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Healthiest Wisconsin 2020: Environmental and Occupational Health Report

This report provides an overview of the environmental and occupational health focus area of the Healthiest Wisconsin 2020 initiative. It includes data on youth and adult asthma, asthma hospitalizations, occupational injuries, and lead poisoning. The report also addresses health disparities and provides links to additional resources.

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Healthiest Wisconsin 2020: Environmental and Occupational Health Report

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  1. Healthiest Wisconsin 2020 Baseline and Health Disparities ReportEnvironmental and Occupational Health

  2. Chapter outline Chapter Outline Background • Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities Report • Healthiest Wisconsin 2020 objectives and indicators • Rationale • Key points Data • Youth asthma • Adult asthma • Asthma hospitalizations • Occupational injury • Lead poisoning References Links to additional reports and resources Contacts

  3. Report overview Report Overview • This chapter is part of a larger report created by the Wisconsin Department of Health Services to track progress on the objectives of Healthiest Wisconsin 2020 (HW2020) and identify health disparities in the state. The full report is available at: http://www.dhs.wisconsin.gov/publications/P0/p00522.pdf • The report is designed to address the Health Focus Areas in HW2020. Where direct measures exist, data are presented; where direct measures are not available, related information may be included. • Information about populations experiencing health disparities is provided in the Health Focus Area chapters and is summarized in separate chapters devoted to specific populations. • Technical notes are available at: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf

  4. Report overview Report Format Sample annotated slide Full Report • Format: PDF • Intended use: reference document Chapters • Format: Annotated PowerPoint slide set • Intended uses: presentations to • Decision-makers • Service providers • Community leaders • The public

  5. Report overview Report Outline Executive Summary Section 1: Introduction Section 2: Demographic overview Section 3: Health focus areas Section 4: Infrastructure focus areas Section 5: Data summaries by population Section 6: Technical notes

  6. Report overview Report Outline: Detail Section 3: Health focus areas Section 4: Infrastructure focus areas

  7. Report overview Report Outline: Detail Section 5: Data summaries by population

  8. Report overview Data notes • Please refer to the Technical Notes chapter for a more detailed description of limitations and methods: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf • The 95% confidence intervals are denoted by error bars. Where confidence intervals do not overlap, as shown in the example on the right, differences are statistically significant. Larger confidence intervals may indicate less reliable estimates that should be interpreted with caution. • Population estimates that are considered unreliable are excluded. • Misclassification of racial/ethnic groups may affect the accuracy of rates. • Unless otherwise indicated, the Hispanic population may include people of various races; Whites, Blacks, Asians, and American Indians are non-Hispanic.

  9. Report overview Factors that influence health Social determinants of health Source: University of Wisconsin Population Health Institute. County Health Rankings 2013, http://www.countyhealthrankings.org/our-approach

  10. HW2020 objectives Healthiest Wisconsin 2020objectives and indicators Objective 1 By 2020, improve the overall quality and safety of the food supply and the natural, built and work environments. Objective 1 Indicator • Proportion of local and tribal jurisdictions that have assessed, prioritized and improved performance on an environmental and occupational health index. Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Environmental and Occupational Health Focus Area Profile.

  11. HW2020 objectives Healthiest Wisconsin 2020 objectives and indicators Objective 2 By 2020, increase the percentage of homes with healthy, safe environments in all communities. Objective 2 Indicator • Proportion of local and tribal jurisdictions that have assessed, prioritized and improved performance on a home health and safety index. Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Environmental and Occupational Health Focus Area Profile.

  12. Rationale Rationale • Environmental and occupational health includes the prevention of illnesses and injuries resulting from hazards in the natural and built environments where people live, work and play. • The air we breathe, water we drink, communities we live in, and food we eat are recognized as underlying determinants of health. • Disparities in the quality of living spaces are often related to socioeconomic, racial/ethnic, and income- and education-level factors. These factors can affect whether or not environmental contaminants are detected and removed. Source: Wisconsin Department of Health Services, Healthiest Wisconsin 2020, Environmental and Occupational Health Focus Area Profile.

