2000 COMMUNITY
HEALTH STATUS ASSESSMENT
WALKER COUNTY

TABLE OF CONTENTS

CHAPTER
1 2 3 4
5
6
7

TITLE

PURPOSE

BUILDING A COMMUNITY APPROACH TO IMPROVE HEALTH STATUS

DEMOGRAPHICS County Profile Population Socioeconomics Education

page 8 pages 9-10 page 11 pages 12-14

PERINATAL INDICATORS Glossary of Terms Live Births Low Birth Weight Infant Mortality Teen Pregnancy

page 15 page 16 page 17 page 18 pages 19-20

PREMATURE DEATH Glossary of Terms Years of Potential Life Lost: Males Years of Potential Life Lost: Females Cancer Quality of Life: Older Adults

page 21 pages 22-23 pages 24-25 page 26 pages 27-28

LEADING CAUSES OF DEATH Glossary of Terms Leading Causes of Death Younger Than 1 Year Old Ages 1-9 Years Old Ages 10-19 Years Old Ages 20-44 Years Old Ages 45-64 Years Old Older Than 64 Years Old

page 29 page 30 page 31 page 32 page 33 page 34 page 35 page 36

BEHAVIORAL RISK FACTORS Use of Marketing Data Tobacco Consumption Estimates Recreational Physical Activity Estimate

page 37 pages 38-39 page 40

PAGES
1-2 3-6 7-14 15-20
21-28
29-36
37-40

TABLE OF CONTENTS

CHAPTER
8 9
10
11

TITLE
OTHER HEALTH INDICATORS Transportation Accidents Fire Accidents Poisoning Accidents Notifiable Diseases
OTHER HEALTH ISSUES Glossary of Terms Child Abuse Drug-Related Violent Crime Substance Use During Pregnancy Indigent Medical Care Mental Health Rape
ENVIRONMENTAL ASSESSMENT Fish Consumption Food Service Inspections Hazardous Site Inventory Lead Poisoning Radon Toxic Releases
APPENDIX SELECTED RESOURCES

page 41 page 41 page 41 pages 42-50
page 51 pages 52-53 page 54 pages 55-56 pages 57-59 pages 59-61 pages 61-62
pages 63-65 page 66 page 67 page 68 page 69 page 70

PAGES
41-50 51-62
63-70
71-72

This publication was partially funded through the INPHO II grant from the Centers for Disease Control and Prevention. INPHO II projects (Information for the Public Health Officals II) help promote the development of information systems integration with a focus on improving immunization surveillance systems.
Data and information in the Community Health Status Assessment for Walker County is available and updated on the "NWGHealth.com" web site. There are links to other local, state and national sources for healthy community data and information. Another goal is for the web site to link medical providers with one way to report required immunization and notifiable disease reports. The web site will be hub visibly linking multiple organizations in our counties working together for healthy communities.
Permission is granted for reproduction of this material as long as you credit: the source of the specific data, information, and Walker County Health Dept. and NWGA Health District 1.1. (2000). Walker County Community Health Status Assessment.

1 P U R P O S E

PURPOSE AUDIENCE
DATA WEB SITE

The purpose of this publication is to inform communities about their local community health status.
Community members and groups can use this information as a starting point in discussions about improvement opportunities and to document local community health conditions.
Walker County Health Department developed the data sets. The data presented is the most recent available from the sources.
The data will be posted and periodically updated on the "NWGAHealth" web site <www.NWGAHealth.com>.

2000 WALKER COUNTY COMMUNITY HEALTH STATUS ASSESSMENT 1

CONTACT

To learn where to obtain more detailed information, or to request more detailed health data, contact:
Walker County Health Dept. P. O. Box 609 LaFayette, Georgia 30728
Janice Pardue, BSW Public Health Planner Phone: 706-858-6965 Fax: 706-858-7075
Northwest Georgia Health District 1.1 1305 Redmond Circle, Building 614 Rome, Georgia 30165
Tasia Atha, MPH Office of Health Planning Phone: 706-295-6789 E-mail: tratha@gdph.state.ga.us
Annette Clairy, RN, MSN Office of Health Planning Phone: 706-295-6641 E-mail: alclairy@gdph.state.ga.us

2 2000 WALKER COUNTY COMMUNITY HEALTH STATUS ASSESSMENT

2 BUILDING A COMMUNITY APPROACH TO I M P ROV E H E A LT H S TAT U S

PUBLIC HEALTH IN GEORGIA

Vision

Our vision is a Georgia with healthy people, families, and communities, where all sectors unite by pooling their assets and strengths to promote Health for all. Decisions are made in harmony with economic and environmental concerns.
We bring to all Georgians a commitment to improving Health status through community leadership, expertise in Health information and surveillance, and assurance of a safer environment.
We are responsive to public Health needs, valued for our expertise and innovation, dedicated to excellence, and known for promoting healthy communities through partnerships.
We are leaders, advocates, and resources for Public Health in Georgia.

