HEALTH REPORT 2016
The Florida Department of Health in Seminole County
The Florida Department of Health in Seminole County
COMPILED BY
EDITED BY
LAYOUT AND DESIGN
Juley Cetoute, BS CDC Public Health Associate Program (2015-2017), Florida Department of Health in Seminole County
Bethany Canales, MPH Health Equity Coordinator, Florida Department of Health in Seminole County
Bethany Canales Mirna Chamorro Pranav Mehta Gloria Rivadeneyra Florida Department of Health in Seminole County
Zeenat Rahman, MBBS, MPH, CIC Epidemiologist, Florida Department of Health in Seminole County Tania Slade, MPH Epidemiology Program Manager, Florida Department of Health in Seminole County Kelsi Williams, DrPH, MSPH Epidemiologist, Florida Department of Health in Seminole County
CONTRIBUTORS Kenyatta Badgett, MPH CDC Public Health Associate Program (2015-2017), Florida Department of Health in Seminole County
Mirna Chamorro, BS Public Information Officer Florida Department of Health in Seminole County Pranav Mehta, BS Operations and Management Consultant Florida Department of Health in Seminole County Gloria Rivadeneyra, MS School Health Program Manager, Florida Department of Health in Seminole County Donna J. Walsh, MPA, BSN, RN Health Officer, Florida Department of Health in Seminole County
Brian Higuera Epidemiology Intern, Florida Department of Health in Seminole County
In This Report • • • • • • • •
Financial Highlights | Page 5 Healthiest Weight | Page 6 Mobile Health | Page 8 This is Public Health | Page 10 Zika Response | Page 14 Health of the County | Page 16 Programs and Services | Page 24 2017 Goals | Page 32
About the Organization The Florida Department of Health in Seminole County was founded in 1941; then known as the Seminole County Health Department. The health department moved to the current location on Airport Boulevard in 1985. Today, the organization has two satellite offices - Women, Infants and Children (WIC) in Casselberry and the Environmental Health Program in downtown Sanford. Community engagement is one of the health department’s priorities which is achieved by collaborations, outreach, community celebrations and events. Educational forums and annual community health fairs such as Take a Loved One to the Doctor Day, Veteran’s Stand Down and Men’s Health Challenge continue to encourage healthy behaviors in the community.
Our mission is achieved by developing living documents, Strategic Plan, Business Plan, Community Heath Assessment and Community Health Improvement Plan in coordination with our workforce and community members. These four documents guide public health actions and fiscal responsibility in providing healthcare services for our community that align with Healthy People 2020, sciencebased 10 year national objectives for improving the health of all Americans.
VALUES ICare. INNOVATION We search for creative solutions and manage resources wisely.
MISSION
VISION
To protect, promote and improve the health of all people in Florida through integrated state, county and community efforts.
To be the Healthiest State in the Nation.
COLLABORATION We use teamwork to achieve common goals and solve problems. ACCOUNTABILITY We perform with integrity and respect. RESPONSIVENESS We achieve our mission by serving our customers and engaging our partners. EXCELLENCE We promote quality outcomes through learning and continuous performance improvement.
www.seminolecohealth.com
A Message from the Health Officer Another healthy year has passed and the 2016 Annual Health Report for the Florida Department of Health in Seminole County (DOH-Seminole) is testimony of the many activities and accomplishments achieved throughout the year. This report also provides you a glimpse into the health of the county and the emergency responses implemented alongside partners. This year, I was appointed as your new Health Officer and I am grateful for the opportunity to continue to serve our community through a dedicated team of professionals to improve the health of our residents. It is our mission to protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts. Where we live determines what we have access to, whether it is grocery stores, recreational facilities, medical providers or schools, where we work and the type of work we do, and the types of stress and challenges we experience. These factors can and do have long-term effects. Social determinants of health are interconnected, and in order for solutions to emerge they must be addressed as such, collectively and by a wide-range of organizations operating in a cooperative manner. There are a number of efforts that have been undertaken to improve the health of Seminole County residents through addressing social determinants of health. DOH-Seminole in partnership with community members
launched several initiatives to address food insecurity such as the Central Florida Feed the Need Inc. Food Pantry and the Goldsboro Farmers Market. Seminole County was also impacted by Hurricane Matthew and the new emerging disease of Zika allowing the health department to implement the plans in place to protect the public’s health. Thank you to Seminole County Government, cities and municipalities, Orlando Health, Central Florida Regional Hospital, Florida Hospital, the Health Council of East Central Florida and many more community partners and leaders who have come together to improve the health of Seminole County. It is with your support, I am certain that we will continue to be one of the healthiest counties in the state. Sincerely,
Donna J. Walsh, MPH, BSN, RN Health Officer
The Executive Leadership Team The Executive Leadership Team are highly skilled and educated leaders who move the mission of DOH-Seminole. Their various backgrounds and experiences are an asset to the evolving public health system. They are dedicated to forming relationships in the community, motivating staff and creating best practices and high standards.
Meena Joseph, MD Medical Director
44
John Meyers, BS Administrative Services Director
Sarah A. Wright, MPH, BSN, RN Executive Community Health Nursing Director
In 2016, operations for DOH-Seminole totaled $10 million. Revenue totaled $9.35 million of which 74% was for salaries and $1 million in awarded grants and contracts. DOH-Seminole receives revenue from federal, state and county entities in addition to grants, fees for services provided and insurance reimbursements. Medicaid earnings continued to decline over the past year and are anticipated to follow the same trend for the coming year, which will directly impact service delivery. DOH-Seminole continues to meet the healthcare needs of our community through innovation and partnerships. Process improvements and organizational restructuring have been implemented to reduce expenses and will continue to be monitored and assessed in the coming year. Additionally, other revenue opportunities such as federal and state grants continue to be explored to support services and programs that align with the public health mission. The agency is held accountable to taxpayers for the use of funds according to Florida Statutes. The federal and state appropriated revenue is for required programs and services which include Women, Infants and Children (WIC), Healthy Start, Family Planning and Public Health Preparedness. *Fiscal year runs July 1 through June 30.
2015-2016
$1M
Grants and Contracts
$2.7M
Federal Revenue
2016-2017
INCOME State Categorical GR Funds
$
923,652
State Non-Categorical GR Funds State Other Funds State Federal Funds
$
908,966
1,870,156
1,475,189
216,528
220,054
2,710,995
2,690,524
Local Contributions
807,970
807,970
Medicaid
801,410
657,975
Medicare
9,000
8,650
63,868
49,911
Clinical Client Fees
491,909
463,983
Environmental Health Fees
643,074
743,559
Vital Statistics Fees
210,000
236,020
1,160,199
996,115
91,239
88,584
0
0
Other Health Insurance
Local Grants and Contracts Other Revenue Fees to County Health Departments Total Income
$
10,000,000
$
9,347,500
EXPENSES Salaries and Benefits
7,323,770
6,908,409
Other Personal Services
796,134
1,039,170
Expenses
810,498
1,128,811
70,961 0
62,336 17,979
546,805
681,734
Risk Management Insurance
97,141
99,985
Lease/Purchase/Equipment
27,749
26,566
TR/DMS/HR SVCS/Statewide Contract
47,194
37,186
Operating Capital Outlay Acquisition/Motor Vehicles Contract Services
Less Total Expenses
$
9,720,252
$
10,002,176
NET BUDGET
$
279,748
$
(654,676)*
* Includes 431K State revenue reduction
Financial Highlights
Financial Highlights
5
Healthiest Weight
Healthiest Weight Florida is a public-private collaboration that brings together state agencies, not for profit organizations, businesses and communities to help Florida's children and adults make healthier choices. Healthiest Weight Florida employs five strategies to address behavior and environmental change. Strategy 1 - Increase opportunities for physical activity Regular physical activity can produce long-term health benefits. People of all ages, shapes, sizes and abilities can benefit from being physically active. The more physical activity you do, the greater the health benefits. Being physically active can help: •Control weight •Reduce the risk of cardiovascular disease •Reduce the risk of type 2 diabetes •Reduce the risk of some cancers •Strengthen bones and muscles •Improve mental health and mood •Improve ability to do daily activities and prevent falls in older adults •Increase the chances of living longer Strategy 2 - Make healthy food available everywhere A number of factors determine what people eat, but access to healthy food and beverages has a major influence. Finding healthy food is not always convenient. Studies have found people buy food that is readily available. Strategy 3 - Promote health in the worksite Staying with a healthy lifestyle while at work can be difficult. Now that many people are spending most of their day sitting at a desk or inside an office, implementing health programs inside the workplace has become a vital part of the healthy lifestyle puzzle. Strategy 4 - Strengthen schools as the heart of health Schools are uniquely positioned to be a national focal point for healthy weight promotion because children spend up to half of their waking hours in school and consume between one-third and one-half of their daily calories in the school setting. Strategy 5 - Market what matters for a healthy life When the messages around us focus on health, it becomes easier to think about making healthy choices. Healthiest Weight Florida seeks to make useful health information and advice available through campaigns, social media and other resources.
