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Section 3: Report of Findings VII. Health and Safety
VIII. Social Cohesion, Culture and Recreation |
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Community residents in focus groups, community visioning sessions, and surveys indicated their “ideal” conditions for themselves, their families and their community. Residents want a safe community and generally regard Cortland as safe, probably due to the small size of its towns, villages and single city. The ideal would be for a cleaner and greener environment and a repair of the infrastructure. The proposed sports-complex that would offer skating and soccer facilities responds to the needs expressed by many. More recreational activities for youth and families would help people maintain healthy lifestyles. This need is even greater in the more rural areas of the county. The proposed River Trail would meet some of that need as well. Furthermore, the disabled need a paved trail to appreciate nature and bikers and skaters want the same. Teens should have fewer reasons to engage in high-risk behaviors. Fewer drugs, less smoking, less alcohol abuse, and fewer bars are desired. The ideal is that everyone has health insurance and that there is quality and accessible health and dental care. Community education to eliminate the stigma associated with seeking mental health services was also indicated as an ideal. |
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The County Health Department prepares a Community Health Assessment every six years with biannual updates. It reports on the health status of the entire community, not merely the services provided by the Health Department. The 2001 update highlights the community cooperation among major agencies and health care providers in addressing numerous issues including: dental health, mental health, welfare reform, asthma, teen pregnancy and smoking. It notes the leading role of the Health Department in successfully providing facilitated enrollment for Child Health Plus in 2000. It is available at local libraries or the Health Department. The U.S. Department of Health and Human Services designates medically underserved areas. It notes two shortage areas for this county -- primary care physicians and dentists. The lack of access to health and dental care of our low-income children has particular long-term ramifications. Between 1996 and 1998, there was a steady decline in the number of children (age 0-20) who accessed dental care through Medicaid, despite an increase in families dependent on Medicaid during that period. (See Table EW-12.) As of June, 2002, no Cortland dentists are accepting new Medicaid patients for preventive dental care -- cleaning teeth and filling cavities. Medicaid recipients generally have to travel to another county for service. There are often long waits for appointments and there is no public transportation to the services. Nearly 66% of the nation has fluoridated public water supplies while in Cortland County only 9.6% of the public has water that is fluoridated. In 1993 and 1996, Cortland was first in the state with regard to the rate of indicated calls to the child abuse registry -- 49.9 calls/1000 families and 49.5/1000 respectively. A call is “indicated” when there is some credible evidence that a child has experienced abuse or neglect. In 1998, Chemung County led the state with 60 calls per 1000 families. Cortland was # 2 with 38/1000. Cortland County calls decreased between 1996 and 1998, unlike those for the rest of the state. (See Table HS-23) The County District Attorney’s office spearheaded a child abuse awareness campaign during these years. In 2001, the county had 775 total child abuse calls investigated, 41% of which were founded. The NYS Touchstones Kids Count Data Book is the usual source of data on child abuse. The 2002 edition of Touchstones uses a different measure than previous editions, thus comparisons cannot be made between the years previous to 2000 and those from 2000 on. (See Table HS-23 and Graph HS-2.) Concern for smoking behavior is not among the top 10 concerns listed by the public. However, Cortland County appears to have the highest rate of smokers of any county in the state. The objective data shows high rates of smoking related diseases in the county. The NYS Department of Health’s Behavioral Risk Factor Surveillance System showed that 40.1 % of Cortland County citizens smoke, while the national average is 25%. The 40% figure appears in several local studies:
Heart disease is the number one killer in the U.S. with a half a million deaths per year. This is far more than the 23,000 deaths each year from alcohol related problems. Cortland’s high rate of cigarette smokers contributes to diseases of the heart. Smoking cessation would prevent more disease than any other single behavior change according to the US Surgeon General. In Cortland County, heart disease causes more deaths than any other disease, but the rate of heart disease here is less than that in Upstate NY and NYS as a whole. In May of 2001, a safety seat check done at Barry Elementary School by the Sheriff’s Department and the County Health Department found that only 25% of the child seats inspected were properly installed and without defects; 42% were so old that they predated the federal safety standards, 13% had been involved in crashes and 21% were subject to a manufacturer’s recall. This survey involved a total of 24 seats. A NYS Office of Alcohol and Substance Abuse (OASAS) study shows Cortland County ranks higher than other similar rural and suburban counties for family problems and alcohol abuse. Youth alcohol and substance abuse consequences such as probation, alcohol treatment, accident involvement, and arrests are nearly double the state rate. (Cortland Standard 12/27/00). The study attributes this to a high rate of unemployment that can lead to alcoholism, divorce, separation and domestic violence, all of which may be interconnected. The County Probation Department has experienced a 14% increase in caseload over the past two years. About 40-50% of all probationers violate their probation or are put on probation more than once. Half of the new cases in 2000 were due to DWI. |
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Healthy People 2010 (HP 2010) presents a comprehensive, nationwide health promotion and disease prevention agenda. It is designed to serve as a roadmap for improving the health of all people in the United States during the first decade of the 21st century. There are two overarching goals for the decade:
These goals are supported by 467 specific objectives in 28 focus areas. Each objective has a target to be achieved by the year 2010. These objectives may be accessed on the web site: www.health.gov/healthypeople/Publications HP 2010 Focus Areas 1. Access to quality health services The leading health indicators determined by HP 2010 reflect the major public health concerns in the United States and were chosen based on their ability to motivate action, the availability of data to measure their progress, and their relevance as broad public health issues. They illuminate individual behaviors, physical and social environmental factors and important health system issues that greatly affect the health of individuals and communities. HP 2010 Indicators 1. Physical activity HP 2010 suggests that the tracking of these indicators will provide a snapshot of the health of the nation. These leading health indicators serve as a link to the 467 objectives in Healthy People 2010 and can become the basic building blocks for community health initiatives. |
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Healthy People 2000 (HP 2000) and the NYS Department of Health have differing standards for childhood immunizations. NYS requires that Haemophilus Influenzae (HIB) and Hepatitis B be added to the federal requirements of Polio, DPT, and MMR. The HP 2000 goal is to have 90% of all 2 year olds immunized. Our County Health Department tracks its immunization clinic and several pediatricians' offices. In 2000, Cortland County had a 72% rate of immunizations for the HP2000 goal and a 71% rate for the NYS requirements. It is an imperfect system, however, in that not all patients' immunizations are reported to the NYS Department of Health's central registry. |
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Cortland Counts: An Assessment of Health and Well Being in Cortland County NY The Seven Valleys Health Coalition, Inc. These five organizations make up the Cortland Community Assessment Team (CAT) Seven Valleys Health Coalition, Inc.
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