Data Snapshot - Thurston County

DATA SNAPSHOT THURSTON THRIVES FOOD ACTION TEAM

Thurston County Public Health & Social Services Department May 2013

TABLE OF CONTENTS

Introduction

2

Food Security

3-7

Enough Food Poverty

Community Food Environment

8

Healthy Eating

9-12

Breastfeeding Fruits and Vegetables Breakfast and Dinner

Food and Illness

13-17

Food Safety Foodborne Illness Obesity

Citations

Food Action Team Data Snapshot Thurston Thrives Community Assessment 2013

18-19

Page 1

INTRODUCTION Thurston Thrives is a community initiative focusing on how healthy people are today and the factors that influence how healthy the community will be in the future. These factors are: health behavior, the physical and built environment, health services, and local social and economic conditions. Together, these factors directly impact how long local residents live and the quality of life they experience during their lifetime. Thurston Thrives was established by the Thurston County Board of Health and is overseen with assistance of the Thurston Thrives Advisory Council. Topics that research has shown significantly influence community health are reviewed with the help of action teams. Each action team is led by a community member with in-depth knowledge of the topic area. The action teams are empowered to develop a common agenda on how best to address their topic area locally and are asked to report their recommendations to the Board of Health and Thurston Thrives Advisory Council.

FOOD AND HEALTH In 2013, the Thurston Thrives Food Action Team was formed to review the topic of food and its connection to health. Robert Coit, Executive Director of the Thurston County Food Bank serves as the Food Action Team lead.

SNAPSHOT The purpose of this report is to provide support to those examining the connections between food and health.  Data in this report provides a current snapshot of community health issues associated with food. A selected set of measures related to the topic are presented.  Other local community data reports and plans with additional information about this topic may be available and are not integrated into the snapshot.

QUESTIONS If you have questions about:  The Thurston Thrives initiative contact Chris Hawkins, Coordinator, 360-867-2513, [email protected]  The Food Action Team contact Lesley Wigen, Registered Dietitian, 360-867-2515, [email protected]  The Snapshot Report contact Mary Ann O’Garro, Epidemiologist, 360-867-2525, [email protected]


Page 2

FOOD SECURITY Hunger and socioeconomic aspects of food security.


Page 3

ENOUGH FOOD. Lack of consistent access to food is a circumstance experienced by children for many reasons including living in a family with limited income or one that lost income due to an unexpected financial hardship. Being food insecure, not having enough food at all times, impacts the health of children. Consequences of child food insecurity range from frequent headaches, having more chronic health conditions, being more withdrawn or anxious, to developmental problems that negatively affect learning and school performance. (1-2) Free and reduced price school meals provide dependable access to food for children who are low income and living in poverty. In 2012, a child living in a family of three would be eligible for this program if the annual household income was about $35,000 or less. In Thurston County, the median household income in 2012 was estimated at $62,009. (3-4)

MEASURE: Percent of public school students enrolled in the free and reduced price meal program. Percent of Public School Students Enrolled in the Free and Reduced Price Meal Program: Thurston County and Washington State 2012 60% 46% 40%

38%

20% 0% Thurston

WA State

Data Source: Public Schools Free and Reduced Price Meal Program Applications (5)

WHAT WE KNOW.  Thurston County has a lower percent of public school students enrolled in the free and reduced price meal program compared to Washington State.  The number of Thurston County public school children enrolled in the free and reduced price meal program increased with 15,345 students enrolled in 2012 compared to 11,904 students in 2008.  Between 2008-2012, the number of Thurston County public school students enrolled in the free and reduced price meal program increased by 29%.


Page 4

Data Source: Public Schools Free and Reduced Price Meal Program Applications (5)

WHAT WE KNOW.  There is substantial variation in free and reduced price meal program enrollment within Thurston County school districts.  In three school districts, over half of all students are enrolled in the free and reduced price meal program.


Page 5

POVERTY. The largest contributor to whether or not people experience hunger is their income. Households who live in poverty are more likely than those who do not to experience food insecurity, which is the lack of enough food for an active healthy life. (6)

MEASURE: Percent of all residents who live in poverty. Percent of Residents of All Ages Living in Poverty: Thurston County and Washington State 2007 and 2011 20% 14%

13% 10%

11%

9%

0% Thurston

WA State 2007

2011

Data Source: American Community Survey (7)

WHAT WE KNOW.  Thurston County has a lower percent of residents living in poverty compared to Washington State.  The number of Thurston County residents living in poverty has increased. In 2011, an estimated 33,018 people lived in poverty compared to 22,206 in 2007.  Between 2007-2011, the number of Thurston County residents living in poverty increased by 49%.


Page 6

Data Source: American Community Survey (7)

WHAT WE KNOW.  There is variation in poverty by Thurston County zip codes.  Six Thurston County zip codes have at least 1 in 10 residents (10% or more) living in poverty.


