort-
ing
Sch
ools
*Percentage of Adequately Immunized Sixth
GradersTJHD, 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
12.910.8
Virginia 13.9
12.7
Nelson TJHD Virginia
Live
Birt
hs*
per 1
,000
Tot
al P
erso
ns L
ivin
g in
Loc
al-
ity
Infant Mortality Rates*TJHD and Virginia,1999-2011
Source: Virginia Department of Health, Division of Health Statistics*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 D
eath
s pe
r 1,0
00 L
ive
Birt
hs b
y P
lace
of R
esi-
denc
e
Infant Mortality Rates* by Race TJHD, Virginia, and U.S., 1999-2011
Source: Virginia Department of Health, Division of Health Statistics
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 1,0
00 L
ive
Birt
hs b
y P
lace
of
Res
iden
ce
*Deaths among infants <1year of age
Neonatal Death Rate* TJHD and Virginia, 1999-2011
Source: Virginia Department of Health, Division of Health Statistics*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 D
eath
s pe
r 1,0
00 L
ive
Birt
hs b
y P
lace
of R
esi-
denc
e
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
Per
cent
of T
otal
Liv
e B
irths
by
Pla
ce o
f Res
i-de
nce
Healthy People 2020
Percentage of Low-Weight* BirthsNelson County, TJHD, Virginia, and U.S., 1999-2011
Source: Virginia Department of Health, Division of Health Statistics*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
Source: Virginia Department of Health, Division of Health Statistics
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
Per
cent
of T
otal
Liv
e B
irths
by
Pla
ce o
f Res
i-de
nce
Healthy People 2020
*Low Birth Weight = Live Births Weighing <2500 grams
Teen Pregnancy Rates: Ages 10-19Nelson County, TJHD, and Virginia, 2000-2011
Source: Virginia Department of Health, Division of Health Statistics
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
Nelson TJHD Virginia
Pre
gnan
cies
per
1,0
00 F
emal
es A
ged
10 to
19
Teen Pregnancy Rates: Ages 15-17Nelson County, TJHD, and Virginia, 2000-2011
Source: Virginia Department of Health, Division of Health Statistics
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
Nelson TJHD Virginia
Pre
gnan
cies
per
1,0
00 F
emal
es A
ged
15-1
7
Healthy People 2020
Teen Pregnancy Rates by Race: Ages 10-19, Nelson County, TJHD, and Virginia, 2000-2011
Source: Virginia Department of Health, Division of Health Statistics
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
Nelson Black TJHD Black Virginia Black Nelson White TJHD WhiteVirginia White
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
Source: Virginia Department of Health, Division of Health Statistics
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
Nelson TJHD Virginia
Indu
ced
Term
inat
ions
per
1,0
00 W
omen
Age
d 15
-44
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%
Nelson TJHD Virginia
Per
cent
of T
otal
Liv
e B
irths
to M
othe
rs b
y P
lace
of R
esid
ence
Healthy People 2020
Percentage of Mothers Entering Prenatal Care in the 1st Trimester
Nelson County, TJHD and Virginia, 2000-2010
Source: Virginia Department of Health, Division of Health StatisticsPercentage 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%
Nelson TJHD Virginia
Per
cent
of T
otal
Liv
e B
irths
to M
othe
rs b
y P
lace
of R
esid
ence
Source: Virginia Department of Health, Division of Health Statistics
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
Per
cent
of T
otal
Liv
e B
irths
to M
othe
rs b
y P
lace
of R
esid
ence
Source: Virginia Department of Health, Division of Health Statistics
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%
Nelson TJHD Virginia
Healthy People 2020 Per
cent
of T
otal
Liv
e B
irths
to M
othe
rs b
y P
lace
of R
esid
ence
Source: Virginia Department of Health, Division of Health Statistics
Reported Substance Exposed Infants*TJHD, FY1999-2011
Source: Virginia Department of Social Services
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
