Community Health Profile For Randolph County

The following information was compiled from various agencies in the state who collect statistics. Much of the information came from Kids Count Missouri, The Missouri Department of Health and Senior Services, the Department of Elementary and Secondary Education, and others. Many of the statistics were from a range of years and the information could have changed since the statistics were gathered. We hope this gives a picture of some of the county problem areas as well as areas we are impacting.

The Randolph County Caring Communities organization put a committee together to look at three problem areas for the community to focus on after reviewing the statistics from the area and some of the sources they have available. The three issues that impact overall health in the community that will be addressed is women smoking, teenage pregnancy, and child abuse, neglect, and out of home placements of children. We hope by bringing this information to the community it will be possible to make more people aware of problems and potentially to help in solving them.

You may either scroll down to view the entire report or jump to the following sections by clicking on a topic:

1. DEMOGRAPHICS
1a.	Age	2003		S	Fewer children <15 y.o. than state. Ages 15-44 same as state; over 65 y.o. more than state. In 2000, fewer 1-5 y.o. than state. No new data for this available.
1b.	Gender	2003		S	51.8% male; 48.2% female. State: 48.6% male, 51.4% female. In Randolph county, there are more females than males both under 15 y.o. and over 65 y.o.
1c.	Marital Status	2000		S	55% over 15 y.o. now married. Less than state, which is 55.5%. US is 54.4%. US Census Bureau
1d.	Race/Ethnicity	2003		S	Randolph county less than state for African American, Asian, Native American, Hispanic, other.
1e.	Non-English speaking students in school	2003		S	Less than 5 noted as limited or non English speaking students. While this is not many, it does reflect an increase.
1f.	Geographic Distrib. of Population	2000		P/S	Densest population is right in and around Moberly, with 859-1036 people/sq mile. North part of the county is most thinly populated with 18 people per square mile. South part of county has 33/sq mile. US Census Bureau map.
1g.	Population increase or decrease	2003		S	Increase of 1.5% from April 2000. U.S Census Bureau.
1h.	Density of population	2003		S	51/sq. mile, up from 50/sq. mile in 2000. State is 81/sq. mile. US Census Bureau.
2. EDUCATION					[top of page]
2a.	Education Levels	2000		S	77% have HS diploma or higher, 12% have Bachelor's. U.S. Census Bureau.
2b.	High School Graduation Rate	2006		S	87.8% Randolph County. Randolph county up from base year of 83.3%. Kids Count	85.80%
2c.	Drop-out Rate	2004	Yes	S	3.5%, about the same as state rate of 3.4%.	3.40%
2d.	Literacy	2001		S	Numbers are 10 % higher for unsatisfactory. ACT scores in Moberly are dropping.
3. SOCIO-ECONOMIC					[top of page]
3a.	Average Household Income	2007	Yes	S	Median household income ?% of U.S. and ?% of state. Randolph county: $38,480; State, $?; lower than U.S.
3b.	Per Capita Income	2003	Yes	S	$22,154 compared with $29,464 for Missouri. OSEDA	$29,464
3c.	Participation in Free/Reduced Cost	2006	Yes	S	51.4 % of kids vs. 40.7% of state. Randolph County up from 46% in last couple of years.	40.70%
3d.	Single-Parent Households	2003	Yes	S	26.3 out of 1000. State 24.3 out of 1000. Kids Count.
3e.	Percent of Population at or below 100%	2002	Yes	S	14.3 living in poverty. Higher than state, which was 11.3%. OSEDA.	11.30%
3f.	Assessed Valuation	2002		S	Owner-occupied housing units valued at a median of $49,300 in Randolph, vs.$89,900 state median value
3g.	Leading Industry	2005		S	Retail trade was highest with 14.5 percent of total jobs. Health care and social assistance, manufacturing, and local government were next highest. OSEDA.
3h.	Transfer Payments	2003		S	Transfer payments, including social security, amounted to almost $142 million, about 26 percent of total personal income. OSEDA.