Mission

Our mission is to promote and protect the Health of people in Georgia wherever they live, work, and play. We unite with individuals, families, and communities to improve their Health and enhance their quality of life.
We do this by:
Developing sound Health policies and plans Monitoring and assessing community Health status and needs Creating partnerships with communities and organizations Providing personal and population-based services and education Enforcing laws and regulations that protect Health and safety Providing population-based data, vital statistics, and registries Gathering information through surveillance and investigation Disseminating wellness and Health information Evaluating our effectiveness, accessibility, and quality of service Assuring a competent, sensitive, and responsive public Health work force Providing a public Health laboratory capacity Carrying out research for innovative solutions to public Health problems

2000 WALKER COUNTY COMMUNITY HEALTH STATUS ASSESSMENT 3

WHAT ARE "ESSENTIAL ELEMENTS OF HEALTHY COMMUNITIES?"
Essential Elements of Healthy Communities
Source: National Association of City and County Health Officials (NACCHO) and the Centers for Disease Control and Prevention (CDC). (1994). Blueprint for a healthy community, Washington, D.C.: Author.

When asked the question "What does it take to create and maintain a healthy community?," the National Association of City and County Health Officials (NACCHO) and the Centers for Disease Control and Prevention (CDC) came up with the essential elements of healthy communities. Many people and organizations are involved in providing these essential elements. Health care providers, local government, schools, public health agencies, industry and individuals contribute to these essential elements in one way or another.
Conducting Community Diagnosis: collecting, managing and analyzing health-related data for the purpose of information-based decision-making
Preventing and Controlling Epidemics: investigating and containing disease and injury
Providing a Safe and Healthy Environment: maintaining clean and safe air, water, food and facilities
Measuring Performance, Effectiveness and Outcomes of Health Service: monitoring health care providers and the health care system
Promoting Healthy Lifestyles: providing health education to individuals and communities
Laboratory Testing: identifying disease agents
Providing Targeted Outreach and Forming Partnerships: assuring access to services for all vulnerable populations and assuring the development of culturally appropriate care
Research and Innovation: discovering and applying improved prevention strategies and health care delivery mechanisms
Mobilizing the Community for Action: providing leadership and initiating collaboration

4 2000 WALKER COUNTY COMMUNITY HEALTH STATUS ASSESSMENT

"ESSENTIAL ELEMENTS" EXAMPLE IN ACTION
Essential Element #1: Community Diagnosis
A Tool for Community Diagnosis: Community Health Status Assessments
How can communities benefit from Health Status Assessments?

Physicians diagnose illnesses based on their assessment of an individual - personal history, environment, signs and symptoms of illness, lab tests, etc. In a similar way, people can diagnose community health based on demographics, environment, health-rated data and information. This is called "community diagnosis." Once people identify priority community health issues, communities can start working together to make improvements.
We all want to live in a healthy community - a community in which people can develop to their full potential. But this is not a perfect world and our communities are no exception. Community health status assessments gather health-related information about the population - male and female, all races and through the lifespan. Then local people and organizations can use the assessments along with community opinion to decide which issues to address.
There will be 10 assessment books - one for Bartow, Catoosa, Chattooga, Dade, Floyd, Gordon, Haralson, Paulding, Polk, and Walker counties. They share common sets of data and information to appraise community health.
Updates and additional information is available on the NWGA Health Watch web site at <www.NWGAHealth.com>.
People interested in a regional view can use the documents together.
People and organizations can use the information in their own community groups, churches and businesses to help plan ways to improve community health, and
The information is suitable for use in grant-writing.

2000 WALKER COUNTY COMMUNITY HEALTH STATUS ASSESSMENT 5

WHAT NOW? WHAT DO WE DO WITH THIS INFORMATION?

Once people decide which community health problems are the most important to them; together, residents and organizations can develop activities to address priority issues. Here is an effective way for communities to improve health conditions using heart disease as an example:
analyze problems for root causes which point to prevention opportunities (e.g. inactivity contributes to heart disease),
set goals for improvement (e.g. x# of adults will participate in recreational activity 3 or more times per week),
scientifically identified risk factors and protective factors must be applied in a way that makes sense for the local population (e.g. promoting physical activity in ways that make sense to your community),
the community must identify and build on community assets (e.g. expand adult recreation programs already available),
multiple communities (counties) can build regional assets to address priority health problems, and
after a period of time, evaluate the strategy (e.g. to see if more adults really are exercising).