6
Healthiest Weight Florida in Seminole County The health department supports community partners on the strategies outlined in Healthiest Weight Florida. Each year the State Surgeon General recognizes Healthy Weight Community Champions, which are municipalities and counties who have implemented “best practice” policies to create healthier communities.
Stephanie Fyock, Healthiest Weight Coordinator
The City of Oviedo was 1 of 80 communities in Florida recognized as a Healthy Weight Community Champion in 2016. The City of Oviedo has a number of policies in place supporting the objectives of the Healthy Weight Community Champion Recognition Program. Initiatives range from establishing mixed-use zoning districts, requiring bike facilities to be placed in new developments and making sure sidewalks are landscaped properly, among others. The City is proud to receive the recognition for the third time in a row and will continue to endorse and enforce policies that promote a healthy environment and a healthy community. The City of Sanford through the Healthy Weight Community Champion Recognition Program is proud to announce the City's designation as a 2016 Community Champion. The City has a positive impact on the health in Sanford by providing access to over 38 parks and the RiverWalk fresh fruits/vegetables every week at the Farmer’s Market held Saturdays in downtown Sanford’s Magnolia Square from 10 a.m. to 3 p.m.
Mr. Norton Bonaparte, City Manager of Sanford, DOH-Seminole Team Captain Lynette Aviles and local race participant at the 2nd Annual Live, Work, Move Seminole 5K.
Employee Wellness 2015-2016 Goals 1. Weight: Increase the proportion of employees who are at a healthy BMI. 2. Physical Activity: Increase the proportion of staff that have access to and participate in employer-encouraged physical fitness activities and wellness programs. 3. Physical Activity: Increase the proportion of employees that engage in 30 minutes or more of moderate intensity physical activity per day. 4. Tobacco: Promote cessation from tobacco use and encourage tobacco-free lifestyles.
7
Mobile Health
20% of Seminole County residents DO NOT have health insurance The Healthy Seminole Mobile Health Unit continued to serve impoverished communities in Seminole County during 2016. The mobile health unit travels to various locations throughout Seminole County and participates in community events to improve access to healthcare. The homeless, uninsured and underinsured populations are able to obtain health services, screenings and referrals. Services are available for the general public as well. Services are provided on a walk-in, first come, first served basis including: Family Planning – Referrals for physicals, birth control, pregnancy testing and free condoms. Immunizations – Flu and pneumonia vaccines for children and adults.
8
Screenings – Diabetes, hypertension, cholesterol, heart disease, Body Mass Index (BMI) and blood pressure.
STD, HIV/AIDS, Hepatitis – Testing, screening and education. Referrals – Follow-up care, smoking cessation and more. WIC — Information on nutrition and breastfeeding counseling and WIC EBT eligibility. The Mobile Health Unit has agreements to visit various locations throughout Seminole County including Remington Inn, Grace & Grits, Rescue Outreach Mission in Sanford, Goodwill Industries in Sanford and other locations and events as requested.
The Mobile Health Unit is graciously funded by the Seminole County Government. While our original mobile health unit experienced mechanical issues that could not feasibly be repaired, we have been able to continue services throughout the community with a mobile health van and community partnerships.
9
This is Public Health 10
Lyman High School Color Guard JROTC presenting the colors at the Veterans Stand Down
Veteran’s Stand Down DOH-Seminole hosted the 4th Annual Veteran’s Stand Down with the Seminole County Government Community Services Division. The stand down provides veteran’s with free haircuts, resources and medical exams. IDignity partners to provide birth certificates so veteran’s are able to obtain IDs.
DOH-Seminole hosted the Suicide Prevention Training & Resource Fair in partnership with Florida Linking Individuals Needing Care (FL LINC). Participants learned to implement QPR (Question, Persuade, Refer).
DOH-Seminole regularly performs environmental safety checks to make sure Seminole County is a healthy and safe place to be!
The 2nd Annual Amoeba Summit was held on September 9, 2016. The summit was an opportunity for specialists and clinicians from around the nation to come together to discuss Primary Amoebic Meningoencephalitis (PAM), a deadly brain-eating amoeba.
World Heart Day DOH-Seminole employees had the opportunity to become certified in CPR on World Heart Day hosted by the Employee Wellness Committee.
Kurt Jennings, Environmental Health Specialist, is inspecting the water chemistry of a public swimming pool.
Goldsboro Farmer’s Market DOH-Seminole, in partnership with Orlando Health and the Goldsboro Front Porch Council, opened a farmer’s market in Historic Goldsboro to increase local access to fresh, healthy food and create economic growth.
Did you know? 39.2% of Florida adolescents reported consuming fruit and 42.8% reported consuming vegetables less than once per day. Having healthy food available and affordable allows people to make healthier food choices and promotes healthy weight.
Central Florida Feed the Need, Inc. Food Pantry DOH-Seminole celebrated the grand opening of a food pantry and another step towards providing food security to families in Seminole County.
National Public Health Week 2016 Each year, DOH-Seminole celebrates National Public Health Week. The purpose of the week is to celebrate our work in the community and educate residents about public health services in Seminole County. We hosted the 2nd annual Live, Work, Move Seminole 5k and Kid’s Dash in downtown Sanford, along with a Health and Wellness Fair.
Kid’s Dash
The Mobile Health Unit provides accessible clinical services and educational resources to Seminole County residents who experience difficulties with transportation.
11
This is Public Health 12
DOH-Seminole celebrated its 75th Anniversary the week of November 1 - 4, 2016. The theme for the week’s celebration was Making Healthy Communities a Reality. Activities included a Programs and Services Open House and Mobile Health Unit Tour, employee activities and a Public Health Awards Ceremony to close the week-long celebration.
DOH-Seminole received the prestigious Health Champion Designation award from the American Diabetes Association. The Health Champion designation recognizes companies and organizations that integrate and champion a culture of wellness within the workplace.
The Office of Health Promotion and Education and Executive Leadership Teams receiving the American Diabetes Association Health Champion Designation award from Nicole Donelson with the American Diabetes Association.
Community Health Planning DOH-Seminole partnered with Quad R, LLC and Harvest Time International, Inc. to conduct the Local Public Health System Assessment (LPHSA) with about 30 community partners and Department of Health staff on December 13, 2016. The agenda included a participatory SWOT (strengths, weaknesses, opportunities and threats) assessment of the 10 Essential Public Health Services. Data collected will be used to enhance the Community Health Needs Assessment which will inform the Community Health Improvement Plan.
Hurricane Matthew Hurricane Matthew rolled into Seminole County on October 6, 2016. While Seminole County was spared the extreme devastation that seemed likely, it responded to its communities’ needs with efficiency and determination. The Florida Department of Health in Seminole County’s Special Needs Shelter teams, staff at the health department Field Operations Center and Seminole County Emergency Operations Center were mobilized to ensure the health and safety of the communities we serve. DOH-Seminole’s environmental and epidemiology teams monitored for conditions that could adversely affect the health of our communities, provided public health education and issued warnings as appropriate.
70 Special Needs Clients were provided exceptional care.
Did you know? Hurricane Matthew brought torrential rain which flooded parts of Sanford and Altamonte Springs, downed trees, and left millions of Floridians without power. It is important to be prepared for natural disasters, such as Hurricane Matthew, to avoid harmful health risks.