Page 7

COMMUNITY FOOD ENVIRONMENT The default choices that surround us.

See other community documents for data about this area.  Local Food Systems Panel, Sustainable Thurston. 2012. Thurston Regional Planning Council. www.trpc.org/regionalplanning/sustainability/Pages/LocalFoodSystemsPanel.aspx  Health and Human Services Chapter, Thurston County Comprehensive Plan. 2012. Thurston County. www.co.thurston.wa.us/planning/planning_commission/agenda/2012-11-14/pcagenda-20121114-hhs-chapter-final.pdf  Community Gardens in Thurston County. 2012. Thurston County Public Health & Social Services Department. www.thurstoncommunitygardens.org


Page 8

HEALTHY EATING Consumption of healthy food and eating patterns.


Page 9

BREASTFEEDING. Infants who are breastfed receive the most complete form of nutrition available. Human milk also uniquely protects the health of babies by decreasing their risk for a range of conditions like ear infections, respiratory infections and obesity - as well as being associated with a lower risk for sudden infant death (SIDS). Beyond nutrition, breastfeeding offers a range of positive and desirable benefits to both mother and child, including bonding or closeness with their baby. (8-9) Healthy moms are encouraged to breastfeed their infant exclusively, using no formula or substitutes, until 6 months old. There are many different factors that influence whether a new mom will begin to breastfeed and whether she will continue to breastfeed throughout the first year of her baby’s life. These influences include the work place (e.g. hours, maternity leave, having a place to pump and store milk), family support and societal view of breastfeeding. (9)

MEASURE: Percent of women breastfeeding their infant at birth. Percent of Women who Breastfeed their Infant at Birth: Thurston County and Washington State 2008-2010

Thurston

90%

WA State

92%

0%

20%

40%

60%

80%

100%

Data Source: Birth Certificates (10)

WHAT WE KNOW.  Thurston County has a lower percent of women breastfeeding their infant starting at birth compared to Washington State.  Between 2008-2010, on average each year 3,040 babies were born to Thurston County women with about 292 not being breastfed at birth.


Page 10

FRUITS AND VEGETABLES. Fruits and vegetables contain vitamins, minerals and other natural substances that protect health. Whether consumed through eating or drinking, they contribute to a balanced diet. The health benefits of fruit and vegetable consumption include reduced risk of heart disease, improved ability to maintain a healthy weight and possible protection against some types of cancer. (11-14)

MEASURE: Percent of adults consuming fruits and vegetables five or more times a day. Percent of Adults Consuming Fruits and Vegetables Five or More Times a Day: Thurston County and Washington State 2009 100%

77%

80%

75%

60% 40% 20%

23%

25%

0% Thurston Enough F/V (5 or more)

WA State Not Enough F/V (less than 5)

Data Source: Behavioral Risk Factor Surveillance Survey (15)

WHAT WE KNOW.  Thurston County has a higher percent of adults that do not consume fruits and vegetables five or more times a day compared to Washington State.  In 2009, an estimated 147,500 Thurston County adults did not consume enough fruit and vegetable.


Page 11

BREAKFAST AND DINNER. Eating a healthy breakfast and dinner with family influences the health of youth. Eating a healthy breakfast is associated with improved memory, reduced school absenteeism and improved mood among adolescents. Eating meals with family is associated with better diet quality and healthier eating behaviors in both adolescence and young adulthood. Research has shown that youth who frequently ate meals with their families during adolescence were less likely to skip breakfast and had higher intakes of fruit, vegetables, and important nutrients in young adulthood. (16-17)

MEASURE: Percent of 8th graders that do not eat breakfast and do not usually eat dinner with family. Percent of 8th Graders that Do Not Eat Breakfast and Do Not Usually Eat Dinner with Family: Thurston County and Washington State 2012 40% 30%

29%

32%

31%

32%

20% 10% 0% Thurston No Breakfast

WA State Not Usually Dinner with Family th

Data Source: Healthy Youth Survey, 8 graders are usually age 13-14 (18)

WHAT WE KNOW.  Thurston County has a lower percent of middle school age children who do not eat breakfast and do not usually eat dinner with family compared to Washington State.  By middle school, about 1 in 3 county youth do not eat breakfast and 1 in 3 do not usually eat dinner with family.


Page 12

FOOD AND ILLNESS Health conditions and diseases connected to food safety and diet.