This document is a tool for communities to use in "conducting community diagnosis" (assessing the health status of their community). Thank you for your interest in our county.
6 2000 WALKER COUNTY COMMUNITY HEALTH STATUS ASSESSMENT

Walker County , the 99th county
created in the state, was formed from part of Cherokee County in 1833. It was
named after Major Freeman Walker of Augusta, a lawyer and U.S. Senator.
Another notable person from Walker County was John Ross, the Principal Chief of the Cherokees, for forty years.
DEMOG

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A

P

H

I

3C S

WALKER COUNTY MAP
2000 WALKER COUNTY COMMUNITY HEALTH STATUS ASSESSMENT 7

Contact your local Chamber of Commerce for a complete county profile.

COUNTY PROFILE

GEOGRAPHY
Source: Cooperative Extension Service, The University of Georgia. (1999). The 1999 Georgia county guide, Athens, Georgia: Author.
LABOR
Source: Georgia Department of Labor. (1999). Georgia area labor profile: Walker County. www.dol.state.ga.us
HOSPITALS & PHYSICIANS
Source: Cooperative Extension Service, The University of Georgia. (1999). The 1999 Georgia county guide, Athens, Georgia: Author.

Metropolitan county in Northwest Georgia
446.7 square miles
Bordered on the north by Tennessee, on the east by Catoosa and Whitfield Counties, on the south by Chattooga County and on the west by Dade County and Alabama
Georgia's rank in land area is 45th largest county out of 159 counties
Municipalities: LaFayette, Chickamauga, Rossville, Lookout Mountain and a portion of Ft. Oglethorpe
Top 5 largest employers in the county - excludes government and public schools (based on 1990 census) Blue Bird North GA Roper Corporation Rossville/Chromatex Shaw Industries, Inc. Synthetic Industries
Top 3 locales where Walker County residents are employed in 1997 Walker County (44.1%) Tennessee (34.3%) Catoosa County (11.1%)
Top 3 occupations in Walker County during 1990 Machine operators, assemblers and inspectors Precision production, craft and repair Administration support including clerical
Walker County had 0.3 physicians per 1,000 population compared to 1.9 per 1,000 for the state of Georgia during 1998.
Walker County has 0 hospitals and 4 nursing homes.

8 2000 WALKER COUNTY COMMUNITY HEALTH STATUS ASSESSMENT

Check out our web site at <www.NWGAHealth.com>.
It will provide periodic updates and additional information.

WHY DO I SEE DIFFERENT POPULATION ESTIMATES USED BY DIFFERENT ORGANIZATIONS?
This population data is extracted from the U.S. Census Bureau.
NOTE: The U.S. Census Bureau releases data at different intervals, thus data may differ slightly according to release date.
Other data sources calculate population projections with different formulas. Thus, estimates differ.
Always cite the source of the population projection you are using to avoid confusion.
The race and Hispanic origin categories used by the United States (U.S.) Census Bureau are mandated by the Office of Management and Budget Directive No. 15, which requires all federal record keeping and data presentation to use four race categories (White, Black, American Indian and Alaska Native, Asian and Pacific Islander) and two ethnicity categories (Hispanic, non-Hispanic).
Source: U.S. Census Bureau. (1999). Explanation of race and hispanic origin categories, <www.census.gov/population/estimates/rho.txt>.
Data Source: Population Estimates Program, U.S. Census Bureau. (1999). Population estimates for counties, Washington, D.C. Release dates: 9/4/98 (1997 data); 9/15/99 (1998 data).

P O P U L AT I O N

Different age groups require different health services. Children need immunizations for childhood diseases; older Americans need immunizations for pneumonia and influenza.
Some racial and ethnic groups have higher rates of certain health problems than other groups. High blood pressure appears to be more prevalent in Black populations; Native Americans are at increased risk of diabetes.
Males and females may have different health needs - such as prostate screening for males and mammograms for females.
Observe the population of your county and think of the health needs unique to them.

WALKER COUNTY POPULATION ESTIMATES

1997

1998

Estimated Population

61,848 63,088

Percent White

94.5% 94.6%

Percent Black

4.9%

4.7%

Percent American Indian/Eskimo

0.3%

0.3%

Percent Asian/Pacific Islander

0.3%

0.4%

WALKER COUNTY HISPANIC ORIGIN

Percent of Total Population Hispanic Origin (any race)
(Based on 1998 data)

1.0%

2000 WALKER COUNTY COMMUNITY HEALTH STATUS ASSESSMENT 9

Walker County's projected population growth, between 1990 and 1998 was 8.1%. Georgia's
projected population growth in the same time period was 18%. (Georgia Department of Labor, 1999)