  13. Black adults had significantly higher percentages of lifetime and current asthma compared to other racial/ethnic groups. Lifetime and current asthma rates are significantly higher among people with lower incomes and those with lower educational attainment. While the statewide rate of asthma hospitalization has declined slightly over the past 10 years, notable disparities exist by race. The hospitalization rate was five times greater for the Black population and two times greater for American Indians than for the White population. Milwaukee and Menominee counties had asthma hospitalization and emergency department visit rates that were roughly twice the statewide rates. The estimated rate of work-related injury and illness has declined over the past decade. Lead poisoning has steadily decreased among children under age six since 2001; however, racial and ethnic disparities remain. In 2010, Black children were six times as likely as White children to have experienced lead poisoning. Key points Key points

  14. Youth asthma

  15. Youth asthma Rates of lifetime and current asthma among Wisconsin children, by sex, 2011-2012 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2011-2012 landline-cellphone combined dataset.

  16. Youth asthma Rates of lifetime asthma among public middle and high school students, by race/ethnicity, Wisconsin, 2008 and 2010 Source: Wisconsin Department of Health Services, Youth Tobacco Survey, 2008 and 2010. Note: “Other” includes Hispanic, American Indian/Alaskan Native, Asian, Native Hawaiian or other Pacific Islander.

  17. Adult asthma

  18. Adult asthma Rates of lifetime and current asthma among Wisconsin adults, by sex, 2009-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 landline-cellphone combined dataset.

  19. Adult asthma Rates of lifetime and current asthma among Wisconsin adults, by age, 2009-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2009-2011 landline-cellphone combined dataset.

  20. Adult asthma Age-adjusted rates of asthma among Wisconsin adults, by race/ethnicity, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset. Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

  21. Adult asthma Age-adjusted rates of asthma among Wisconsin adults, by income level, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

  22. Adult asthma Age-adjusted rates of asthma among Wisconsin adults, by level of urbanization, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

  23. Adult asthma Rates of lifetime and current asthma among Wisconsin adults, by sexual orientation, 2008-2011 Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.

  24. Asthma hospitalizations

  25. Asthma hospitalizations Asthma hospitalizations, age-adjusted rate per 10,000, Wisconsin, 2001-2010 Source: 2001-2010 hospital inpatient discharge file.

  26. Asthma hospitalizations Asthma hospitalizations by race/ethnicity, age-adjusted rate per 10,000, Wisconsin, 2010 Source: Wisconsin Inpatient Hospitalization Discharge file, 2010.

  27. Asthma hospitalizations Asthma hospitalizations by age and sex, rate per 10,000, Wisconsin, 2010 Source: 2010 Wisconsin inpatient hospitalization discharge file.

  28. Asthma hospitalizations Counties exceeding the statewide age-adjusted rates per 10,000 of asthma hospitalizations and emergency department visits, Wisconsin, 2008-2010 Source: 2008-2010 Wisconsin hospital inpatient discharge file; 2008-2010 Wisconsin emergency department visit file.

  29. Asthma hospitalizations Distribution of asthma hospitalizations by primary payer, Wisconsin, 2010 Governmental payers Non-governmental payers Asthma hospitalizations in 2010: Number: 4,949 Average hospitalization charge: $12,420 Source: 2010 Wisconsin hospital inpatient discharge file.

  30. Asthma hospitalizations Asthma hospitalizations among Medicaid recipients by race/ethnicity, rate per 10,000, Wisconsin, 2007-2009 Source: Wisconsin Division of Health Care Access and Accountability, 2007-2009 Medicaid Data. Note: White, Black, and American Indian are non-Hispanic; Hispanic may include people of any race.

  31. Occupational injury

  32. Occupational injury Estimated work-related nonfatal injury/illness incidence rate and crude fatality rate per 100,000 full-time-equivalent workers (FTEs) age 16 years or older, Wisconsin, 2001-2010 Source: U.S. Bureau of Labor Statistics Survey of Occupational Illnesses and Injuries and U.S. Bureau of Labor Statistics Census of Fatal Occupational Injuries.

  33. Lead poisoning

  34. Lead poisoning Percent of children under age six who were lead tested and had a confirmed elevated blood lead level, by state, 2010 Source: Centers for Disease Control and Prevention (CDC) Lead Program, National Surveillance data. Data exclude children who have been previously tested and found to have elevated blood lead levels.

  35. Lead poisoning Number of Wisconsin children under age six who were lead tested and lead poisoned (10 mcg/dL or higher), Wisconsin, 2001-2010 Source: Wisconsin Department of Health Services, Wisconsin Childhood Lead Poisoning Prevention Program (WCLPPP).

  36. Lead poisoning Annual prevalence of lead poisoning (10 mcg/dL or higher) among tested children under age six, by race/ethnicity, Wisconsin, 2000-2010 Source: Wisconsin Department of Health Services, Wisconsin Childhood Lead Poisoning Prevention Program (WCLPPP).