13
Boots on the Ground
Aedes aegypti
Zika fever is a mild febrile illness caused by a mosquito-borne virus similar to those that cause dengue and West Nile virus infections. It was first identified in Uganda Zika Forest in 1947. This illness is transmitted by Aedes aegypti and Aedes albopictus mosquito bites. Signs and symptoms of Zika fever include a low-grade fever, rash, joint pain, conjunctivitis and body aches. Zika virus has been linked to serious birth defects, including microcephaly, when contracted by expectant mothers during pregnancy. Zika virus has been identified in several countries in Central and South America, Mexico and the Caribbean since 2015. Outbreaks have previously been reported in Africa, Southeast Asia and the Pacific Islands. Local transmission has been reported in Puerto Rico and Florida. Cases of Zika fever have been reported in travelers returning to the United States. Seminole County had 27 cases of travel related Zika virus cases. Governor Rick Scott signed Executive Order 16-29 Declaration of Public Health Emergency for Zika to declare that a public health emergency exists in Florida. Seminole was included in this order with our first travel related case in January 2016.
Aedes albopictus
We Responded It is our job to monitor disease threats and keep the public informed and prepared. Our preparedness activities included: •
Distributing Zika virus guidance documents to healthcare providers, local hospitals and emergency management contacts.
•
Providing free Zika virus testing for all pregnant women per Governor Scott’s July 2016 mandate.
•
Attending Zika virus preparedness trainings for Central Florida Epidemiology and Environmental Health staff.
•
Presenting Zika virus updates at Seminole County Emergency Operations Center (EOC) and Emergency Management Services (EMS) monthly meetings.
•
Participating on weekly Department of Health (DOH) conference calls with the State Incident Management Team.
•
Working with Seminole County Mosquito Control upon suspicion of mosquito-borne illness to implement appropriate mosquito control measures.
•
Working with internal partners: Birth Defects Registry, Maternal and Child Health and Healthy Start.
•
Providing public information on disease transmission, prevention and protective actions.
•
Assisting with field investigation staffing requests of non-travel related cases and contacts in areas of limited local transmission in Miami, FL.
•
Community outreach and presentations.
14
In addition to the response activities, DOHSeminole communicated to over 100 healthcare providers and community partners in Seminole County through the DOH-Seminole Epi Gazette newsletters. Further communication was provided through Everbridge faxes to over 300 medical providers. In order to prepare our staff and the Region 5 Epidemiology and Environmental Health Strike Teams, members were trained on conducting door to door survey case investigations to identify local transmission.
Zika Virus Outreach Tania Slade (pictured left), Epidemiology Program Manager giving a presentation about the Zika virus. Kenyatta Badgett (pictured right), CDC Public Health Associate Program (PHAP) fellow, was part of the Zika response providing education on mosquito bite prevention and offering free testing in Miami-Dade County.
15
Population Growth Overall, Seminole County has experienced a slow but steady population growth over the past decade. As of Census 2010, the population for Seminole County was 422,718. Florida Charts 2016 updates show an increase to 449,705 population estimate or a 2.2% increase.
Languages Spoken English remains the main language spoken by 79.8% of the population five years of age and old in Seminole County according to the American Community Survey. The percent of residents who speak a language other than English is 20.2%, and those who do not speak English well were estimated to be 5.8% in 2016. Of all the residents speaking a language other than English at home, the most common language was Spanish.
population, and 19.78% of Seminole County residents are of Hispanic or Latino origin.
Age The largest group of residents in Seminole County by age in 2016 was 45 to 64 year-olds followed by the 25 to 34 years age group, each comprising approximately 27% of the population. However, since 2003, the 25 to 44 years age group decreased by 4%, while those in the age group 45 to 66 years increased by 11%. The median age in Seminole County was 39.2 years.
Seminole County Population Estimates, 2016 7.35% 12.26%
Health Insurance Coverage According to the 2016 Behavioral Risk Factor Surveillance System (BRFSS) survey, the percentage of adults having health care coverage in Seminole County was higher than the state.
80.39%
Hispanics had the lowest percentage of health coverage in Seminole County and Florida compared to Whites and Blacks.
Black
White
Other
Unemployment Rates Health Insurance Coverage by Race & Ethnicity, 2016
Percentage
Historically, the unemployment rate in Seminole County has been lower than the national rates. There has been a decline in the unemployment rate for Seminole County from 2011 (9.6%) to 2015 (4.8%). There is an overall decrease of 4.8% over a 5-year period. Unemployment Rate, Seminole County, 2012-2016
& Ethnicity RaceRace & Ethnicity
Race & Ethnicity Following national trends, the proportion of nonWhite residents in Seminole County continues to increase since 1990. According to the 2016, Florida CHARTS estimates, Seminole County has a White population of 80.39%, a 12.26% Black
4.8%
10
Percentage Percentage
Health of Seminole County 16
Demographic and Socioeconomic Status
8 6 4 2 0 2012
2013
2014
2015
2016
Year Seminole
Source: Bureau of Labor Statistics
Seminole
Florida
Florida
Education overall decrease in unemployment over a 5-year period.
According to 2016 estimates, 23.4% of Seminole County residents have at least a high school diploma compared to the state estimate of 29.2%.
$58,538 Approximately 7.0% of Seminole County residents 25 years and older did not earn a high school diploma, compared to 13.1% for the state. Seminole County had 35.3% of residents who earned Bachelor’s Degree or higher, compared to the state rate of 27.3%. Individuals 25 Years Older withwith a Bachelor's Individuals 25and Years and Older a Degree or Higher, 2012-2016
Bachelor’s Degree or Higher, 2011—2015
40 35
15
27.9
27.3
26.8
26.4
Percentage
Percentage Percentage
20
34
33.6
30 25
10 5 0 2012
Economic Status According to the 2016 American Community Survey, the median household income in Seminole County was $58,538. This was an increase of $1,528 from 2015 which was $57,010. The mean travel time to work in 2016 for Seminole County residents was 27.3 minutes which is a 1.6-minute increase from 2011 (25.7 minutes).
35.8
35
35
26.2
Median household income in Seminole County, 2016
2013
2014
Year
Seminole
Seminole Seminole
2015
2016
Federal poverty thresholds are defined by the U.S. Department of Health and Human Services and vary by size and composition of the household. In 2016, 11.4% of the Seminole County population was living below poverty level (a family of four was considered living below poverty level if their household income was less than $23,850). A higher percentage of Black (19.9%) and Hispanic (18%) households had incomes below $25,000 than White (10.4%) households in Seminole County.
Florida
Florida
Florida
Median Household Income by Race & Ethnicity, 2016
Median Household Income by Race & Ethnicity, Median Household Income by Race & Ethnicity, 2016 2016
Individuals 25 Years and Older with a High School Diploma, 2012-2016 25
29.8
24.8
29.8
24.3
29.7 25.5
29.5
24.1
29.2
23.4
20
15 10
$51,444
$50,000 $43,469
$41,909
$39,200
$40,000
$35,722
$30,000
5 $20,000
0 2012
2013
2014
2015
2016 $10,000
Year
Seminole Seminole
Race & Ethnicity
Florida
0$-
Florida
SC White
FL White
SC Black
FL Black
SC Hispanic
FL Hispanic
Median Household Income, 2012-2016 $70,000 $60,000
Income Income
Percentage Percentage
30
$61,766 $60,000
Income Income Income
35
$70,000
$50,000
$58,577 $47,309
$58,175 $46,956
$57,875 $47,212
$57,010 $47,507
$58,538 $48,900
$40,000 $30,000 $20,000 $10,000 0 $-
2012
2013
2014
2015
2016
Year
Seminole Florida Florida Florida Seminole Seminole
17
The total number of deaths from all causes in Seminole County in 2016 was 3,431. The ageadjusted death rate from all causes was 657.6 per 100,000. This was lower than the rate for Florida (686.6). Seminole County death rates in 2016 for both genders were lower than the state statistics; the rate for male residents was 33% higher than the rate for females (801.1 compared to 545.3 per 100,000) in all races.