Page 13

FOOD SAFETY. Regular inspection of food service establishments, such as restaurants and grocery stores, reduce the risk of becoming sick from a foodborne illness. Local government food programs are given the authority to conduct food inspections by state law and county regulations. Food establishments are inspected annually without prior notice. The number of inspections per year is determined by risk for illness from the type of food prepared or served by the establishment. Minimal and low risk establishments, which include grocery stores and bakeries, are inspected once per year. Medium and high risk establishment, like restaurants and delis, are inspected twice a year. (19-20) A point system is used to determine compliance with requirements for food service establishments. Red (critical) points are assigned to violations that could more immediately impact health by causing a foodborne illness. Each critical violation found may be worth 5-30 red points each. Examples of problems that result in red points are not cooking, cooling or storing food at the right temperature. Improper hand-washing or touching food directly without gloves are other examples of critical violations. Food service establishments are generally re-inspected automatically if an inspection results in more than 45 red points. (19-20)

MEASURE: Percent of permanent food establishments that received a routine inspection resulting in 0-35 red points.

100%

Percent of Permanent Food Service Establishments with a Routine Inspection resulting in 0-35 Red Points: Thurston County and Washington State 2010 97% 95%

80% 60% 40% 20% 0% Thurston

WA State

Data Source: Environmental Health Records (21)

WHAT WE KNOW.  Thurston County does better on percent of food inspections resulting in 35 or less red points when compared to Washington State.  In 2010, the Thurston County Food Program conducted 1,304 routine inspections of food service establishments.  8 food service establishments were re-inspected due violations resulting in more than 45 red points in 2010. Food Action Team Data Snapshot Thurston Thrives Community Assessment 2013

Page 14

FOODBORNE ILLNESS. Many illnesses can be foodborne, which means caused by food that is contaminated with a bacteria, virus or parasite that makes people sick. Some illnesses are commonly connected to food, including Campylobacter, E.coli and Salmonella. Foodborne illnesses can have serious health consequences resulting in hospitalization and death. (22-23) Local, state and federal public health agencies track reported foodborne illnesses to prevent them from spreading to other people and to identify the source of outbreaks. However, most foodborne illnesses are not connected to an outbreak. Foodborne illnesses are thought to be under-reported due to whether people seek care when they are sick and whether they are diagnosed with a foodborne illness when they do seek care. (22-23)

MEASURE: Rate per 100,000 of Campylobacter, E.coli and Salmonella cases among residents of all ages. Rate per 100,000 of Campylobacter, E.coli and Salmonella Cases among Residents of All Ages: Thurston County and Washington State 2012 30.0

24.5

20.0

16.1

12.5 10.0

11.8

4.7

3.4

Thurston

WA State

0.0 Campylobacter

E.coli

Salmonella

Data Source: Notifiable Condition Report (24)

WHAT WE KNOW.  Thurston County has a higher rate of Campylobacter, E.coli and Salmonella compared to Washington State.  In 2012, the Thurston County Investigation and Control of Disease Program reported the following number of confirmed cases for the calendar year: − Campylobacter = 63 − E.coli = 12 − Salmonella = 32


Page 15

OBESITY. Obesity is a health condition that increases your risk for several diseases including Type 2 Diabetes, Heart Disease and Stroke which are leading causes of death in Thurston County. In children and adults, obesity can cause high blood pressure, liver problems, joint problems and breathing problems. There are many factors that influence obesity, but your weight fundamentally comes down to an imbalance between the number of calories consumed and amount of physical activity you get. (25-26) Obesity in adults is defined as having a Body Mass Index (BMI) of 30 or higher based on height and weight. In children, obesity is defined as having a BMI at or above the 95% percentile for children the same age and sex. (26-27)

MEASURE: Percent of adults age 18 and older who are obese. Percent of Adults who are Obese, Overweight or Neither: Thurston County and Washington State 2011

Thurston

29%

WA State

27% 0%

34%

37%

34% 20%

Obese

40%

Overweight

39% 60%

80%

100%

Neither Obese or Overweight

Data Source: Behavioral Risk Factor Surveillance Survey, may not add to 100% due to rounding (15)

MEASURE: Percent of 8th grade students who are obese. Percent of 8th Graders who are Obese, Overweight or Neither: Thurston County and Washington State 2012

Thurston

11%

WA State

10%

17%

72%

14%

0%

75%

20% Obese

40%

Overweight

60%

80%

100%

Neither Obese or Overweight th

Data Source: Healthy Youth Survey, 8 graders are usually age 13-14 (18) Food Action Team Data Snapshot Thurston Thrives Community Assessment 2013

Page 16

WHAT WE KNOW.  Thurston County has a higher percent of adults and middle school age children who are obese compared to Washington State.  In 2011, an estimated 57,030 Thurston County adults were obese.  By middle school, 1 in 10 county youth are obese.

