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Community Health
The health of the public is enhanced when citizens make healthy choices in their lifestyles and take advantage of preventive health practices. Infants should have every opportunity to be born healthy and to grow up and to be productive adults. During childhood, the incidences of vaccine-preventable disease and accidents can be minimized. Reducing obesity, smoking and teenage pregnancy can impact lifelong health and lifestyle. The State of Florida is committed to promoting healthy communities through creating a sound public health infrastructure that emphasizes preventive care, education and access to treatment.
Why Is This Important?
Healthy citizens are crucial to Florida's continuing economic growth. Students must be healthy to learn, and healthy adults are the basis of a productive workforce.
Teen pregnancy is a critical public health issue that affects the health, educational, social and economic future of the mother and child. Teen pregnancy is closely linked to a host of other critical social issues as well such as welfare dependency, out-of-wedlock births, responsible fatherhood, and workforce development in particular. Adolescents are less likely to seek prenatal care because they are afraid or embarrassed. This phenomenon and the immature physical nature of adolescents results in higher rates of low birth weight babies than in other age groups. As the offspring of adolescent mothers grow, they are more likely than children born to older women to have health and cognitive problems, and to be the victims of neglect or abuse.
Poor nutrition, physical inactivity and tobacco are the leading causes of preventable death in the United States. Poor nutrition and inactivity lead to overweight and obesity, which are causally related to a variety of chronic diseases and conditions, including adult-onset diabetes, high blood pressure, high cholesterol, coronary heart disease, stroke, osteoarthritis and some cancers.
Smoking remains the leading cause of preventable death in the United States, impacting people at all stages of life. Approximately 28,700 adult Floridians die each year from their own smoking. Annual health care costs directly caused by smoking in Florida are $6.32 billion. Of adults who smoke, 89 percent began smoking when they were 18 or younger. Of the approximately four million children under age 18 in Florida, about 369,000 will die prematurely from smoking. Smoking kills more people than alcohol, AIDS, car crashes, illegal drugs, murders and suicides combined. There is no risk-free level of secondhand smoke exposure. Quitting smoking has immediate and long term benefits, reducing the risks for diseases caused by smoking and improving health in general.
Immunizations have proven to be one of the most cost-effective public health interventions, and vaccine-preventable disease levels are at or near record lows. To maintain our progress, Florida must continue to maximize immunizations among all Floridians, particularly young children.
Young children need to be immunized to prevent them from contracting serious diseases. Florida is striving to increase the proportion of two-year-old children who are fully immunized against diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, Haemophilus influenzae type b, hepatitis B, and varicella (chickenpox).
Influenza is responsible for an average of approximately 114,000 hospitalizations and 20,000 deaths per year in the United States. Influenza and pneumonia together were the eighth leading cause of death in Florida in 2004, with over 3,000 deaths statewide. Florida's greater proportion of older adults (Florida has 17 percent compared to 12 nationwide), coupled with increased risk to this age-group, makes improving the influenza vaccine coverage rate among adults aged 65 and older an important strategy for decreasing disease, hospital length-of-stay and medical costs, and for improving quality of life.
How Is Florida Doing?
The rate at which adolescents between ages 15 and 19 are giving birth has been declining in Florida and across the nation for more than 15 years. Florida's rate at which adolescents between ages 15 and 19 gave birth declined from 1992 (65.7 per 1,000) to 2008 (40.7 per 1,000). This is a decrease of 38% in 16 years. In 2008, the rate fell from 43.2 to 40.7.
According to the 2008 Behavioral Risk Factor Surveillance System (BRFSS), 17.5 percent of Florida's adult population smokes, which is significantly lower than previous years. In 2008, the Foundation for America's Health ranked Florida's adult smoking prevalence 19th among 50 states and the District of Columbia. Florida remains significantly higher than the Healthy People 2010 objective of 12.0 percent for all adults.
The 2008 statewide survey of two-year-old children indicates that 83 percent of Florida's two-year-old children had completed age-appropriate immunizations, fewer than in the previous year.
According to the 2008 Behavioral Risk Factor Surveillance System (BRFSS), 63.5 percent of adults aged 65 and older had received a flu shot within the past year, which is significantly lower than the Healthy People 2010 goal of 90 percent.
Scorecard
What Influences Community Health?
Many factors go into building healthy communities and healthy families, including:
• The health status of women of reproductive age, which greatly influences pregnancy outcomes and the health and developmental outcomes of infants.
• Teen use of alcohol and/or drugs, including tobacco; dropping out of school, being uninvolved in school, family, or community activities; perceiving little or no opportunity for success. All lead to greater likelihood of early childbearing.
• Obesity, substance use, smoking, and untreated chronic disease or infections in pregnant women, which can cause a baby to be born too early or with serious health or developmental conditions.
• Poverty, domestic violence and educational delays which may prevent a woman or infant from receiving timely prenatal and infant health care.
• Personal behaviors including poor food choices, portion sizes and inactivity that cause people to be overweight and obese.
• Policy and environment changes that support healthy lifestyles and makes the healthy choice the easy choice.
• Physical environments and misinformation that do not support good nutrition and exercise.
• Educational campaigns that discourage new smokers and encourage current smokers to quit.
• Laws and policies aimed at restricting smoking to reduce the amount of exposure to secondhand smoke.
• Education about immunizations at various stages of life.
• Readily available immunizations at minimal or no cost.
• Availability of flu shots, reimbursed by insurance or at reasonable cost, for Florida seniors.
What Is the State's Role?
To continue reducing teen pregnancy, states can ensure availability of primary care services, mental health/chemical dependency services; adolescent well-care services and family-planning services and can focus policy on the idea that preventing teen pregnancy is more than a reproductive health issue, but also incorporates assisting teens to reach their life potentials and a host of other social issues.
To deter the damaging effects of smoking, states may adopt and enforce smoking bans to reduce exposure to secondhand smoke, and promote quitting by establishing toll-free tobacco cessation quit lines and offering nicotine replacement therapies. In addition, states may place restrictions on tobacco advertising aimed at youth, enforce laws concerning tobacco sales to minors and build and sustain capacity and infrastructure for comprehensive tobacco control programs.
Most states already have mandatory immunization requirements for children attending childcare facilities and public and private schools. States also take advantage of the federal Vaccines for Children Program, which provides free vaccines to doctors who serve eligible children. States can arrange for flu shots to be provided annually to at-risk patients at county health departments. Communities can coordinate with the statewide Florida Flu and Pneumonia Coalition, and other organizations to increase influenza immunization coverage levels for adults age 65 and older.
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