P O P U L AT I O N

WALKER COUNTY POPULATION DISTRIBUTION BY AGE AND RACE, 1998

<5 5-9 10-19 20-44 45-64 >65 TOTAL

White Male 1,919 2,004 4,492 10,056 7,073 3,411 28,955

White Female
1,875 1,945 4,049 10,236 7,622 5,005 30,732

White Total 3,794 3,949 8,541 20,292 14,695 8,416 59,687

Black Male
73 109 232 615 323 152 1,504

Black Female
80 103 238 507 330 202 1,460

Black Total 153 212 470 1,122 653 354 2,964

American Indian/Eskimo
Total 10 7 20 57 52 28
174

Asian and Pacific Islander
Total 21 21 55 94 66 6
263

TOTAL POPULATION BY AGE CATEGORY, 1998 WALKER COUNTY

Age Category
younger than 5 5-9 years of age 10-19 years of age 20-44 years of age 45-64 years of age 65 and older Total

Total
3,978 4,189 9,086 21,565 15,466 8,804 63,088

Percent of Total 6.3% 6.6% 14.4% 34.2% 24.5% 14.0% 100%

Georgia's Percent of Total
7.5% 7.5% 14.5% 40.2% 20.4% 9.9% 100%

Source: Georgia Department of Human Resources, Division of Public Health, Health Assessment Services. (2000). 1998 population estimates: Walker County. Atlanta, Georgia: Author.

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The average poverty threshold for a family of four persons was $15,569 in 1995.
The average poverty threshold for a family of four persons is $16,450 in 1998.

INCOME FOR WALKER COUNTY

Walker County Georgia

Average median household income,* 1995

$28,993

$33,623

Percent of population below poverty level, 1995

14.0%

15.6%

* Average median household income means the same number of households have a higher income as have a lower income than the median.

UNEMPLOYMENT RATE FOR WALKER COUNTY
Unemployment rate per 100 in labor force 1998
Walker County Georgia

All Races:

Female Rate

8.5

5.9

Male & Female:

White Rate

4.6

3.0

Black Rate

8.9

8.1

SOCIOECONOMICS
People with different income levels have different health risks and needs. Low economic status has been shown to be a strong risk factor for poor health. In addition, people with lower incomes may not be able to afford all of their prescription medicines, doctor visits, preventive screenings and health care costs in general. People in some income levels may not qualify for Medicaid, but cannot afford to purchase their own health insurance.
Observe the socioeconomic indicators for your county, then describe what they suggest regarding health care needs and services.

PUBLIC ASSISTANCE FOR WALKER COUNTY
Expressed as a percent of total population

Walker County Georgia

Medicaid Recipients Fiscal Year 1998

15.5%

17.1%

Food Stamp Recipients, 1998

5.3%

8.4%

Social Security Beneficiaries for 1997

18.8%

13.9%

Percent change in total number of Social Security Beneficiaries 1996-1997

0%

+1.5%

Source: Cooperative Extension, The University of Georgia. (1999). The 1999 Georgia county guide, Athens, Georgia: Author.

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E D U C AT I O N

Source: Plimpton, S. and Root, J. (1994, Jan./Feb.). Materials and strategies that work with low literacy health communications. Public Health Reports, pages 45-55.

The most poorly educated American adults have the lowest literacy levels and suffer the highest rates of morbidity (sickness) and mortality (death).
What do the education indicators suggest for your county?

EDUCATION IN GENERAL
Source: Cooperative Extension Service, The University of Georgia. (1999). The 1999 Georgia county guide, Athens, Georgia: Author.

EDUCATION IN GENERAL
Expressed as percent of the population of persons 25 and older.

Walker County Georgia

Persons 25 and Older NOT Completing High School
Persons 25 and Older WITH College or Higher Education

41.7% 8.4%

29.1% 19.3%

based on 1990 census

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Walker County's two Public School Systems are Walker County Schools
and Chickamauga City Schools.

E D U C AT I O N

DROP-OUTS
Sources: Georgia Department of Education. (2000). Walker county school system. In the Georgia Public Education Report Card, 19971998 and 1998-1999, Atlanta, Georgia: Author.
Georgia Department of Education. (2000). Chickamauga city school system. In the Georgia Public Education Report Card, 1997-1998 and 1998-1999, Atlanta, Georgia: Author.
Georgia Department of Education. (1999). State summary. In the Georgia Public Education Report Card, 1997-1998 and 1998-1999, Atlanta, Georgia: Author.

DROP-OUT RATES
For Grades 9-12 during 1997-1998

Number of Children

Walker County Chickamauga City All Georgia School System School System Schools

# Children to Drop-Out

296

19

26,534

Percent of Total Enrollment (grades 9-12)

12.4%

4.2%

6.5%

Note: Drop out rate measures the number of 9, 10, 11 and 12 grade students who dropped out of school in 1997-1998 school year.

DROP-OUT RATES
For Grades 9-12 during 1998-1999

Number of Children

Walker County Chickamauga City All Georgia School System School System Schools

# Children to Drop-Out
Percent of Total Enrollment (grades 9-12)

299 12.5%

16

27,352

3.6%

6.5%

Note: Drop out rate measures the number of 9, 10, 11 and 12 grade students who dropped out of school in 1997-1998 school year.