Age-Adjusted Death Rate (All Causes) by Gender, 2016 819.1
Rate per 100,000 Rate per 100,000
801.1
570.2
545.3
Seminole County males had higher death rates than females for each of the top ten causes of death during 2016. Malignant cancers were the leading cause of deaths across all races. Blacks had a higher death rate from cancer, stroke, diabetes, pneumonia and kidney diseases, while the age-adjusted death rates for heart diseases, chronic lower respiratory diseases (CLRD), suicide, unintentional injuries and Alzheimer’s disease were higher in Whites. White males had a higher rate of cancer, CLRD, and unintentional injuries; while Black men and women had a higher rate of heart disease, stroke, diabetes, kidney disease and hypertension compared to their White counterparts. The rate of deaths due to Alzheimer’s was highest in White females. Leading Cause of Death (Rate) by Gender, Leading Case of Death (Rate) by Gender, 20162016
Age-Adjusted Death Rate Causes) Race,2006-2016 2006Age-Adjusted Death Rate (All(All Causes) bybyRace, 2016 Age-Adjusted Death Rate (All Causes) by Race, 2006-2016
Rate per 100,000 100,000 per Rate Rate per 100,000
Leading Cause of Death (Rate) by Gender, 2016
Rate per 100,000 100,000 RateRateper per 100,000
900
200
180 160 140
120 100
80 60 40
20 0
800 700 600
Male Male
Female Female
500 400 300 200 100 0 2007
2008
2009
2010
2011
White White
2012
2013
2014
2015
2016
Black
Black
Leading Cause of Death Percentage, 2016 2.1 1.6 3.9
3.0
1.6
24.4
5.5 6.0
7.8
22.4
Malignant neoplasm, commonly known as cancer, was the number one cause of death in Seminole County during 2016, accounting for 14% of all deaths. In addition to cancer, the other top causes of death were heart disease, stroke/ cerebrovascular disease, chronic lower respiratory disease (including COPD) and unintentional injuries.
Rate per 100,000
Health of Seminole County 18
Causes of Death
Leading Cause of Death (Rate) by Race, 2016
Cancer In 2016, the age-adjusted rate of death from all cancers combined in Seminole County (156.7 per 100,000) was slightly higher than Florida’s rate of 151.5. This rate is also slightly lower than the Healthy People 2020 goal of 161.4 deaths per 100,000. However, when distributed by gender, the age adjusted death rate for males in Seminole County and Florida were higher than the Healthy People 2020 target. Although there are more than 100 different types of known cancers, cancer of the lung/bronchus, prostate and breast are the most prevalent.
Female Breast Cancer All Cancers: Age-Adjusted Death Rates, 2016 All Cancers: Age-Adjusted Death Rates, 2016 Seminole County andFlorida Florida Seminole County and 200
189
Healthy People 2020 Goal: 161.4
180
180
per 100,000 Rateper 100,000 Rate
160.7 151.9
160 134.7
140
149.7
155.8
129.1
120
100 80 60 40
20 0 SC Male
FL Male SC Female FL Female SC White FL White
Race/Gender
SC Black
FL Black
Race/Gender
Breast cancer is the second leading cause of cancer death among women. In Seminole County, the age-adjusted death rate for female breast cancer in 2016 was 20.7 per 100,000 population, higher than the rate for Florida (19.3). The ageadjusted death rate for female breast cancer in Seminole County met the Healthy People 2020 target of 20.7 per 100,000. Both White and Black females in Seminole County had a higher rate (20.0 and 29.8 respectively) than the White and Black females in Florida (18.4 and 24.9 respectively). The age-adjusted rate for breast cancer in Black females in Seminole County in 2016 was 4.9% higher than the rate in Black females in Florida (29.8 compared to 24.9).
All Cancers: Age-Adjusted Death Rate by Gender Seminole County and Florida, 2007-2016
Rate per 100,000
Age-Adjusted Death Rate: Breast Cancer 2016
Rate per 100,000
Healthy People 2020 Goal: 20.7
29.8
24.9 20.7
19.3
20.0 18.4
Lung Cancer The age-adjusted death rate for lung cancer in Seminole County decreased from 47.8 per 100,000 in 2007 to 38.3 per 100,000 in 2016. Age-Adjusted Death Rate: Prostate Cancer 2016
Healthy People 2020 Goal: 45.4
Healthy People 2020 Goal: 21.8
Rate per 100,000
100,000 per 100,000 Rateper Rate
Age-Adjusted Death Rate: Lung Cancer, 2007 - 2016
33.4
22.9
21.4 16.7
14.5
15.4
19
Prostate Cancer
45
In 2016, the age-adjusted death rate for prostate cancer in Seminole County was 21.4 per 100,000 males, greater than the overall rate for the State (16.7), but below the Healthy People 2020 goal of 21.8. Consistent with the state rates for prostate cancer, the rate for White males in Seminole County was approximately twice the rate for Black males (22.9 compared to 14.5).
40
Rate per 100,000
35
30 25 20
15 10 5
0
Obesity and Overweight
In 2016, 62.8% of Seminole County adults indicated they were overweight or obese. This decreased from 64.8% in 2010. Twenty-four percent of Seminole County adults are obese. Although this was below the goal (30.5%) of Healthy People 2020, county health officials and the Healthy Seminole Collaboration chose obesity as one of their top five target areas for intervention. Percentage of Overweight or Obese Adults in Seminole:
Percentage of Overweight Dependentor onObese Age Aduts in Seminole: Dependent on Age
80.00% 70.00%
Heart Disease In 2016, the age-adjusted rate of death for heart disease in Seminole County (145.4 per 100,000) was lower than Florida’s rate of 150.7, but higher than the Healthy People 2020 goal (110.8 deaths per 100,000). The age-adjusted death rate for heart disease among Seminole County Blacks (1143.5 per 100,000) continues to be lower than Whites (148 per 100,000), since 2012. Age-Adjusted Death Rate for Disease Heart Disease Age-Adjusted Death Rate: Heart by Raceby and Gender, Race, 2007-2016 2006-2015
250
Age Adjusted Rate per 100,000
The BMI is a calculated index that attempts to normalize weight for height as an indirect measurement of body fat. A BMI of 25 to 29 is classified as overweight and a BMI of 30 or more indicates obesity. The BRFSS survey asked participants for their height and weight to compute a Body Mass Index (BMI).
200
150
100
50
0 2007
60.00%
Percentage Percentages
2008
2009
2010
SC White
50.00%
2011
SC Black
2012
2013
FL White
2014
2015
2016
FL Black
40.00%
30.00% 20.00%
Age-Adjusted Death Rate: Heart Disease, 2016
10.00%
200
0.00% 2007
2010
2013
2016
189.3
180 160
18-44 Year Olds
45-64 Year Olds
65 & Older
148
145.4
143.5
150.7
140
Rate perRate100,000 per 100,000
Health of Seminole County 20
Age-Adjusted Death Rate: Chronic Lower Respiratory Disease (CLRD), 2016 Age-Adjusted Death Rate: Chronic Lower Respiratory Disease (CLRD), 2016
112.6
120 100
Chronic Lower Respiratory Disease The age-adjusted death rate for chronic lower respiratory disease (CLRD) in Seminole County in 2016 was 39.0 deaths per 100,000, lower than the rate in Florida (39.3 per 100,000). Seminole County Whites had a higher rate (39.8) than Blacks (39.5). Seminole County females had higher death rates due to CLRD when compared to males (40.4 compared to 37.7); however, the rate for females in Seminole County was consistent with Florida females. Mortality due to CLRD in Blacks in Seminole County was higher compared to Blacks in Florida (39.5 compared to 26.6).
80
60 40
20 0
SC White
SC Black
SC Male
SC Female
Seminole County
Florida
Asthma In 2016, 5.4% of Seminole County adults participating in a Behavioral Risk Factor Surveillance Systems (BRFSS) survey reported currently having asthma. This was slightly lower compared to the state percentage. The percentage of adults reporting having asthma currently (at the time of survey) shows a
Diabetes
Preventable Hospitalizations Under 65 from Asthma, Seminole County, 2007 - 2016
Rate per 100,000
The age-adjusted diabetes mortality rate was 19.2 deaths per 100,000 for Seminole County in 2016. This rate was slightly higher than the state rate of 19.1. Seminole County Blacks had the highest age-adjusted death rate from diabetes (50.3 per 100,000), which was more than twice the overall rate for Seminole County. Seminole County Blacks continue to have the highest age adjusted death rates due to diabetes over the years while the rates have remained steady for Whites in Seminole County and in Florida.
Adults Who Have Ever Been Told They Have Pre-Diabetes 2013 vs 2016 Comparison
downward trend over the years. If managed timely and appropriately, hospitalization due to asthma and associated complications could be reduced. In Seminole County, the rate of hospitalizations for individuals less than 65 years old has shown a decrease over time from 68.9 per 100,000 in 2005 to 58.6 per 100,000 in 2016.
