Lilian Ogari, PhD, MPH and David Sweat, MPH Chief of Epidemiology and Infectious Diseases Shelby County Health Department

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1 Lilian Ogari, PhD, MPH and David Sweat, MPH Chief of Epidemiology and Infectious Diseases Shelby County Health Department

2 Shelby County TN Population Estimate 937,750 (2016 ACS 5 years Estimate). Predominant races Black and White (52% B, 41%W, 6 % other) 217 Census Tracts in Shelby County 33 Zip Codes in Shelby County Deaths ~8,000 (2016)

3

4 Causes of Death Leading Causes of Death in Shelby County 2016 Numbe of Deaths **Disease of the Heart **Malignant Neoplasms Unintentional Injury **Cerebrovascular Disease **Alzheimer Disease **Chronic Lower Respiratory Disease Number of Deaths **Diabetes Homicide Septicemia Influenza Pneumonia Nephritis Nephrotic Syndrome

5 Zip Code Level

6 Life Expectancy in Shelby County 2015 Map by Office of Epidemiology and Infectious Diseases- Ogari Data source- Vital statistics Death Data TDH

7 Economic Hardship Index EHI focuses on 6 key social determinants that are critical for one s health. These include: Unemployment: The percent of the civilian population over the age of 16 who were unemployed Dependency: The percentage of the population that are under the age of 18 or over the age of 64 Education: The percentage of the population over the age of 25 who have less than a high school education Income Level: The per capita income Crowded Housing: The percent of occupied housing units with more than one person per room Poverty: The percent of people living below the federal poverty level. Richard P. Nathan and Charles F. Adams, Jr 1976

8 Why EHI? Uses multiple social determinants indicators to determine EHI Gives a comprehensive look on Economic Hardship Allows easy comparison with Mortality and Morbidity Rates. Data easily available through American Community Survey.

9 EHI Calculations For the calculation of all variables except for income. X = ((Y-Ymin)/(Ymax Ymin))*100 where: X = standardized value of component variable (for example, unemployment rate) for each area to be computed. Y = unstandardized value of component variable for each city. Ymin = the minimum value for Y across all area Ymax = the maximum value for Y across all area For the calculation of Income: X = ((Y-Ymax)/(Ymin Ymax))*100 Note: The Index represents the average of the standardized ratios of all six component variables Higher value indicating higher hardship.

10 Map by Office of Epidemiology and Infectious Diseases- Ogari Data source- American Community Survey 5-year Estimates EHI in Shelby county 2015

11 EHI Drivers in Select Shelby County zip codes % % 17% 16% 16% 17% unemployment EHI Dependency EHI Education EHI Income EHI Crowded Housing EHI Poverty EHI 19% % 16% 19% 19% 19% unemployment EHI Dependency EHI Education EHI Income EHI Crowded Housing EHI Poverty EHI % 16% 17% 11% 20% 17% unemployment EHI Dependency EHI Education EHI Income EHI Crowded Housing EHI Poverty EHI 27% 16% 4% 13% 19% 21% unemployment EHI Dependency EHI Education EHI Income EHI Crowded Housing EHI Poverty EHI

12 CORRELATION BETWEEN EHI AND LE IN SHELBY COUNTY TN ZIP CODES 2015 Map by Office of Epidemiology and Infectious Diseases- Ogari Data source- Vital statistics Death Data TDH and American Community Survey 5-year Estimates

13 CORRELATION BETWEEN EHI AND LE IN SHELBY COUNTY TN ZIP CODES 2015 Map by Office of Epidemiology and Infectious Diseases- Ogari Data source- Vital statistics Death Data TDH and American Community Survey 5-year Estimates

14 CORRELATION BETWEEN EHI AND LE IN SHELBY COUNTY TN ZIP CODES 2015 P= Map by Office of Epidemiology and Infectious Diseases- Ogari Data source- Vital statistics Death Data TDH and American Community Survey 5-year Estimates

15 Correlation between EHI and ED visits due to heart condition 2015 P= Map By Office of Epidemiology and Infectious Diseases-Ogari Data Source: ACS and ESSENSE

16 Correlation between EHI and Mortality rate due to heart condition P= Map By Office of Epidemiology and Infectious Diseases-Ogari Data Source: ACS and Vital Statistics

17 Census Tract Level

18 Hot Spot Map for Death Rates in Shelby County TN Data source: Vital Statistics Data, Death Certificate Data Tennessee Department of Health Map by office of Epidemiology and Infectious Diseases- Ogari

19 Life Expectancy at Birth in Shelby County TN Census Tracts Data source: Vital Statistics Data, Death Certificate Data Tennessee Department of Health Map by office of Epidemiology and Infectious Diseases- Ogari

20 EHI in Shelby County TN Census Tracts

21 Anselin Local Moran's I for EHI in Shelby County TN Census Tracts Data source: American Community Survey Estimates Map by office of Epidemiology and Infectious Diseases- Ogari

22 Cancer Death Rates in Shelby County TN Census Tracts Data source: Vital Statistics Data, Death Certificate Data Tennessee Department of Health Map by office of Epidemiology and Infectious Diseases- Ogari

23 Heart Disease Death Rates in Shelby County TN Census Tracts Data source: Vital Statistics Data, Death Certificate Data Tennessee Department of Health Map by office of Epidemiology and Infectious Diseases- Ogari

24 Contact Information Lilian Ogari PhD, MPH Chronic Disease Epidemiologist Shelby County Health Department David Sweat, MPH Chief of Epidemiology and Infectious Diseases Shelby County Health Department

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