3i.	Unemployment Rate	2007		S	5.2% of adults unemployed, vs 5.1% of state.	5.10%
	Food Stamps	2006		S	2,466 kids or 41%	30.90%
4. ENVIRONMENT					[top of page]
4a.	Age of Housing			S	33.2% of housing in Randolph county was developed before 1950
4b.	Lead Abatement Projects	2007		P	85 tested at clinic 3%	4%
4c.	Food Borne Outbreaks	2005		S	Salmonella cases in tomatoes 2 found in NE Missouri
4d.	Communicable Disease Outbreaks	2005		P/S	The majority of all outbreaks are influenza and STD related. Also Hep C had 17 chronic cases	228 in U.S.
4e.	Water Quality	2004		P	The majority of the county is on rural water or municipal systems.
4f.	Water Fluoridation	2004		P	All municipal and rural water is fluoridated.
4g.	Air Quality	2004		P	Good. Very few industrial pollutants although potential for agricultural pollutants.	smoking ordinances
4h.	Solid Waste	2004		P	City operated landfill for the largest county community and the smaller towns and rural areas utilize an out-of-county landfill. Municipal sewage system. Sewage ordinance for the County is in the development process.
4i.	Other
5. PUBLIC SAFETY					[top of page]
5a.	Homicide Rate	2004		S	No homicides reported in Randolph this year.
5b.	Overall Crime Rate	2004		S	716 total crimes for county. Overall rate 3% for county.
5c.	Violent Crime Rate	2004		S	40 violent crimes, 6% of total crimes for county for year. 109 violent offenses
5d.	Juvenile Crime Rate	2004		S	1001 delinquent referrals for county this year, above state average. Juvenile Court Services
5e.	Seat Belt/Child Safety Seat Use	2007		S		88% use childseat, 61% teens, 77% overall
5f.	Illegal Drug Use	2004		S	197 drug arrests	14% use ilicit drugs
5g.	DWI Arrest Rate	2004		S	124 DWI arrests in 2004. 171 in '03; 292 in '02; 191 in '01. Average of 4.75 were under 18 years old
5h.	Viiolent Deaths	2002		S	10 reported
6. FAMILY/DOMESTIC VIOLENCE					[top of page]
6a.	Child Abuse and Neglect	2004		S	Ranked #50 out of 115 MO counties; 57 out of 1000. 199 reported, 47.4%	41/1000 or 32.7%
6b.	Child Out-of-Home Placement	2004	Yes	S	Both went down in 1 year. 6.5 changed to 6.3out of 1000 for county. or 35 reported	5.1/1000 changed to 4.8/1000
6c.	Domestic Partner Violence	2004		S	MO state hwy patrol indicates 262 reports	have rate of 8.9%
6d.	Elder Abuse and Neglect	2004		S	71 validated reports of abuse/neglect in Randolph. 70.8% of reports validated for state vs 85.5% of reports for Randolph.
6e.	Other
7. UNINTENDED INJURIES					[top of page]
7a.	Work-related Injuries			S	plastics, metal, rubber and other equipment manufacturing, air transportation, forestry, medicine and waste management have highest industry rates	4.7/100 full time workers had non-fatal injuries in 2006
7b.	Alcohol and Drug Related Traffic Accidents	2004		S	42 Alcohol involved, 7 drug involved
7c.	Motor Vehicle Accident Injuries	2003		S	2 MVA deaths; 397 injuries (rate 1,617.6 /100,000)	1317.30/100,000
7d.	Unintentional Injuries	2003	Yes	S	3,618 (rate 148.7/1,000)
7e.	Firearms Injuries Falls ER Visits	2003 2006 2004		S S S	3 cases 3846 falls in 2 years 156 alcohol related and 132 drug related	1,669 cases 2725 falls in 2 years from DHSS
7f.	Total Deaths	2006		S		167 from OSHA
8. MATERNAL AND CHILD HEALTH					[top of page]
8a.	Unintended Pregnancies					38% of total births, 70% unmarried, 67% under 20 years old
8b.	Smoking during Pregnancy	2002		S	88 of 336 or rate of 26.2 per 100, above state's rate of 18.1 per 100
8c.	Immunization Rate	2005		S	Rate of 55.7 2 year olds born in 2003 adequately immunized with 4-3-1 series, compared to MO 43.3. MICA.	43.3
8d.	Low Birth Weight	2006	Yes	S	Rate of 9.4 per 100, above state's rate of 8.3 per 100. MICA.	8.3
8e.	Birth Defects
8f.	Number of Births to Teens	2006			43 of 352 or about 12%. MICA.	11381 out of 93647 or about 12%
8g.	Number of Births to Women over 40	2006		S	3 of 352 or .9%. MICA.	1870 out of 93647 or 2%
8h.	Rate of Multiple Births	2003		S	6 multiple births or rate of 1.7 per 100, below state's rate of 3.4 per 100
8i.	Births to Women without High School	2004	Yes	S	91 or 25.8%	14,4000 or 18%
8j.	Inadequate Prenatal Care	2002		S	29 of 336 or rate of 10.9, very close to the state's rate of 10.7 per 100	12.1/1000 or 18% in 2005
8k.	Repeat Pregnancies under age 20	2003		S	3 of 344 or rate of 0.9, below state's rate of 2.1
8l.	Birth Spacing less than 18 months	2003		S	no data found for Randolph county, state's rate of 10.8
8m.	Child Emergency Room Visits	2003			unintentional injuries are common with falls esp. motor vehicle injuries,
8n.	Causes of Child Hospitalizations	2003		DHSS	Asthma visits were 5.6 per 1000, 369 preventable hospitalizations
8o.	Lead Testing Rates/Percentage Elevated	2003		S	5.5 out of 1000 children have elevated blood lead levels, higher than state. Kids Count.