Age-Adjusted Death Rate for Stroke by Race 2016
Rate per 100,000
Healthy People 2020 Goal: 34.8
100,000 100,000 per per Rate Rate 100,000 per Rate
Age-Adjusted Hospitalizations From or With Diabetes, 2007-2016
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Age-Adjusted Death rate from Stroke, 2007-2016 Age-Adjusted DeathRate Ratefrom fromStroke, Stroke,2007 2007-2016 Age-Adjusted Death - 2016 Seminole and FL
60
Rate per 100,000
100,000 per 100,000 per RateRate
50
4,500.00 4,000.00 3,500.00 3,000.00 2,500.00 2,000.00 1,500.00 1,000.00 500.00 0.00
Year
SeminoleCounty Countyand andFlorida Florida Seminole Age-Adjusted Death Rates from Stroke, 2006 - 2015 Seminole and FL
SC White
SC Black
40
30
20
Age-Adjusted Death Rate for Diabetes, 2016
10
Healthy People 2020 Goal: 66.6
0 2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
Florida Florida
Stroke/Cerebrovascular Disease The age-adjusted death rate for stroke, or cerebrovascular disease, in 2016 was 49.7 deaths per 100,000. This rate is higher than the Healthy People 2020 goal and above the state rate of 36.7 deaths per 100,000. Seminole County and Florida Blacks had a higher age-adjusted death rate from stroke (56.1 per 100,000) than Whites (50.0 per 100,000).
Rate per 100,000
Year
Seminole County Seminole County
21
Birth Rate There were 4,753 live births in Seminole County in 2016. Most of these births (74%) occurred to White women, followed by Black women (16%). Twenty-three percent of these births were of Hispanic ethnicity. Births
%
4,821 4,772 4,643 4,470 4,373 4,441 4,415 4,416 4,515 4,554 4,753
Birth Rate 11.6 11.4 11.0 10.6 10.3 10.4 10.3 10.2 10.3 10.2 10.5
Live Births in Seminole County in 2016 Race White 3,514 74% Black 766 16% Other 463 9.7%
Repeat Birth Rates for Females Age 15-19 Years,
Repeat Birth Rates for2007-2016 Females Age 15-19 Years, 2007-2016 20 18
16 14
9.7 13.9 14.0
Percentage
Live Births in Seminole County by Year 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
represent the number of live births, induced abortions and fetal deaths combined. High teen birth rates are an important concern for a community because teen mothers and their babies face increased health risks and diminished opportunities to build a healthy future. Teenage mothers face a higher risk for premature birth, and babies with low birth weight, developmental problems and death. Teen births can have adverse long-term social and economic impacts on teen parents, their children and the community. The teen birth rate in Seminole County in the past decade has shown a decline. In 2016, the overall teen birth rate was 7.8, which was lower than the state (15.9).
Percentage
Health of Seminole County 22
Maternal and Child Health
12 10
8 6 4
2 0 2007
Ethnicity Non-Hispanic Hispanic Unknown Age of Mother (by AgeGroups) 15-19 20-24 25-34 35-44 45-50
2008
2009
2010
2011
2012
2013
2014
2015
2016
Year
3,627 1,117 9
167 776 2,855 947 7
76% 23.5% <1%
3.5% 16.3% 60% 19.9% <1%
10.0 12.5
Seminole County Seminole County
Florida
Florida
Prenatal Care 5.9 26.5 44.6 15.8 0.2
Birth rate is calculated as the number of births per 1,000 people. The birth rate was 10.5 live births per 1,000 population in 2016, with the highest birth rate occurring among women of Other race (13.9) and by Black women (13.9). More than half of the live births in 2016 (54.4%) were to women 25 to 34 years of age. Women age 20 to 24 years accounted for 16.3% of births while women age 35 to 44 years accounted for 19.92% of births. Teenage females (ages 15 to 19 years) accounted for 3.5% of the live births. Teen births (ages 15 to 19 years) have decreased nearly 58% over the past 10 years from 376 births in 2005 to 167 in 2016. Approximately 93.1% of mothers that gave birth in 2016 were high school graduates.
Teen Birth Rates in Seminole County The teen birth rate is defined as the number of live births per 1,000 women 15 to 19 years of age. It is important to note that teen pregnancy rates differ from teen birth rates. Teen pregnancy rates
Approximately 17.1% of Seminole County and 21.6% of Florida women who gave birth in 2016 did not receive prenatal care during the first trimester. Seminole County and Florida failed to meet the Healthy People 2020 goal of not more than 10% of pregnant women failing to receive prenatal care in the first trimester. Hispanic and Black mothers were less likely to receive prenatal care in their first trimester. In 2016, Blacks had the highest number of mothers (27.5%) that did not receive prenatal care in the first trimester while Hispanic mothers followed with (18.3%), compared to Whites (14.8%). Teenage mothers (ages 15-19 years) were the least likely to receive prenatal care during the first trimester, 30.8%. Women, 35 years of age and older, were most likely to receive prenatal care, with only 11.2% not receiving care during the first trimester.
Percentage
Seminole County Percentage of Mothers Not Receiving Prenatal Care in First Trimester by Age: 2016
Age of Mother in Years
2016, 378 of the 4,753 live births in Seminole County were classified as LBW and of these, 51 (or 1.2%) were VLBW. The rate of low birth weight infants in Seminole County (8.0) was lower than the state (8.7) and national rate of 8.1. The overall county rate was above the Healthy People 2020 goal of 7.8 per 1,000 populations; however, in the Black populations, the LBW for 2016 was 11.6 compared to 7.3 for Whites. The Healthy Start, Florida Healthy Babies and WIC programs work diligently to educate and ensure access to quality healthcare for pregnant women to improve health outcomes for infants in Seminole County.
Infant Mortality
Low Birth Weight Birthweight is one of the strongest predicators of an infant’s health and survival. Low birth weight (LBW) is classified as live births under 2500 grams, while very low birth weight (VLBW) is classified as live births under 1500 grams. In
Rate per 100,000
Birth Rate for Females Between Ages 15 - 19 for Seminole County, Florida & U.S: 2016
Infant mortality is the death of an infant before a child’s first birthday. The infant mortality rate (IMR) is calculated by dividing the number of newborns who die before a year of age by the number of live births during the year. The IMR is reported as the number of live newborns dying under a year of age per 1,000 live births. Infant mortality is an important indicator of the health of a community and its reproductive female population. The IMR for Seminole County in 2016 was 4.0 deaths per 1,000 live births. This rate was lower than the reported rate Seminole County Infant Mortality Rate by Race/Ethnicity, 2016
Rate per 100,000
Healthy People 2020 Goal: 6.0
Seminole County Low Birth Weight, 2016
Rate per 100,000
11.6
7.3
Healthy People 2020 Goal: 7.8 8.0
8.7
for Florida (6.1) and the United States (5.9 in 2015). It also exceeded the Healthy People 2020 goal of no more than 6.0 deaths per 1,000 live births. IMR among Whites was lower than the rate for Blacks (3.4 per 1,000 live births compared to 6.5). Hispanics had the lowest IMR for 2016 (2.7). IMR for Blacks decreased from 2015 to 2016 (from 10.2 to 6.5).
Smoking During Pregnancy and Low Birth Weight For 2016, 95% of the mothers of infants in Seminole County reported not smoking during pregnancy which is under the Healthy People 2020 goal of 98.6% of females abstaining from smoking while pregnant.
Our Tobacco Prevention Program is working closely with the Healthy Start, Florida Healthy Babies and prenatal programs to ensure every pregnant Tobacco Free Florida’s Mission is to protect the Approximately 1 in 10 pregnant women smoke during the mother is educated on the effects of people of Florida from last three months of pregnancy which may have an impact smoking during pregnancy. the dangers of Tobacco. on the health of their children. For those mothers in Seminole County who had a low birth weight infant, 7% of them reported smoking during pregnancy.
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Programs & Services 24
DOH-Seminole was named a Healthiest Employer for the Orlando Business Journal, earned the Health Champion designation through the American Diabetes Association, and was designated the Fit-Friendly Gold Award through the American Heart Association.
To protect, promote and improve the health of all people in Florida through integrated state, county & community efforts.
Main location: 400 West Airport Boulevard, Sanford, FL 32773 Casselberry: 132 Sausalito Boulevard, Casselberry, FL 32707 Environmental Health: 1101 East First Street, Sanford, FL 32771 Visit us at www.seminolecohealth.com or call: Information: (407) 665-3000 Appointment: (407) 665-3700
Services Include: Dental Care ● Family Planning ● STD/HIV/AIDS ● Environmental Health ● Teen Choices ● Immunizations ● Birth and Death Certificates ● School Health ● WIC ● Hepatitis ● Refugee Health ● Tobacco Prevention ● Breast & Cervical Cancer Early Detection
Affordable and reduced cost for Seminole County residents who qualify. *Some insurance accepted.