Num
ber o
f Rep
orte
d S
ubst
ance
Exp
osed
In
fant
s
*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
Source: Virginia Department of Health, Division of Health Statistics
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 VirginiaAge
-Adj
uste
d D
eath
s pe
r 100
,000
Per
sons
Liv
ing
in L
ocal
-ity
Mortality Rates by Race Nelson County, TJHD, and Virginia, 2000-2010
Source: Virginia Department of Health, Division of Health Statistics
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
1173.61277.0
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 1
00,0
00 P
erso
ns L
ivin
g in
Loc
al-
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 InjuriesSource: Virginia Department of Health, Division of Health Statistics
Leading Causes of Death By AgeVirginia, 2010Youth/Teens
Source: Virginia Department of Health, Division of Health Statistics
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
Source: Virginia Department of Health, Division of Health Statistics
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
Source: Virginia Department of Health, Division of Health Statistics
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
Source: Virginia Department of Health, Division of Health Statistics
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
Nelson TJHD Virginia
Age
-Adj
uste
d H
eart
Dis
ease
Dea
ths
per 1
00,0
00
Per
sons
Liv
ing
in L
ocal
ity
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
Nelson Black TJHD Black Virginia Black Nelson White TJHD WhiteVirginia White
Age
-Adj
uste
d H
eart
Dis
ease
Dea
ths
per
100,
000
Per
sons
Liv
ing
in L
ocal
ity
Source: Virginia Department of Health, Division of Health StatisticsFive-year rolling averages
Stroke-Related Death Rates Nelson County, TJHD, and Virginia, 1999-2010
Source: Virginia Department of Health, Division of Health Statistics
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
Nelson TJHD Virginia
Age
-Adj
uste
d S
troke
-Rel
ated
Dea
ths
per
100,
000
Per
sons
Liv
ing
in L
ocal
ity
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
Age
-Adj
uste
d S
troke
-Rel
ated
Dea
ths
per 1
00,0
00
Per
sons
Liv
ing
in L
ocal
ity
Source: Virginia Department of Health, Division of Health Statistics
Cancer-Related Death RatesNelson County, TJHD, and Virginia, 1999-2010
Source: Virginia Department of Health, Division of Health Statistics
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
Nelson TJHD Virginia
Age
-Adj
uste
d C
ance
r Dea
ths
per 1
00,0
00 P
er-
sons
Liv
ing
in L
ocal
ity
Cancer-Related Death Rates by RaceNelson County, TJHD, and Virginia, 2000-2009
Source: Virginia Department of Health, Division of Health Statistics
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
189.1176.4
Nelson Black TJHD Black Virginia Black Nelson WhiteTJHD White Virginia White
Age
-Adj
uste
d C
ance
r Dea
ths
per 1
00,0
00
Per
sons
Liv
ing
in L
ocal
ity
Five-year rolling averages
COPD-Related Death RatesNelson County, TJHD, and Virginia, 2000-2010
Source: Virginia Department of Health, Division of Health StatisticsFour-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
Nelson TJHD Virginia
Age
-Adj
uste
d C
OP
D D
eath
s pe
r 100
,000
Per
-so
ns L
ivin
g in
Loc
ality
COPD-Related Death Rates by Race TJHD and Virginia, 2000-2009
Source: Virginia Department of Health, Division of Health Statistics
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
31.5 26.3
44.7
39.0
46.3
42.6
TJHD Black Virginia Black TJHD White Virginia White
Age
-Adj
uste
d C
OP
D D
eath
s pe
r 100
,000
Per
sons
Li
ving
in L
ocal
ity
Diabetes-Related Death RatesNelson County, TJHD, and Virginia, 1999-2010
Source: Virginia Department of Health, Division of Health Statistics
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
Nelson TJHD Virginia
Age
-Adj
uste
d D
iabe
tes
Dea
ths
per 1
00,0
00
Per