HIGH SCHOOL COMPLETION RATE
Percent of 1994 Grade 9 Enrollment in Graduation Class of 1998
Walker County Chickamauga City All Georgia School System School System Schools

Completion Rate 1994-1998

49.0%

84.6%

68.4%

Note: High School completion rate measures the percentage of students who entered the ninth grade and who graduated 4 years later.

HIGH SCHOOL COMPLETION RATE
Percent of 1995 Grade 9 Enrollment in Graduation Class of 1999
Walker County Chickamauga City All Georgia School System School System Schools

Completion Rate 1995-1999

48.2%

91.9%

68.9%

Note: High School completion rate measures the percentage of students who entered the ninth grade and who graduated 4 years later.

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Walker County is home to Northwestern Technical Institute, an institution of the State board
of technical and adult education.

E D U C AT I O N

ETHNIC DIVERSITY IN SCHOOL ENROLLMENT
School enrollment reports include ethnic identity which helps identify ethnic diversity in our community.
Sources: Georgia Department of Education. (2000). Walker county school system. In the Georgia Public Education Report Card, 1998-1999, Atlanta, Georgia: Author.
Georgia Department of Education. (2000). Chickamauga city school system. In the Georgia Public Education Report Card, 1998-1999, Atlanta, Georgia: Author.
Georgia Department of Education. (2000). State summary. In the Georgia Public Education Report Card, 1998-1999, Atlanta, Georgia: Author.

NUMBER OF STUDENTS
K-12 Enrollment, by Race/Ethnicity for Public Schools in Walker County, 1999
Walker County Chickamauga City School System School System Total

Black

445

0

445

White

7,911

1,256

9,167

Hispanic

36

0

36

Asian

47

2

49

American Indian

6

1

7

Multi-Racial

74

10

84

TOTAL

8,519

1,269

9,788

PERCENT OF TOTAL ENROLLMENT
K-12 Enrollment, by Race/Ethnicity for Public Schools in Walker County, 1999
Walker County Chickamauga City Georgia School System School System Schools

Black

5.2%

0.0%

37.8%

White

92.9%

99.0%

55.7%

Hispanic

0.4%

0.0%

3.3%

Asian

0.6%

0.2%

2.0%

American Indian 0.1%

0.1%

0.1%

Multi-Racial

0.9%

0.8%

1.0%

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FOR ADDITIONAL INFORMATION CONTACT:
TASIA R. ATHA, MPH, District Health Planner Northwest Georgia Health District 1.1 1305 Redmond Circle, Building 614 Rome, Georgia 30165 Phone: 706-295-6789 E-mail: tratha@gdph.state.ga.us
P E R I N ATA L

4I N D I C AT O R S

GLOSSARY OF TERMS
BIRTH DEFECTS: Abnormalities or "congenital anomalies" resulting from faulty development in utero (before birth). Spina bifida is a birth defect of the spine.
INDUCED ABORTION: The purposeful interruption of an intrauterine pregnancy with intention other than to produce a live-born infant, and which does not result in a live birth.
INFANT MORTALITY: Infant deaths from the birth event to less than one year of age.
LIVE BIRTHS: The number of babies born breathing or showing other evidence of life. This is not the same as number of pregnancies because not all pregnancies result in live birth.
LOW BIRTH WEIGHT: Newborn weight of less than 2,500 grams (5 pounds, 8 ounces).

MISCARRIAGE: The medical term for miscarriage is "spontaneous abortion." A miscarriage is the interruption of a pregnancy, due to natural causes, before the fetus is viable.
PERINATAL: The perinatal period extends from the 28th week of gestation (pregnancy) through the end of the 28th day after birth.
PERINATAL PERIOD CONDITIONS: Conditions developing in the perinatal period which extends from the 28th week of gestation of pregnancy through the end of the 28th day after birth. Examples of perinatal period conditions are respiratory distress and birth trauma.
TEEN PREGNANCY: Teen pregnancy indicators measure the number of total pregnancies (including pregnancies ultimately resulting in miscarriage and induced abortions) in females ages 10 to 19.

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Healthy Baby Recipe: DO ADD early and continued prenatal visits plus 3-6 healthy meals.
DO NOT ADD smoking, alcohol and/or illegal drugs.

LIVE BIRTHS

HELP FIGHT BIRTH DEFECTS
Each year about 4,000 pregnancies in the U.S. are affected by birth defects of the spine and brain such as spina bifida and anecephaly.
The Centers for Disease Control and Prevention estimates that up to 3,000 of these birth defects could be prevented every year if women consumed folic acid before pregnancy and early in pregnancy. Folic Acid comes in multi-vitamin form. Folic acid is also found in the following foods:
Green leafy vegetables Legumes such as beans or lentils Cereal Whole grains Asparagus and brussel sprouts Orange juice Tomato juice Pineapple juice
Source: Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Birth Defects and Developmental Disabilities. (1998). Birth defect prevention: An urgent need for folic acid to prevent birth defects.