  37. Lead poisoning Annual mean blood lead level (mcg/dL) for tested children under age six, by race/ethnicity, Wisconsin, 2010 Source: Wisconsin Childhood Lead Poisoning Prevention Program (WCLPPP). Note: Racial groups are non-Hispanic; Hispanics may include any race.

  38. Lead poisoning Percentage of lead poisoning (10 mcg/dL or greater) among tested children under age six, by Medicaid enrollment, Wisconsin, 2010 Source: Wisconsin Department of Health Services, Wisconsin Childhood Lead Poisoning Prevention Program (WCLPPP).

  39. Lead poisoning Percentage of lead poisoning (10 mcg/dL or greater) among tested children under age six, by county, Wisconsin, 2010 Source: Wisconsin Department of Health Services, Wisconsin Childhood Lead Poisoning Prevention Program (WCLPPP).

  40. References References • University of Wisconsin Population Health Institute. County Health Rankings, 2013. http://www.countyhealthrankings.org/our-approach • Center for Urban Population Health. Milwaukee Health Report, 2011. http://www.cuph.org/mhr/2011-milwaukee-health-report.pdf • LaVeist TA, Gaskin DA, Richard P (2009). The Economic Burden of Health Inequalities in the United States. Joint Center for Political and Economic Studies. http://www.jointcenter.org/sites/default/files/upload/research/files/The%20Economic%20Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf • Thomas JC, Sage M, Dillenberg J, Guillory VJ (2002). A Code of Ethics for Public Health. Am Journal of Public Health. 92(7):1057–1059. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447186/ • Wisconsin Department of Health Services (DHS). Healthiest Wisconsin 2020. http://www.dhs.wisconsin.gov/publications/P0/P00187.pdf • Centers for Disease Control and Prevention (CDC). Asthma. http://www.cdc.gov/asthma/faqs.htm • CDC. Adolescent and School Health: Asthma and Schools. http://www.cdc.gov/healthyyouth/asthma/index.htm • American Lung Association. Asthma and Children. http://www.lung.org/lung-disease/asthma/resources/facts-and-figures/asthma-children-fact-sheet.html

  41. References • Wisconsin Department of Health Services (DHS). Burden of Asthma in Wisconsin 2010: http://www.dhs.wisconsin.gov/eh/asthma/pdf/BurdenofAsthma2010Web.pdf • U.S. Department of Health and Human Services, Office of Minority Health. Asthma and African Americans. http://minorityhealth.hhs.gov/templates/content.aspx?ID=6170 • Leigh, JP. Individual and job characteristics as predictors of industrial accidents. Accident Analysis and Prevention, 1986; 18(3). • National Institute for Occupational Safety and Health. Occupational Health Disparities. http://www.cdc.gov/niosh/programs/ohd/ • DHS. The Legacy of Lead: Report on Childhood Lead Poisoning in Wisconsin 2008: http://www.dhs.wisconsin.gov/lead/doc/LegacyofLead2008webpage.pdf • DHS. Lead-Safe Wisconsin: Action level changed from blood lead level of 10 to 5. http://www.dhs.wisconsin.gov/lead/

  42. Burden of Asthma in Wisconsin 2010: http://www.dhs.wisconsin.gov/eh/asthma/pdf/BurdenofAsthma2010Web.pdf Wisconsin Asthma Plan 2009-2014: http://www.dhs.wisconsin.gov/eh/Asthma/pdf/WACPlan20092014.pdf Wisconsin Occupational Health Program Website: http://www.dhs.wisconsin.gov/dph_boh/occ/pages/index.htm The Legacy of Lead: Report on Childhood Lead Poisoning in Wisconsin 2008: http://www.dhs.wisconsin.gov/lead/doc/LegacyofLead2008webpage.pdf Centers for Disease Control and Prevention (CDC). Environmental Health: http://www.cdc.gov/Environmental/ CDC. Environmental Health: Workplace Health and Safety: http://www.cdc.gov/Workplace/ Links Links to additional reports and resources

  43. Contacts Contacts Carrie Tomasallo, PhD, MPH Senior Epidemiologist Bureau of Environmental and Occupational Health Division of Public Health Wisconsin Department of Health Services Email: Carrie.Tomasallo@dhs.wisconsin.gov Marjorie Coons, MS Program Manager Wisconsin Healthy Homes and Childhood Lead Poisoning Prevention Program Bureau of Environmental and Occupational Health Division of Public Health Wisconsin Department of Health Services Email: Marjorie.Coons@dhs.wisconsin.gov

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