sons
Liv
ing
in L
ocal
ity
Five-year rolling averages
Diabetes-Related Death Rates by RaceTJHD and Virginia, 2000-2009
Source: Virginia Department of Health, Division of Health Statistics
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
TJHD Black Virginia Black TJHD White Virginia White
Age
-Adj
uste
d D
iabe
tes
Dea
ths
per 1
00,0
00
Per
sons
Liv
ing
in L
ocal
ity
Unintentional Injury Death RatesTJHD and Virginia, 1999-2010
Source: Virginia Department of Health, Division of Health StatisticsFour-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
70
7569.6
51.8
TJHD 33.8
38.4
Virginia 34.0 34.5
Nelson TJHD Virginia
Age
-Adj
uste
d U
nint
entio
nal I
njur
y D
eath
s pe
r 10
0,00
0 P
erso
ns L
ivin
g in
Loc
ality
Unintentional Injury Death Rates by Race TJHD and Virginia, 2000-2009
Source: Virginia Department of Health, Division of Health Statistics
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
TJHD Black Virginia Black TJHD White Virginia White
Age
-Adj
uste
d D
eath
s pe
r 100
,000
Per
sons
Liv
-in
g in
Loc
ality
Four-year rolling averages
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 per
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 p
er 1
00,0
00 P
erso
ns L
ivin
g in
Loc
ality
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
69.87 68.40
Age
-Adj
uste
d R
ate
of L
ung
& B
ronc
hus
Can
cer
Cas
es p
er 1
00,0
00 P
erso
ns L
ivin
g in
Loc
ality
1999
-20
03
1999
-20
03
1999
-20
03
2004
-20
08
2004
-20
08
2004
-20
08
Source: Virginia Cancer Registry
Lung Cancer Incidence Rates by Race TJHD and Virginia, 1999-2008
Source: Virginia Cancer Registry
Black White Black WhiteTJHD Virginia
05
10152025303540455055606570758085
73.38
63.31
69.12
64.39
78.06
69.06 71.73 68.91
Age
-Adj
uste
d R
ate
of L
ung
& B
ronc
hus
Can
cer
Cas
es p
er 1
00,0
00 P
erso
ns L
ivin
g in
Loc
ality
1999
-20
03
1999
-20
03
1999
-20
03
1999
-20
03
2004
-20
08
2004
-20
08
2004
-20
08
2004
-20
08
Lung Cancer Death Rates TJHD and Virginia, 1996-2007
Source: Virginia Department of Health, Division of Health Statistics
1996-2000 1997-2001 1998-2002 1999-2003 2000-2004 2001-2005 2002-2006 2003-200705
10152025303540455055606570758085
55.252.5
60.7
54.8
TJHD Virginia
Age
-Adj
uste
d R
ate
of L
ung
Can
cer D
eath
s pe
r 10
0,00
0 P
erso
ns L
ivin
g in
Loc
ality
Breast Cancer Incidence Rates Nelson County, TJHD, and Virginia, 1999-2008
Source: Virginia Cancer Registry
Nelson TJHD Virginia0
20
40
60
80
100
120
140
160
180
200
106.35
144.81
124.5
146.6
127.52 124.81
Age
-Adj
uste
d R
ate
of F
emal
e B
reas
t Can
cer
Cas
es p
er 1
00,0
00 F
emal
es L
ivin
g in
Loc
ality
1999
-20
03
1999
-20
03
1999
-20
03
2004
-20
08
2004
-20
08
2004
-20
08
Breast Cancer Incidence Rates by Race TJHD and Virginia, 1999-2008
Source: Virginia Cancer Registry
Black White Black WhiteTJHD Virginia
0102030405060708090
100110120130140150160
129.15
147.74
118.13126.59
133.84125.95 127.06 124.83
Age
-Adj
uste
d R
ate
of F
emal
e B
reas
t Can
cer
Cas
es p
er 1
00,0
00 F
emal
es L
ivin
g in
Loc
ality
1999
-20
03
1999
-20
03
1999
-20
03
1999
-20
03
2004
-20
08
2004
-20
08
2004
-20
08
2004
-20
08
Breast Cancer Death Rates TJHD and Virginia, 1996-2007
Source: Virginia Department of Health, Division of Health Statistics
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
Age
-Adj
uste
d R
ate
of B
reas
t Can
cer D
eath
s pe
r 10
0,00
0 P
erso
ns L
ivin
g in
Loc
ality
Prostate Cancer Incidence RatesNelson County, TJHD, and Virginia, 1999-2008
Source: Virginia Cancer Registry
Nelson TJHD Virginia0
25
50
75
100
125
150
175
200
225
202.11
154.94165.13165.51 163.15 160.73
1999
-200
3
1999
-200
3
1999
-200
3
2004
-200
8
2004
-200
8
2004
-200
8
Age
-Adj
uste
d R
ate
of P
rost
ate
Can
cer C
ases
per
10
0,00
0 M
ales
Liv
ing
in L
ocal
ity
Prostate Cancer Incidence Rates by Race, TJHD and Virginia, 1999-2008