NUMBER OF LIVE BIRTHS FROM 1994 TO 1998
Total All Races for Walker County Five Year
1994 1995 1996 1997 1998 Total Total 832 792 878 802 824 4,128 Source: Georgia DHR, Division of Public Health, Epidemiology and Prevention Branch, Health Assessment Services Section, (2000). Selected vital statistics, Atlanta, Georgia: Author.
NUMBER OF LIVE BIRTHS, MISCARRIAGES AND INDUCED ABORTIONS
Totals 1994 through 1998 All Races, Mothers Ages 10 to 49
433 Induced Abortions
122 Miscarriages
4,128 Live Births
5 YEAR TOTALS

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For additional information contact Janice Pardue, Public Health Planner, Walker County Health
Department, P. O. Box 609, LaFayette, GA 30728, 706-858-6965.

RATES
Low birth weight is the single most important predictor of infant survival.
Source: Georgia DHR, Division of Public Health, Epidemiology and Prevention Branch, Health Assessment Section. (2000). Selected vital statistics. Atlanta, GA: Author.

LOW BIRTH WEIGHT

NUMBER OF LOW BIRTH WEIGHT BABIES FROM 1994 TO 1998
Total All Races for Walker County

Five Year 1994 1995 1996 1997 1998 Total

Total

80 60 61 68 68

337

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The World Health Organization and the American Academy of Pediatrics recommend breast-
feeding as the best source of infant nutrition. Breastfeeding lowers the risk of disease in infants.

INFANT MORTALIT Y

Nearly two-thirds of infant deaths occur in the first month of life the neonatal period. These deaths are most often related to perinatal conditions such as respiratory distress and to birth defects. Neonatal mortality has decreased greatly over the years. In the year 1900, about 100 out of every 1,000 newborns died in the first month of life. In 1991, in the United States, approximately 9 infants out of every 1,000 newborns died in the first month of life. This decrease in neonatal death is the result of improvements such as technologies and treatments used in newborn intensive care units. There is still need for improvement in other factors associated with infant death such as birth defects, the number of low birth weight babies and the lack of early prenatal care.
Source: Jacobs Institute of Women's Health, (1995). The women's health data book: A profile of women's health in the United States, 2nd edition, Washington, DC: Elevier.

NUMBER OF INFANT DEATHS FROM 1994 TO 1998
Total All Races, Male and Female for Walker County

1994

younger than

28 days

7

28 days to

1 year old

4

Total 0 to 1 year old 11

1995 2 4 6

1996 1997

2

4

2

2

4

6

1998 Total 3 18 1 13 4 31

Source: Georgia DHR, Division of Public Health, Epidemiology and Prevention Branch, Health Assessment Services Section. (2000). Selected vital statistics. Atlanta, Georgia: Author.

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Our web site, www.NWGAHealth.com is on-line.
It provides periodic updates and additional information.

TEEN PREGNANCIES

Pregnancies and Live Births to Teens (ages 10-19) in Walker County

YEAR
1994 1995 1996 1997 1998

NUMBER OF PREGNANCIES
219 222 225 206 196

NUMBER OF BIRTHS TO UNWED TEENS
103
117
112
116
104

TOTAL NUMBER OF LIVE BIRTHS
180 199 191 185 172

Source: Georgia DHR, Division of Public Health, Health Assessment Information Resources. (2000). Selected vital statistics. Atlanta, Georgia: Author.

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For additional information contact Janice Pardue, Public Health Planner, Walker County Health
Department, P. O. Box 609, LaFayette, GA 30728, 706-858-6965, or Tasia R. Atha, MPH, District Health Planner, Northwest Georgia Health District 1.1, 706-295-6789.
TEEN PREGNANCIES
Repeat Pregnancies to Teenage Mothers in Walker County Of 225 pregnancies in 1996, 38 were repeat pregnancies Of 206 pregnancies in 1997, 40 were repeat pregnancies Of 196 pregnancies in 1998, 65 were repeat pregnancies
Source: Georgia DHR, Division of Public Health, Health Assessment Services, Health Information Resources. (2000). Selected vital statistics. Atlanta, Georgia: Author.
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FOR ADDITIONAL INFORMATION CONTACT:
ANNETTE CLAIRY, RN, MSN, Public Health Planner, Office of Health Planning
Northwest Georgia Health District 1.1 1305 Redmond Circle, Building 614 Rome, Georgia 30165 Phone: 706-295-6641 E-mail: alclairy@gdph.state.ga.us
P R E M AT U R E