Services provided by the BCCEDP are : clinical breast exams, screening and diagnostic mammograms, sonograms, biopsies, surgical consults and pap smears.
Breast and Cervical Cancer Detection The Breast and Cervical Cancer Early Detection Program (BCCEDP) started in Seminole County in 2003 and serves women 50 to 64 years of age who are uninsured Florida residents in Seminole, Orange, Lake and Osceola counties. These women are at 200% of the poverty level.
In 2016, 304 Mammogram Screenings were provided with an approximate total of 1,313 services. Of those receiving mammograms, 8 women started treatment for breast cancer. While the program was established to screen women 50 to 64 years of age, the eligibility criteria has been expanded to include individuals having a first degree relative with a history of breast cancer such as mother, father or siblings, breast cancer survivors and any person with breast cancer symptoms. The BCCEDP staff coordinated and presented to the community a Breast & Cervical Cancer Awareness and Survivor’s Celebration Brunch in October 2016. The event was attended by over 30 individuals including community partners and also served as an educational session to promote breast cancer awareness and the importance of early intervention. In the upcoming year, efforts will be focused on promoting the importance of breast cancer screenings through media, billboard and other venues.
Employee Wellness Program The Employee Wellness Program was established to promote a culture of wellness among the employees of DOHSeminole. In order to promote health in our community, the committee encourages employees to be examples to the clients they serve by promoting healthy lifestyle choices. Members of the Employee Wellness Committee coordinate monthly Encouraging Wellness Lunch and Learns, weekly Wednesday Walks to Wawa, Healthy Happy Hours, physical activity challenges and newsletters to promote employee wellness. The program also coordinated the 2nd annual Live, Work, Move Seminole 5K during National Public Health week with nearly 300 race participants.
Environmental Health Program Our Environmental Health Program works to prevent diseases of environmental origin. Environmental health activities focus on prevention, preparedness and education, and are implemented through routine inspections, monitoring and surveillance of conditions that may contribute to the occurrence or transmission of disease. 2016 Accomplishments • Completed 100% of mandatory inspections. • Scored 92% on onsite septic programs State Evaluation. • Permitting new public pools with sun shelf.
Breast Cancer Survivor’s event
Dental Care Program Our Dental Care Program provides services for children and adults over the age of 20 years with Medicaid as well as self-paying patients. Services offered by the dental clinic include exams, x-rays, cleanings, sealants, fillings and simple extractions. The Dental Care Program has Electronic Oral Health Records and Digital X-Rays. In 2016, the Dental Care Office provided 2,919 exams - 1,822 cleanings, 1,821 fluoride treatments and 1,271 sealants. Did You Know? Dental Care partners with Seminole County Government’s Community Services Office who provides free dental services to those who qualify. The plans for 2017 include: • School Based Sealant Program – to provide preventive services to 2nd Graders in Title I schools in Seminole County. • Collaborate with Amerigroup to start providing preventive services to children in their Mobile Unit. • Partner with Head Start to provide Screenings, Fluoride Treatments and Education on Oral Hygiene and Nutrition.
Jerry Henkins, Environmental Supervisor performs an inspection of a new system installation.
In 2016, Environmental Health (EH) received 1,020 applications for septic system permits and 177 applications for new facilities. EH permitted 58 new biomedical waste facilities, 2 new body piercing facilities, 22 new food hygiene facilities, 16 new group care facilities, 2 new limited use wells, 28 new foster homes, 16 new public swimming pools and 26 new tattoo shops. EH also conducted 5,054 inspections, a 17% increase over 2015, with no increase in staffing.
Epidemiology Disease Reporting and Surveillance Epidemiology is a core public health function. Physicians and other health professionals are required by Florida Statute to report any disease of public health significance to the Florida Department of Health. Typically this is done through a county health department’s epidemiology program. Our Epidemiology Program monitors reportable diseases other than sexually transmitted diseases and HIV/AIDS. Program staff members investigate disease outbreaks in order to identify their source, intervene to
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Programs & Services 26
including counseling, testing, access to support groups and more. In 2016, the Hepatitis Program provided 394 services including testing, vaccines and outreach.
HIV/AIDS Testing, Surveillance and Treatment
protect others who may be at risk and identify ways to prevent additional cases. Epidemiology staff also provide disease control education and consultation for the public, physicians, veterinarians, hospitals, schools, daycare centers, nursing homes, animal services and other institutions in the community. Chronic disease, flu and arbovirus surveillance is also performed by the Epidemiology team. Did You Know? In collaboration with Seminole County Mosquito Control the Epidemiology Program investigated and responded to 110 suspect cases of Zika Virus in 2016, of which 27 were confirmed as travel related Zika.
Healthy Start Program The Healthy Start Program is available to all pregnant women and infants in Seminole County. The program is voluntary and eligibility is not based on financial factors. The Healthy Start Program’s core goals are to prevent infant death, decrease the number of low birth weight babies born within the county and improve health and developmental outcomes. The Healthy Start Program care coordination staff coordinate services in the comfort of the client’s home. Services such as psychosocial assessment and counseling, childbirth education, breastfeeding assistance, parenting instruction, inter-conception care and nutrition education are available to all participating families to ensure the very best start for their babies.
Hepatitis Prevention Program Viral hepatitis is an inflammation of the liver caused by a virus. In 2016 there were 29,456 cases of Hepatitis C (including perinatal) in Florida and 401 cases in Seminole County. People are at risk of contracting Hepatitis A, B or C from various risk factors such as eating contaminated food prepared by an infected person who did not wash their hands properly (Hepatitis A), to having unprotected sexual contact with an infected person (Hepatitis B) and sharing injection drug equipment (Hepatitis C). As a core function of public health, our Hepatitis Prevention Program offers a variety of preventative services
The HIV/AIDS Program has been providing HIV Outpatient Ambulatory Medical Care with Ryan White Part A funding for over 20 years. Our in-house services consist of acute care office visits, physical exams, follow-up exams, immunizations and laboratory services. We have also contracted with local community specialists to provide specialty care services for those patients who qualify for our Ryan White Part A medical program. These services consist of diagnostic testing, consultations and outpatient surgical procedures in many different specialties. DOH– Seminole also provides HIV/AIDS medication to eligible clients free of charge through the AIDS Drug Assistance Program (ADAP). In 2016, the Program experienced an overall increase in the number of new HIV cases and a slight decrease in the number of new AIDS cases. HIV cases increased from 83 in 2015 to 92 in 2016 an 11% increase. AIDS cases dropped from 30 in 2015 to 28 in 2016, a 7% decrease. Seminole County ranks 12th among all counties in Florida for HIV cases and 13th among all counties in Florida for AIDS cases. Plans for 2017 are to continue to provide excellent service to all HIV/AIDS clients within Seminole County and the Orlando Eligible Metropolitan Area (EMA).
Immunizations Program
The Immunizations Program provides childhood immunization services through Vaccines for Children (VFC). We also provide routine adult vaccines and travel services. During the 2016 reporting period, over 6,000 clients were served by the immunizations program with over 17,000 services provided. As of January 2016, the immunization coverage rate was 100% for twoyear-old patients. This rate exceeded the state goal of 95% and the national goal of 80%. Vaccine Accountability was 99.10%, kindergarten students’ immunization status was 93.4% and seventh grade students 96.9%. The Immunizations Program continues to promote the HPV 9 vaccine for adolescents. The vaccine has received positive reviews for preventing cervical cancer. A new Meningitis B vaccine is available for 10-23 year olds to increase protection from N. Meningitis. A new
Cholera vaccine is soon to become available for travelers to foreign countries.