Source: Virginia Cancer Registry
Black White Black WhiteTJHD Virginia
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
Age
-Adj
uste
d R
ate
of P
rost
ate
Can
cer C
ases
per
10
0,00
0 M
ales
Liv
ing
in L
ocal
ity
1999
-20
03
1999
-20
03
1999
-20
03
1999
-20
03
2004
-20
08
2004
-20
08
2004
-20
08
2004
-20
08
Prostate Cancer Death RatesTJHD and Virginia, 1996-2007
Source: Virginia Department of Health, Division of Health Statistics
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
Age
-Adj
uste
d R
ate
of P
rost
ate
Can
cer D
eath
s pe
r 100
,000
Per
sons
Liv
ing
in L
ocal
ity
Colorectal Cancer Incidence Rates Nelson County, TJHD, and Virginia, 1999-2008
Source: Virginia Cancer Registry
Nelson TJHD Virginia0
5
10
15
20
25
30
35
40
45
50
55
60
65
70 66.80
53.0850.20
38.20
44.17 45.14
Age
-Adj
uste
d R
ate
of C
olor
ecta
l Can
cer C
ases
per
10
0,00
0 P
erso
ns L
ivin
g in
Loc
ality
1999
-20
03
1999
-20
03
1999
-20
03
2004
-20
08
2004
-20
08
2004
-20
08
Colorectal Cancer Incidence Rates by Race, TJHD and Virginia, 1999-2008
Source: Virginia Cancer Registry
Black White Black WhiteTJHD Virginia
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
Age
-Adj
uste
d R
ate
of C
olor
ecta
l Can
cer C
ases
pe
r 100
,000
Per
sons
Liv
ing
in L
ocal
ity
1999
-20
03
1999
-20
03
1999
-20
03
1999
-20
032004
-20
08
2004
-20
08
2004
-20
08
2004
-20
08
Colorectal Cancer Death RatesTJHD and Virginia, 1996-2007
Source: Virginia Department of Health, Division of Health Statistics
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
Age
-Adj
uste
d R
ate
of C
olor
ecta
l Can
cer D
eath
s pe
r 100
,000
Per
sons
Liv
ing
in L
ocal
ity
Unintentional Injury
Percent of Hospitalizations due to Unintentional Injury by Cause
Nelson County, 1999-2009
Source: Virginia Department of Health, Virginia Online Injury Reporting System
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%
Source: Virginia Department of Health, Virginia Online Injury Reporting System
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 VirginiaRep
orte
d H
ospi
tal D
isch
arge
s fo
r Inj
urie
s du
e to
Fal
ls p
er
100,
000
Per
sons
Age
d 65
and
Ove
r Liv
ing
in L
ocal
ity
Rates of Unintentional Injury Deaths by CauseNelson County, TJHD, and Virginia,1999-2009
Source: Virginia Department of Health, Virginia Online Injury Reporting System
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
Nelson TJHD Virginia
Age
-Adj
uste
d U
nint
entio
nal I
njur
y D
eath
s pe
r 10
0,00
0 P
erso
ns L
ivin
g in
Loc
ality
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
Nelson TJHD Virginia
Mot
or V
ehic
le A
ccid
ents
per
100
,000
Per
sons
Li
ving
in L
ocal
ity
Motor Vehicle Crash Fatality RatesNelson, TJHD, and Virginia, 2000-2011
Source: Virginia Department of Motor VehiclesFive 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
Nelson TJHD Virginia
Mot
or V
ehic
le C
rash
Fat
aliti
es p
er 1
00,0
00 P
er-
sons
Liv
ing
in L
ocal
ity
Percent of Alcohol-Related Motor Vehicle Crashes, Nelson, TJHD, and Virginia, 2000-2011
Source: Virginia Department of Motor Vehicles
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%
Nelson TJHD Virginia
Per
cent
of T
otal
Mot
or V
ehic
le C
rash
es b
y P
lace
of
Occ
urre
nce
Percent of Alcohol-Related Motor Vehicle Crash Fatalities, TJHD and Virginia, 2000-2011
Source: Virginia Department of Motor Vehicles
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
Per
cent
of T
otal
Mot
or V
ehic
le C
rash
Fat
aliti
es in
w
hich
Alc
ohol
was
Invo
lved
-- b
y P
lace
of
Occ
urre
nce
v
Infectious Diseases
Rates of Reportable Communicable Diseases, TJHD and Virginia, 2000-2010
CommunicableDisease
TJHD VirginiaAverage
Number ofCases
Average RatePer 100,000*
AverageNumber of
CasesAverage RatePer 100,000*