8p.	Infant Mortality Students enrolled in free & reduced lunch program	2002 2006	Yes	S S	9.3/1000 1,902 kids or 51.4%	7.7/1000 40.70%
9. INFECTIOUS DISEASE					[top of page]
9a.	HIV/AIDS	2004		S	Cumulative HIV 14 cases, AIDS 23 cases	4,735 HIV, 5,021 AIDS
9b.	Sexually Transmitted Disease	2003		S	Chlamydia- 62 cases (251.4 rate/100,000); Gonorrhea- 17 cases (rate 68.9/100,000). 2004: 65 chlamydia (49 white, 7 black), 14 gonorrhea (6 white, 8 black).No syphillis	#10 rank of all states: 373/161
9c.	Communicable Disease	2004	Yes	S	40 Lab confirmed influenza
9d.	Salmonella	2004		S	2 reports in NE Mo	766 in 2006
9e.	Tuberculosis	2004		S	1 TB disease; 14 Latent TB Infection	104 in 2006
9f.	Vaccine-Preventable Diseases	2004		S	2 Pertussis	308 in 2006
9g.	Hepatitis A and B	2004			2 Hep B, 9 Hep C	45 for A, 62 Acute B, 175 Chronic B
9h.	E-Coli H-0157	2004		S	2 confirmed	90 in 2006
9i.	Other
10. NUTRITION					[top of page]
10a.	Pregnant Women Achieving Proper Weight	2004		S	17% of WIC prenatal women have inadequate weight gain.
10b.	Breast Feeding Rates	2004		S	22.3% are breastfeeding fully and 15.5% are breastfeeding partially (30% of WIC newborns are breastfed)
10c.	Potential Eligible being served by WIC
10d.	Iron Deficiency Anemia among WIC Population	2004		S	13% of children are anemic; 5% of women are anemic
10e.	Obesity in children	2004		S	According to WIC, 21% of children age 2 to 5 years are obese.	22.5% of Adults
10f.	Daily Consumption of Fruit and Vegetables	2004	Y	S	81% of Randolph County citizens do not eat recommended servings of fruits and veggies. Five-a-Day.
10g.	Senior Nutrition Sites	2003		P	Higbee senior center and Moberly Towers
10h.	Participation in Food Assistance Programs
10i.	% of individuals with cvd eating fewer high fat foods
10j.	% of individuals with cvd exercising more	2004		P	Moberly Regional Medical Center has a cardiac wellness center but statistics are unavailable.
10k.	%of individuals with diabietes and/or diagnosed		Yes	S	18.4%.	14.80%
10l.	% of babies born with neural tube defects
10m.	Other
11. CHRONIC DISEASE					[top of page]
	Overweight/ Obesity for adults	2007				62% more males, more blacks. 27% obese, 35% overweight
11a.	Smoking Rates (Teens and Adults)	2003	Yes	S	34.9% of Randolph County citizens reported being smokers.	26.5% of adults smoke
11b.	Physical Inactivity	2003	Yes	S	30.1% of Randolph County citizens reported physical inactivity.	23.00%
11c.	Causes of Hospitalization		Yes	S	The majority of hospital charges ($17,062,645) were for heart and circulation related admitions.