Office of Health Promotion and Education The Office of Health Promotion and Education (OHPE) promotes and coordinates community engagement and partnerships to offer chronic disease prevention, education and screenings, host health observance events, and assess community-specific health needs. The OHPE manages the following programs and services to meet the needs of our employees and community: • Employee Wellness Program and Committee • Grants Administration and Committee • Health Education and Community Outreach • Healthiest Weight Florida • Health Impact Assessments • Health Equity • Diabetes Prevention Program • Reach and Connect Outreach for Breast and Cervical Cancer Screening The OHPE increasingly directs its focus on population health, outreach activities, preventative screenings, and partnerships to positively impact social determinants of health and close the gap on health disparities. The office is also responsible for pursuing grant opportunities for all programs. The OHPE engaged community partners and initiated new community projects to address food insecurities such as the Goldsboro Farmers Market, funded by a grant through Orlando Health Community Benefits, in partnership with the Goldsboro Front Porch Council, Inc.; regular local stops from the Fresh Stop Bus in partnership with Hebni Nutrition Inc., and an onsite food pantry in partnership with Central Florida Feed The Need, Inc. OHPE staff presented outcomes of the Goldsboro Garden Project at the National Association of County and City Health Officials Annual Conference in Arizona. Did you know? The OHPE facilitated applications for the following awards and recognitions: Orlando Business Journal’s Heathiest Employer; American Heart Association Workplace Food & Beverage Impact Award.
Office of Men’s Health The mission of the Office of Men’s Health (OMH) is to serve Seminole County males ages 12 and older to provide healthcare education, screenings and support services to
Hebni Nutrition Consultants, Inc. Fresh Stop Bus with DOH-Seminole Outreach Team and community partners at the Westside Community Center in Sanford, FL.
promote healthy lifestyles and emotional wellness. The goal of OMH is to maintain a forum for men and community partners to voice their concerns regarding specific health care needs for men, develop strategies to prevent disease and identify resources to improve quality of life for all men in Seminole County. The OMH hosts an annual Men’s Health Challenge event with speakers, vendors and food in June to commemorate Men’s Health Month. The OMH hopes to encourage men and community partners to increase awareness, coordinate outreach activities and engage stakeholders to decrease the disparate rate of disease and death among men. In 2016, OMH received a grant from the Seminole County Community Development Office to conduct health risk assessments and screenings for 40 men during outreach events.
Office of Minority Health The Office of Minority Health was established in July 2013 as the Minority Health Task Force and reestablished in 2015 as the Office of Minority Health. Its primary goals are to coordinate specific events and projects which focus on the health of minority populations in Seminole County disproportionately affected by infant mortality and chronic health conditions such as diabetes, obesity, heart disease and cancer, as well as to reduce and eliminate racial and ethnic health disparities. These efforts aim to ensure all community
Dr. Richard Bocco from Seminole Wellness presenting to participants at the 2016 Men’s Health Challenge.
members are equally respected, treated fairly, valued and have equal access to grow and reach their optimal potential. 2016 Accomplishments include: • Participation in the Martin Luther King Parade, health fairs, “Take a Loved One to the Doctor Day,” “National Night Out” events and Hispanic Heritage event. • Coordination of the Black History Month Celebration with the theme, “Are We There Yet? On the Road to Health Equity.” Health Equity Champions were recognized. • Chair and Co-Chair of OMH attended CDBG application seminar, and assisted with writing CDBG grant to continue work identifying persons with pre-diabetes and resources for those with diabetes in at-risk populations. Grant awarded. • Members participated in Men’s Health Summit on June 4, 2016 and screenings for diabetes and high blood pressure were provided.
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Programs & Services 28
•
Members attended National Diabetes Prevention Program (NDPP) training at DOHSeminole August 30 - 31, 2016 and received certification as Diabetes Lifestyle Coaches. • Provided assistance in planning and participated on panel: Florida Healthy Babies, Community Action-Planning Conversation. Did you know? Members of the Office of
In October of 2016 Florida was affected by Hurricane Matthew. In response to this, four of DOH-Seminole’s special needs shelter teams comprising one-hundred and four staff provided registration, sheltering and care of persons with special needs, before, during, and after the hurricane at Bentley Elementary and Highlands Elementary Schools simultaneously.
Minority Health completed their certification as Community Health Workers.
On-scene shelter staff continuously provided medical and functional needs care to over seventy special needs clients, fifty client caregivers, many client and staff family members who took refuge in the shelters, and shelter support staff from the Seminole County School Board and the Seminole County Sheriff’s Office. A specially designed shelter team moved to the Lyman High School general population shelter housing special needs clients that were reassigned from the special needs shelter upon deactivation. Special needs shelter staff registered one-hundred and thirty new special needs clients to the county’s special needs registry during the response.
Florida Healthy Babies, Community Action-Planning ConversationSeptember 20, 2016, Sanford Civic Center.
Public Health Preparedness Program
Refugee Health Program The Refugee Health Program serves Refugees,
Our Public Health Preparedness Program has dual responsibilities in preparedness and response. Our mission is to protect the employees, residents and visitors through the development of local emergency operations plans through pre-incident planning, training and exercising. In addition, our main objective is to provide support to core public health services through the coordination of public health and medical system preparedness, response and recovery activities. DOH-Seminole ensures public health services continue to serve the community during natural or man-made emergencies through an efficient and effective coordinated response and allocation of resources through coordination with other community agencies and stakeholders.
DOH-Seminole staff working the Special Needs Shelter during Hurricane Matthew.
Political Asylees and Parolees who have recently immigrated to the United States. Refugee Services in the state of Florida are coordinated by the Florida Department of Children and Families (DCF). Clients are typically referred by our community partners at Catholic Charities and Lutheran Services who work with DCF to resettle refugees in the U.S. The Refugee Health Program provides an initial health history, mental health
Take a Loved One to the Doctor Day Event, September 2016, Westside Community Center, Goldsboro, Sanford, FL.
and physical assessments, conducts a comprehensive laboratory screening for communicable and chronic diseases and provides routine immunizations and immigration form validation for those clients seeking to adjust their immigration status. The Refugee Health Program is highly regarded for providing quality service, facilitating quick appointments and for its warm and caring staff. In 2016, the program provided 4,008 services including assessments, appointments and I-693 forms.
School Health Services Program
The goal of the School Health Program is to minimize health barriers to learning for students in pre-kindergarten through 12th grade. We partner with Seminole County Public Schools (SCPS) to provide basic health services to students in 66 public schools and charters, as mandated by Florida Statute section 381.0056. The program’s combined staff includes registered nurses, school health aids, licensed practical nurses and administrative staff. Seminole County Public School’s vision and hearing screening teams collaborate with DOH-Seminole to ensure the delivery and reporting of required services. Basic health services are also available to private schools. In an average school year, the School Health Services Program team provides over 750,000 services to more than 66,000 students in Seminole County. The program collaborates with community partners to connect students
Teen Outreach Program
The School Health Program oversees the Teen Outreach Program (TOP). Thanks to funding from the Florida Department of Health and the Seminole County Sheriff’s Office, the Teen Outreach Program (TOP) has been serving youth in Seminole county since 2011. TOP is an engaging positive youth development curriculum that encourages healthy behavior, life skills and a sense of purpose in youth. The program offers 25 facilitated curriculum lessons and 20 hours of community service learning to youth over a period of 9 months. This evidence based program has been proven to impact the following outcomes among teens: • 52% lower risk of school suspension • 60% lower risk of course failure • 53% lower risk of pregnancy • 60% lower risk of school dropout (observed) Since it began in Seminole County, the School Health Program has partnered with various organizations to offer TOP, including The Grove Counseling Center, Boys & Girls Club in Altamonte Springs, SCPS 21st Century After School Programs, Journey’s Academy, Eugene Gregory Memorial Youth Academy and the Department of Juvenile Justice. More than 500 Seminole County youth have been served through TOP, and surveyed participants have indicated gaining skills in decision making, dealing with peer pressure, taking care of themselves and helping others. In addition, the Teen Outreach Program staff offers positive youth development sessions and trainings in our community.
STD Testing, Surveillance, Treatment Program
and families with needed health and social resources to support students’ health and their academic goals. The School Health program helps facilitate health resources, such as immunizations, to Seminole county students through various partnerships. A collaboration between Healthy Schools LLC, Seminole County Public Schools and our health department, facilitated the delivery flu vaccine to over 9,000 students through school based vaccination clinics.
The School Health program actively participates in the School Health Advisory Committee (SHAC) in a collaborative effort with Seminole County Public Schools, other Department of Health programs and community organizations and agencies to help identify needs, share available resources and promote the health of students in Seminole County schools. SHAC meetings are held quarterly and are open to the public.