Chlamydia 559 260.2 23,406 306.7Gonorrhea 134 62.3 8,723 119.3Pertussis 56 26.3 246 3.3Salmonellosis 35 16.3 1,186 15.8Giardiasis 33 15.5 489 6.5Chicken Pox 25 11.7 1,079 14.3Campylobacteriosis 21 9.8 687 9.2Lyme 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
255075
100125150175200225250275300325350375400425
Nelson; 189.2167.5
219.6
280.7
Virginia 189.3
397.7
Nelson TJHD VirginiaRep
orte
d C
ases
of C
hlam
ydia
per
100
,000
Per
sons
Liv
ing
in L
ocal
-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
Nelson TJHD VirginiaRep
orte
d C
ases
of G
onor
rhea
per
100
,000
Per
sons
Liv
ing
in L
ocal
-ity
Source: Virginia Department of Health, Division of Disease Prevention
HIV and AIDS Incidence RatesTJHD and Virginia, 1997-2009
Source: Virginia Department of Health, Division of Disease Prevention
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 AIDSRep
orte
d C
ases
of H
IV/A
IDS
per
100
,000
Per
sons
Liv
ing
in L
ocal
-ity
Syphilis (early) Incidence RatesTJHD and Virginia,1999-2010
Source: Virginia Department of Health, Division of Surveillance and Investigation
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 S
yphi
lis p
er 1
00,0
00 P
erso
ns L
ivin
g in
Loc
ality
Pertussis Incidence RatesTJHD, and Virginia, 1999-2010
Source: Virginia Department of Health, Division of Surveillance and Investigation
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 VirginiaRep
orte
d C
ases
of P
ertu
ssis
per
100
,000
Per
sons
Liv
ing
in L
ocal
-ity
Chicken Pox Incidence RatesTJHD and Virginia, 1999-2010
Source: Virginia Department of Health, Division of Surveillance and Investigation
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
Source: Virginia Department of Health, Division of Surveillance and Investigation
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
Rep
orte
d C
ases
of H
epat
itis
B p
er 1
00,0
00 P
erso
ns L
ivin
g in
Lo-
calit
y
Salmonellosis Incidence RatesTJHD and Virginia,1999-2010
Source: Virginia Department of Health, Division of Surveillance and Investigation
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 S
alm
onel
losi
s pe
r 100
,000
Per
sons
Liv
ing
in L
ocal
ity
Campylobacteriosis Incidence Rates TJHD and Virginia,1999-2010
Source: Virginia Department of Health, Division of Surveillance and Investigation
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 C
ampy
loba
cter
iosi
s pe
r 100
,000
Per
sons
Li
ving
in L
ocal
ity
E. Coli O157:H7 Incidence Rates TJHD and Virginia, 1999-2010
Source: Virginia Department of Health, Division of Surveillance and Investigation
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 100
,000
Per
sons
Liv
ing
in L
ocal
ity
Giardiasis Incidence Rates TJHD and Virginia,1999-2010
Source: Virginia Department of Health, Division of Surveillance and Investigation
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 VirginiaRep
orte
d C
ases
of G
iard
iasi
s pe
r 100
,000
Per
sons
Liv
ing
in L
o-ca
lity
Legionellosis Incidence Rates TJHD and Virginia, 1999-2010
Source: Virginia Department of Health, Division of Disease Prevention
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 VirginiaRep
orte
d C
ases
of L
egio
nello
sis
per 1
00,0
00 P
erso
ns L
ivin
g in
Lo-
calit
y
Lyme Disease Incidence Rates TJHD and Virginia, 1999-2010
Source: Virginia Department of Health, Division of Surveillance and Investigation
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 L
yme
Dis
ease
per
100
,000
Per
sons
Liv
ing
in L
ocal
ity
Spotted Fever Rickettsiosis Incidence Rates, TJHD and Virginia, 1999-2010
Source: Virginia Department of Health, Division of Surveillance and Investigation
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 Fe
ver R
icke
ttsio
sis
per
100,
000
Per
sons
Liv
ing
in L
ocal
ity
Tuberculosis Incidence RatesTJHD and Virginia, 1999-2010
Source: Virginia Department of Health, Division of Disease Prevention
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