Data Source: Behavioral Risk Factor Surveillance Survey (15) Data from 2006-2010 are not comparable to 2011 due to a changes in survey methodology


Page 17

CITATIONS. Food Security (1)

(2)

(3) (4) (5) (6)

(7)

Who Are America’s Poor Children: Examining Food Insecurity among Children in the United States. 2010. National Center for Children in Poverty, Mailman School of Public Health, Columbia University. www.nccp.org/publications/pub_958.html Food Insecurity in Households with Children: Prevalence, Severity and Household Characteristics. 2009. Economic Research Service, United States Department of Agriculture. www.ers.usda.gov/publications/eib-economic-information-bulletin/eib56.aspx Child Nutrition Services, National School Lunch and Breakfast Program. Office of Superintendent of Public Instruction. www.k12.wa.us/ChildNutrition/Programs/NSLBP/default.aspx Median Household Income. 2012. Washington State Office of Financial Management. www.ofm.wa.gov/economy/hhinc/ Public Schools Free and Reduced Price Applications. 2012. Office of Superintendent of Public Instruction. www.k12.wa.us/ChildNutrition/StatisticsReports.aspx Household Food Security in the United States in 2011. United States Department of Agriculture, Economic Research Service. www.ers.usda.gov/publications/err-economic-research-report/err141.aspx American Community Survey. 2007-2011. United States Census Bureau. http://factfinder2.census.gov/

Healthy Eating (8) (9)

(10) (11) (12) (13) (14) (15) (16) (17)

(18)

Breastfeeding and the Use of Human Milk. 2005. Pediatrics. pediatrics.aappublications.org/content/115/2/496 The Surgeon General’s Call to Action to Support Breastfeeding. 2011. United States Department of Health & Human Services, Office of the Surgeon General. www.cdc.gov/breastfeeding/promotion/calltoaction.htm Birth Certificates, Maternal and Child Health Data Book. 2012. Washington State Department of Health. www.doh.wa.gov/Portals/1/Documents/Pubs/140-047-MCHDataBook-Oct2012.pdf Nutrient Information for Fruits and Vegetables. 2012. Centers for Disease Control and Prevention. www.cdc.gov/nutrition/everyone/fruitsvegetables/nutrient-info.html Dietary Guidelines for Americans. 2010. United States Department of Agriculture and United States Department of Health & Human Services. health.gov/dietaryguidelines/ How to Use Fruit and Vegetables to Manage Your Weight. 2011. Centers for Disease Control and Prevention. www.cdc.gov/healthyweight/healthy_eating/fruits_vegetables.html Cancer Prevention Overview. 2012. National Cancer Institute. www.cancer.gov/cancertopics/prevention Behavioral Risk Factor Surveillance Survey. 2006-2011. Thurston County Public Health & Social Services Department. Nutrition Facts: Nutrition and the Health of Young People. 2013. Centers for Disease Control and Prevention. www.cdc.gov/healthyyouth/nutrition/facts.htm Nutrition and Physical Activity: Washington State Adolescent Needs Assessment Report. 2010. Washington State Department of Health. www.doh.wa.gov/DataandStatisticalReports/HealthBehaviors/AdolescentHealthAssessment.aspx Healthy Youth Survey. 2012. Thurston County Public Health & Social Services Department.


Page 18

Food and Illness (19) (20) (21)

(22) (23) (24) (25) (26) (27)

Food Protection. 2013. Centers for Disease Control and Prevention. www.cdc.gov/nceh/ehs/etp/food.htm Food Program. 2013. Thurston County Public Health & Social Services Department. www.co.thurston.wa.us/health/ehfood/index.html Food Service Safety: Local Public Health Indicators. 2010. Washington State Department of Health. www.doh.wa.gov/PublicHealthandHealthcareProviders/PublicHealthSystemResourcesandServices/Publi cHealthImprovementPartnershipPHIP/PublicHealthIndicatorsWorkgroup/LPHIWebsite.aspx Food Safety Frequently Asked Questions. 2012. Centers for Disease Control and Prevention. www.cdc.gov/foodsafety/facts.html A-Z Index of Foodborne Illness. 2011. Centers for Disease Control and Prevention. www.cdc.gov/outbreaknet/foodborne_az.html Notifiable Conditions Year-End Summary. 2012. Investigation and Control of Disease Program, Thurston County Public Health & Social Services Department. Overweight and Obesity: Causes and Consequences. 2012. Centers for Disease Control and Prevention. www.cdc.gov/obesity/adult/causes/index.html Basic about Childhood Obesity. 2012. Centers for Disease Control and Prevention. www.cdc.gov/obesity/childhood/basics.html Defining Overweight and Obese. 2012. Centers for Disease Control and Prevention. www.cdc.gov/obesity/adult/defining.html


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Thurston County Public Health & Social Services Department 412 Lilly Road NE, Olympia, WA 98506 Phone: 360-867-2500, Fax: 360-867-2601 TDD: 1-800-658-6384 Website: www.co.thurston.wa.us/health Twitter: @ThurstonHealth