11d.	Persons with Functional Limitations			P	We have a significant population of elderly who have functional limitations. The sheltered workshop also has a number of working age adults with mental and physical functional limitations
	Heart Disease	1995-2005		S	Deaths-945 , Hospitalizations(2001-2005)-2730 , ER visits(2001-2005)- 1583	187501, 538593, 359908
	Ischemic heart disease	1995-2005			Deaths-529 , Hospitalizations(2001-2005)-1229 , ER visits(2001-2005)- 266	133632, 218161, 30287
	Stroke/Cerebrovascular disease	1995-2005			Deaths-191 , Hospitalizations(2001-2005)-607 , ER visits(2001-2005)- 153	41476, 105302, 24284
	All Cancers	1995-2005			Deaths-678 , Hospitalizations(2001-2005)-540	134792, 132321
	Colorectal Cancer	1995-2005			Deaths-60 , Hospitalizations(2001-2005)- 80	13986, 17205
	Lung Cancer	1995-2005			Deaths- 165, Hospitalizations(2001-2005)- 52	14609, 17369
	Breast Cancer	1995-2005			Deaths-44 , Hospitalizations(2001-2005)-37	10099, 8936
	Cervical cancer	1995-2005			Deaths-2 , Hospitalizations(2001-2005)-9	978, 2869
	Prostate Cancer	1995-2005			Deaths-31 , Hospitalizations(2001-2005)-45	6860, 9228
	Chronic Obstructive Pulmonary Disease (COPD)	1995-2005			Deaths-172 , Hospitalizations(2001-2005)-365 , ER visits(2001-2005)- 1290	29676. 70970, 149729
	Asthma	1995-2005			Deaths-9 , Hospitalizations(2001-2005)-253 , ER visits(2001-2005)- 680	980, 38104, 151369
	Arthritis/Lupus	1995-2005			Deaths-11 , Hospitalizations(2001-2005)-646 , ER visits(2001-2005)- 1202	2389, 110041, 235148
12. MORTALITY RATE INDICATORS					[top of page]
12a.	All Cancers	2003		S	68 cases (238.6/100,000)
12b.	Breast Cancer	2001		S	106 case (2 of these being males)
12c.	Cardiovascular Disease	2003		S	93 cases (291.8/100,000)
12d.	Cerebrovascular Disease	2003		S	13 cases
12e.	Pulmonary Disease	2003		S	17 cases
12f.	Infant Mortality	2003		S	0 cases- no deaths related to birth defects, SIDS, or during early infancy
12g.	Alcohol Related	2004		S	2/246
12h.	Substance Abuse	2004		S	3/246 drug related, 35 smoke related
12i.	Suicide	2003		S	3 suicides in 2003, .04% per capita of county vs. .01% per capita of state
12j.	Unintentional Injury Death Rate	2003		S	2 casued MVA, 2 related to other accidental and adverse effects
12k.	Child Deaths	2003	Yes	S	43.9 out of 100,000 under 14 y.o. Much higher than state rate of 24.9 per 100,000.
12l.	Diabetes	2003		S	18.40%	24.10%
12m.	High blood pressure	2003			26.50%	28.50%
	High cholesterol (over 35 years of age)	2003			50.10%	37.30%
13. HEALTH CARE SYSTEM					[top of page]
13a.	Physician/Patient Ratios				1 to 649
13b.	Access to Medicaid Providers	2004		P	Local physicians and rehab accept a limited number of Medicaid patients. RCHD is a Medicaid provider for primary care issues and women's health.
13c.	Access to Dental Services	2004		P	4 full-time dentists, 2 part-time. No one accepts Medicaid. RCHD has Filling the Gaps Dental program for children on Medicaid and low income adults.
13d.	Access to Mental Health Services	2004		P	University Behavior Health and other community providers. RCHD has 1 MSW. Services available have greatly reduced over the past several years. Various support groups available, i.e. AA.	32% report poor mental health 1400 beds in the state
13e.	Availability of Other Health Care Manpower			P
13f.	Medically Uninsured Population	2004-2006		P		12.30%
13g.	Emergency Medical Services Response Time/Distance to Care	2004		P	EMS and the emergency room are located in the largest community on an easy-to-access junction of Hwy 24 and Hwy 63. The rural areas and smaller towns have trained first-responders. All areas of the county can receive emergency care within 15 minutes.