5D E A T H

GLOSSARY OF TERMS
BIRTH DEFECTS: Abnormalities or "congenital anomalies" resulting from faulty development in utero (before birth). Spina bifida is a birth defect of the spine.
CANCER: A group of diseases characterized by uncontrolled growth and spread of abnormal cells. There are many types or sites of cancer such as lung, prostate, breast, cervical, skin and colon cancers. Leukemia and lymphoma are also cancers.
CEREBROVASCULAR: All cerebrovascular disease caused by blockage of blood flow to the brain or bleeding into the brain (commonly: "stroke or brain attack").
HIV/AIDS: "Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome"
HOMICIDE: Death determined as murder.
MOBILITY LIMITS: Requiring assistance in mobility such as a cane, wheelchair or personal assistance.
MORTALITY: "death."
MVA: Also known as Motor Vehicle Accident and Motor Vehicle Crash. Includes all injuries where a motor vehicle was involved.

OTHER ACCIDENT: Also referred to as "injuries." Includes injury deaths other than motor vehicle accidents, homicide and suicide. Examples include falls and drowning.
PERINATAL PERIOD CONDITIONS: Conditions developing in the perinatal period which extends from the 28th week of gestation or pregnancy through the end of the 28th day after birth. Examples of perinatal period conditions are respiratory distress and birth trauma.
PREMATURE DEATH: Death before the age of 65.
SELF-CARE LIMITS: Requiring assistance in self-care activities such as bathing, dressing and meals.
SIDS: "Sudden Infant Death Syndrome." SIDS is a medical term that describes the sudden and unexplained death of an apparently healthy infant (less than one year of age).
SUICIDE: Death determined as a person ending his or her own life.
TOTAL CANCER: Includes deaths from all cancers.
TOTAL HEART: Includes deaths from all forms of heart disease.

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High blood cholesterol increases your chances of getting heart disease. All adults over
age 20 should have his/her blood cholesterol checked at least once every 5 years.

YPLL-MALES

WHAT IS "YEARS OF POTENTIAL LIFE LOST (YPLL)?"
Identifying premature mortality (death) is one way to understand opportunities for disease and injury prevention in a community. Death before the age of 65 is considered "premature." The measure of premature mortality is called "Years of Potential Life Lost (YPLL)."
YPLL is calculated by determining the number of years "lost" by persons who die before they are 65 years old. We applied the calculation to the total mortality data for your county for the past 10 years.
Source: National Association for City and County Health Officials (NACCHO), and the Center for Disease Control and Prevention (CDC). (1991, March). Assessment protocol for excellence in public health (APEXPH), (pg. 86), Washington, D.C.: Author.
WHY USE 10 YEARS OF DATA INSTEAD OF ONE YEAR?
We used 10 years of data to minimize drastic fluctuations in the disease rates.

WHAT DOES "YEARS OF POTENTIAL LIFE LOST" SHOW FOR WALKER COUNTY MALES?
The YPLL calculation shows the top five causes of premature death for males in Walker County:
Total Heart Disease Total Cancer (with 37% due to lung cancer) Motor Vehicle Accident Other Accidents Perinatal Conditions
NOTE: For Walker County, we combined data for black males and white males in the YPLL calculations because of the County's population size.
Source of Mortality Data: Georgia DHR, Division of Public Health, Epidemiology and Prevention Branch, Health Assessment Services Section. (1998). Planning information report: District 1.1 Rome, 1996. Atlanta, GA: Author.
YPLL Calculation: Clairy, A.(1999). NWGA Health District 1.1, Office of Health Planning. 706-295-6641.

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Ways to improve your blood cholesterol: lose weight (if you are overweight), increase
physical activity and cut down on saturated fats like whole milk, fatty meats and lard.

YPLL-MALES

Causes of Mortality

YEARS OF POTENTIAL LIFE LOST (YPLL) FOR MALES IN WALKER COUNTY DURING 1987-1996

Years of Potential Life Lost

0

500

1,000

1,500

2,000

2,500

Birth Defects - 761 HIV/AIDS - 515

Homicide - 450

Liver Cirrhosis - 410

MVA - 2,505

Other Accidents - 1,944

Perinatal Conditions - 1,355

Total Cancer - 3,531

Total Heart - 4,714

Suicide - 705

3,000 4,000

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Did you know that smoking increases your heart attack risk by 50-70%?
If you don't smoke, DON'T START!

YPLL-FEMALES

AMERICAN CANCER SOCIETY GUIDELINES FOR BREAST CANCER DETECTION
Perform self-breast exams monthly if you are 20 or older.
Get a clinical breast exam every 3 years if you are 20 to 40 and every year if you are 40 or older.
Have a mammography screening every 2 years if you are 40 to 49 and every year if you are 50 or older.
For answers to your questions about breast cancer, call your local public health department or private health care provider. You may call the American Cancer Society at 1-800-ACS-2345
Source: American Cancer Society, Inc. (1993). The older you get, the more you need a mammogram, (brochure), (ACS Publication No. 93-mm-No.5020).