Rep
orte
d C
ases
of T
uber
culo
sis
per 1
00,0
00 P
erso
ns L
ivin
g in
Lo-
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
Per
cent
of T
otal
Adu
lts A
ged
20 a
nd O
ver L
ivin
g in
Loc
ality
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 2009-1102468
10121416182022242628303234
TJHD 15.8317.01
Virginia 15.4614.82
TJHD Virginia
Age
-Adj
uste
d H
ospi
tal D
isch
arge
s fo
r Dia
bete
s
per 1
0,00
0 P
erso
ns L
ivin
g in
Loc
ality
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 2008-1002468
10121416182022242628303234
23.84
24.65
Albemarle Charlottesville FluvannaGreene Louisa Nelson
Age
-Adj
uste
d H
ospi
tal D
isch
arge
s fo
r Dia
bete
s
per 1
0,00
0 P
erso
ns L
ivin
g in
Loc
ality
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
Nelson TJHD Virginia
Age
-Adj
uste
d H
ospi
tal D
isch
arge
s fo
r Ast
hma
per
10,0
00 P
erso
ns L
ivin
g in
Loc
ality
Source: Virginia Hospital Information Systems
Hospital Discharge Rates for Hypertension, TJHD 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
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 Hyp
erte
nsio
n pe
r 10,
000
Per
sons
Liv
ing
in L
ocal
ity
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
Nelson TJHD Virginia
Age
-Adj
uste
d H
ospi
tal D
isch
arge
s fo
r CO
PD
per
10
,000
Per
sons
Liv
ing
in L
ocal
ity
Source: Virginia Hospital Information Systems
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
Num
ber*
of P
hysi
cally
Unh
ealth
y/P
oor
Men
tal H
ealth
Day
s
0%
5%
10%
15%
20%
25%
30%
25%
12%11%
9%
7% 7%
3%2%
Per
cent
of T
otal
Reg
ion
Ten
Pat
ient
s S
erve
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
Num
ber o
f Reg
ion
Ten
Ser
vice
s D
eliv
ered
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
Perc
ent o
f Tot
al A
dults
/Chi
ldre
n Se
rved
thro
ugh
Stat
e M
enta
l Hea
lth A
genc
ies
Percent 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
Per
cent
of T
otal
Adu
lts/C
hild
ren
Ser
ved
thro
ugh
Sta
te M
enta
l Hea
lth A
genc
ies
Percent 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
Source: VDH Data Warehouse; Virginia Hospital Information Systems
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 20110
100
200
300
400
500
600
700
800
677.19
418.60
586.01563.09
TJHD VA
Hos
pita
l Dis
char
ges
per 1
00,0
00 P
erso
ns L
ivin
g in
Loc
al-
ity
Hospital Discharge Rates for Neurotic Disorders, Personality Disorders, and other Nonpsychotic Mental Disorders
TJHD and Virginia, 2000-2011
Source: VDH Data Warehouse; Virginia Hospital Information Systems
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 VAHos
pita
l Dis
char
ges
per 1
00,0
00 P
erso
ns L
ivin
g in
Loc
al-
ity
Section Four: What are community members’ perceptions of health in their
communities?
Thomas Jefferson Area Community SurveyMAPP 2 Health Focus GroupsLouisa 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?
Source: UVA Center for Survey Research
• 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?
Source: UVA Center for Survey Research
• 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.”
Smoking Weight and obesity
Alcohol/ 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?
Source: UVA Center for Survey Research
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%
RaceWhite 11 73.3%Other 4 26.7%
EthnicityHispanic 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%
Focus Group DemographicsNelson County, 2012
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%
Focus Group DemographicsNelson County, 2012
Number Percent
Education CompletedLess 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 PercentMedical 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
Nelson County Focus Group Results2012
• 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
Nelson County Focus Group Results2012
• 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