13h.	Hospitals in the County	2004		P	Moberly Regional Medical Center
13i.	Nursing Homes	2004		P	5 Nursing Homes
13j.	Access to Tertiary Care	2004		P	3 large hospital systems located 35 miles south (on Hwy 63) in Columbia, MO.
13k.	Home Health Care	2004		P	2 home health agency have their central office in Randolph Co. Various out-of-county agency are providers in this area.
13l.	911 Service	2004		P	An county-wide enhanced 911 system is in place.
13m.	Reproductive Health Services	20024		P	2 OB/GYN, RCHD is a Title X provider and offers women's health services on a sliding scale.
13n.	Local Enforcement of Laws re: Tobacco Sales to Minors	2004		P	Law enforcement includes investigation of complaints and periodic screens/set-ups at the various distributors. Liquor sales to minors in no longer screened due to State budget cuts.
13o.	Public Transportation	2004		P	Taxi services, Magic City Express, and CareTran available within the city limits. OATS available.
13p.	Persons with 1 or more Disabilities	2006		P		15%
14. COMMUNITY HEALTH RESOURCES					[top of page]
14a.	Recreational/Exercise Facilities/Opportunities	2004		P	New YMCA (replaced Gold's gym). MRMC Wellness Center. Rothwell Park walking/jogging trail, skate board arena, basket ball courts and tennis courts. Moberly Park and Recreation Sporting Complex for baseball, softball and soccer. Weekly indoor skateboarding events.
14b.	Drug and Alcohol Treatment	2004		P	ESCAPE and various other programs- no inpatient treatment centers. AA support groups.
14c.	Smoking Cessation	2004		P	RCHD periodically offers smoking cessation classes and promotes Great American Smoke Out.
14d.	Health Education Opportunities	2004		P	1 RN focuses on tobacco, nutrition, and exercise. 1 RN and Dental Assistant focus on oral health. 1 RN targets preschool issues. In addition, RCHD participates in health fairs and utilizes the media for ongoing health promotion.
14e.	Wellness/Prevention Programs	2004		P	RCHD has a health promotion and worksite wellness program. Filling the Gaps Dental Program contains a prevention component.
14f.	Summer Feeding Sites	2004		P	1 site available for children.
14g.	Services for those with Physical Disability	2004		P	Sheltered Workshop available. Various out-patient, in-home, and skilled nursing rehab available. Downtown Moberly is handicapped accessible. Public and government buildings in the county are handicapped accessible.
14h.	Food Pantry Resources	2004		P	3 separate entities provide food commodities.
14i.	Crisis Centers	2004		P	Women's shelter is available for women and their children. Provides a temporary living space and counseling. No other crisis centers are available.
14j.	Community Coalitions/Partnerships	2004		P	Randolph Co. Caring Communities Partnership is the largest coalition. Under its umbrella are numerous task forces addressing various health issues. RCHD is greatly involved with this coalition. Numerous other partnerships also exist.
14k.	School Nurse/Student Ratio	2004		P	Each school district has a school nurse and health program. Several schools have 2 or more nurses.
14l.	Other	2004		P	MACC offers nursing and EMT programs, as well as a police officers training program.
A) Review of community health status indicators, including primary and secondary data, reveals the following problems: The tobacco use indicators show this county to have more tobacco use than state average. The child death rate was much higher than the state rate and out of home placements is still much higher than the state rate. The child immunization rate is still very low. Physicians and the hospital adminstrator have identified a lack of mental health resources available.
B) Review of Behavioral Risk Factor Surveillance System or other locally conducted Community Survey (if a community survey was completed within the past 36 months) reveals the following problems: The primary care clinic nurse practitioners are seeing increased needs for dental health improvement and the need for additional health care options for uninsured and underinsured adults with chronic health problems. There is a need for medication and management of hypertension, diabetes, elevated cholesterol, and various respiratory problems.
The 3 most significant problems affecting the health status of population within the jurisdiction of the local public health agency are (public health priorities): Lack of health care for uninsured adults with chronic health problems. Lack of mental health services available for the underinsured population. Lack of improvement in maternal child health issues (all issues inter-related). Increase in violent deaths.
Note on question B, the Core Public Health Functions Contract does not require a locally conducted community survey.