The STD Program provides services including exams, testing and treatment for sexually transmitted diseases (STDs) such as HIV, syphilis, gonorrhea and chlamydia. Herpes culture and typing along with wart removals are also conducted for patients needing those services. We have highly trained medical staff including Disease Intervention Specialists (DIS) who counsel, educate and provide clients with methods to reduce their risk of reinfection. Annually, the STD Program provides free testing for HIV and syphilis in April for STD Awareness Month, National HIV Testing Day on June 27th and World AIDS Day on December 1st. Our DIS participate in outreach events and conduct presentations at schools, churches, community centers, jails and colleges. In the past year Seminole County has seen an increase in morbidity for all sexually transmitted infections. Did you know? HIV and syphilis affects the Men Who Have Sex With Men (MSM) population in Seminole County more so than any other group. Did you know? Chlamydia and gonorrhea rates have been increasing steadily in the 15-24 years age group.
Tobacco Prevention Program Tobacco use is the most preventable cause of death and disease in our society. Tobacco is recognized as a cause of multiple cancers, heart disease, stroke, complications of pregnancy and chronic obstructive pulmonary disease (COPD), and is responsible for over
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Programs & Services 30
438,000 deaths in the U.S. each year. We are an active member of the Tobacco Free Seminole Coalition (TFSC), a group of local individuals and community agencies who are committed to a tobacco-free Seminole County.
the SWAT program. Goal 4.2 Students Working Against Tobacco • SWAT students spoke before Seminole County legislators at an advocacy trip to Tallahassee to educate them about the dangers of tobacco and how our youth have been always targeted by their deadly products.
Tuberculosis Program
Tobacco Prevention staff celebrated the Great American Smoke out by informing attendees of the “Seminole Sessions” Seminole County Regional Chamber of Commerce event of tobacco cessation resources.
In 2016, the Tobacco Free Seminole Coalition accomplished: Goal 1.2- Point of Sales • 214 retail stores in Seminole County were surveyed to identify tobacco marketing strategies in Seminole County. Goal 1.4- Young Adults • Active outreach involvement with Seminole State College 0n all campuses to maintain tobacco use awareness and prevent tobacco initiation among young adults. Goal 2- Housing • Seminole County Housing Authority started working in partnership with the coalition to adopt a smoke free policy mandated by Housing and Urban Development (HUD). Goal 3- Tobacco Free Worksites • Tobacco free worksites and free cessation resources were provided to many local employers through active participation at the Seminole Regional Chamber of Commerce. Goal 4.1- Tobacco Free Seminole Coalition • Partnered with Seminole State College to prevent initiation among young adults and 21st Century after school program to educate them about the dangers of Tobacco through
Our Tuberculosis (TB) Program provides TB skin testing, chest x-ray referrals, medications, investigation of active cases, Directly Observed Therapy (DOT), nurse case management and expert medical management for cases and suspects of active TB disease and latent TB infection. Seminole County had three active TB cases in 2016, one reactivation of previously treated TB, and one inter-jurisdictional case of TB. Twenty-four clients were treated for Latent tuberculosis infection (LTBI). Our TB program continues to perform TB testing on high risk populations. These populations include homeless, substance abusers, HIV infected and previously incarcerated individuals. Use of the new Interferon Gamma Release Assay (IGRA) in our foreign born population has led to greater specificity and compliance in these patients as well. This test has led to greater compliance with medication and completing treatment. The TB program is working to educate local providers and Civil Surgeons on CDC guidelines for TB screening and testing. Did you know? In 2016, the TB Program staff provided 690 total services - 615 TB tests (420 skin tests and 195 blood tests) and conducted 75 TB assessments.
Vital Statistics Office: Birth and Death Certificates The Vital Statistics Office provides official records of birth, death, fetal death, marriage and dissolution of marriage. These records are essential for just administration of our law and for the protection of individual rights. In addition, the statistical data from these records are of great value to public health and other agencies. In 2016,
5 reasons why birth registration is so important: •
DID YOU KNOW?
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It opens up a world of health care. A child can access medical treatment and the vaccinations he or she needs to stay healthy. It means an education. A child will have the necessary documentation needed to enroll in publicly funded schools. It can provide protection. Protects children and provides them with their legal rights. It can help provide an inheritance or benefits. Legally proves a child is related to deceased parents to inherit their family property or be eligible for benefits such as Social Security survival benefits. It creates a permanent record of existence. It provides legal identity, citizenship.
Vital Statistics issued 132 birth certificates to the homeless at IDignity Outreach Events. 2016 Vital Statistic Facts for Seminole County • 2,973 Births and 3,624 Deaths. •
The peak months of birth in 2016 were January with 273 births, followed by December with 268 births.
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The peak months for deaths in 2016 were May with 320 deaths and April with 317 deaths.
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Vital Statistics serviced 10,458 clients issuing 29,041 certificates of birth and death. This included 1,367 electronic requests from funeral homes and 285 requests by mail.
Women, Infants and Children Program Women, Infants and Children (WIC) is a federallyfunded special supplemental nutrition program for lowmoderate income women, infants and children under 5 years of age. WIC’s purpose is to improve health by providing nutritional and breastfeeding support during critical periods of growth and development. This occurs through the provision of nutritious foods, nutrition education and counseling, breastfeeding promotion and support and referrals to health and social services. WIC employs one Nutrition Educator and eight Licensed Dietitians/ Nutritionists (LD/Ns). The WIC Program in Seminole County is provided at two locations, Sanford and Casselberry. In 2016 the WIC program in Seminole County served a total of 12,881 individuals. Florida WIC clients now enjoy the convenience of using a WIC EBT card to purchase WIC approved foods at any of the 45 authorized WIC grocery stores throughout Seminole County.
IDignity event at the Salvation Army of Sanford hosted by several agencies such as the Florida Division of Driver’s License, County Health Department (birth certificates), Veterans Affairs, Social Security Administration, legal counsel and volunteers to provide these services.
Volunteer and Internship Program DOH-Seminole provides a rewarding experience for volunteers in a state government organization addressing public health needs in coordination with Federal, State and County programs. DOH-Seminole further reflects its commitment to assisting in instruction of effective professionals, developing and promulgating public health knowledge and providing leadership to students as a means of achieving its mission in the community as an academic health department.
WIC promotes and supports breastfeeding as the best choice for infant feeding. We maintain high breastfeeding rates through frequent contact with nursing mothers. During the prenatal period, moms-to-be are provided with the education necessary to make an informed decision on how to nourish their babies. After delivery, mothers receive ongoing individual counseling to ensure every woman has the support she needs to successfully reach her personal breastfeeding goals. In 2016, a total of 861 breastfeeding classes were facilitated and 8,593 individual contacts educated or counseled on breastfeeding. WIC employs two International Board Certified Lactation Consultants (IBCLCs), five Certified Lactation Counselors (CLCs) and three breastfeeding peer counselors.
Did you know? Breastfeeding is an important preventative health measure for mom. It reduces mom’s risk of breast and ovarian cancer and osteoporosis (weak bones). Did you know? WIC clients now enjoy the convenience of using a WIC EBT card to purchase WIC approved foods at any of the 45 authorized WIC grocery stores throughout Seminole County.
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Seminole Health Programs & Connection Services 32
Health
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The Goldsboro Farmers Market is truly a blessing for the community as we work to improve the quality of life in Goldsboro.
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- Vernon McQueen, Chairman of the Goldsboro Front Porch Council
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Our goal is to ensure that more children can be successful in school and in life.
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- Robert Mulligan, President and CEO of Renaissance Dental
in the News
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Seminole County is making progress to improve the quality of life for its residents through partnerships and programs.
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The Florida Department of Health in Seminole County is among the 2016 healthiest employers.
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- Orlando Business Journal
- Donna Walsh, Health Officer
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2017-2020 Goals 34
Strategic Plan
Priority: 1. Health Protection and Promotion
Goals: •
Roadmap
Improve STD and HIV Rates
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Improve Asthma Rates
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Improve Diabetes Rates Improve Infant Mortality Rates
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Improving
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Improve Obesity Rates
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Improve Cancer Rates
Population Health
Priority: 2. Access to Care Goals: •
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Increase Clients Served Through DOH-Seminole Services Improve Health Impact Assessment
Priority: 3. Financial and Business Excellence Goals: •
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Improve Process Efficiencies at DOH-Seminole Promote a Culture of Quality Improvement at DOH-Seminole
Priority: 4. Workforce Development Goals: •
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Improve internal and external customer service at DOHSeminole Develop an engaged and satisfied workforce at DOH-Seminole
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A Publication of the Florida Department of Health in Seminole County 400 West Airport Boulevard, Sanford, Florida 32773 Phone | 407-665-3000 | www.SeminoleCoHealth.com