WHAT DOES "YEARS OF POTENTIAL LIFE LOST" SHOW FOR WALKER COUNTY FEMALES?
The YPLL calculation shows the top five causes of premature death for females in Walker County:
Total Heart Total Cancer (with 23% due to lung and 23% due to
breast cancer) Motor Vehicle Accidents Perinatal Conditions Birth Defects
NOTE: For Walker County, we combined data for black males and white females in the YPLL calculations because of the County's population size.
Source of Mortality Data: Georgia DHR, Division of Public Health, Epidemiology and Prevention Branch, Health Assessment Services Section. (1998). Planning information report: District 1.1 Rome, 1996. Atlanta, GA: Author.
YPLL Calculation: Clairy, A.(1999). NWGA Health District 1.1, Office of Health Planning. 706-295-6641.

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If you use tobacco, STOP! Benefits begin immediately, and after five years, your heart attack
risk drops by 50-70%. (GA Division of Public Health www.ph.dhr.state.ga.us/healthy living/healthy living 19.htm)

YPLL-FEMALES

Causes of Mortality

YEARS OF POTENTIAL LIFE LOST (YPLL) FOR FEMALES IN WALKER COUNTY DURING 1987-1996

Years of Potential Life Lost

0

500

1,000

1,500

2,000

2,500

3,000

Birth Defects - 767

Cerebrovascular - 419

Chronic Obstructive Pulmonary Disease - 415 Homicide - 180 MVA - 867 Other Accidents - 509 Perinatal Conditions - 903 Total Cancer - 2,602 Total Heart - 2,034 SIDS - 387

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The American Cancer Society states, "All cancers caused by cigarette smoking and heavy
use of alcohol could be prevented completely."

CANCER

TOBACCO USE IN THE UNITED STATES
"An estimated 47 million adults in the US smoke cigarettes, even though this behavior will result in death or disability for one out of every two regular users. Tobacco use results in...one in every five deaths. Paralleling this enormous health burden is the economic burden of tobacco use: more than $50 billion in medical expenditures and another $50 billion in indirect costs.
...It is now well documented that smoking can cause chronic lung disease, coronary heart disease, and stroke, as well as cancer of the lung, larynx, esophagus, mouth and bladder. In addition, smoking is known to contribute to cancer of the cervix, pancreas and kidney.
The effects of smoking don't end with the smoker...Each year, exposure to environmental tobacco smoke causes an estimated 3,000 nonsmoking Americans to die of lung cancer... Evidence also indicates that environmental tobacco smoke increases the risk of coronary heart disease."
Source: Centers for Disease Control and Prevention. (1998). Targeting tobacco use: The nation's leading cause of death at-a-glance 1998, (pages 1-3), http:/www.cdc.gov/nccdphp/osh/oshaag.htm

WHAT CAUSES CANCER?
Cancer can be the result of a complex interaction of both internal (inside your body) or external (outside your body) factors. Examples of internal factors are hormones, immune conditions and inherited mutations. Examples of external factors are chemicals, radiation and viruses. Ten or more years often pass between exposures or mutations and detectable cancer.
CAN CANCER BE PREVENTED?
Research has shown that certain cancers are related to tobacco use, excessive alcohol use, dietary factors and excessive exposure to sunrays. Altering life styles can help prevent cancer. The American Cancer Society, 1998, states "all cancers caused by cigarette smoking and heavy use of alcohol could be prevented completely (page 1)."
Regular screening examinations by a health professional can detect cancers of the breast, colon, rectum, cervix, prostate, testis, tongue, mouth and skin at an early stage when treatment is more likely to be successful. People can also learn how to help detect cancers early through self-examination for cancers of the breast and skin. The American Cancer Society estimates that if all Americans had regular cancer screenings, the 5 year survival rate for the above cancers could be more than 95%.
Source: American Cancer Society. (1998). Cancer facts & figures-1998, (ACS Publication No. 98-300M-No. 5008.98). For more information call 1-800-ACS-2345.

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The best way to prevent flu is to get immunized in the fall of the year.
But it's not too late to immunize later. Flu season extends through May.

SELECTED DEMOGRAPHIC AND "QUALITY OF LIFE" INDICATORS
The "Years of Potential Life Lost" calculations do not consider death at or above the age of 65 as "premature."
Demographic and "Quality of Life" indicators help focus on the special needs of the 65 and older population.

QUA L I T Y O F L I F E - O L D E R A D U LTS

POPULATION ESTIMATES, AGE 65 AND OLDER, ALL SEXES AND ALL RACES WALKER COUNTY, 1998

AGE

AGE GROUP

TOTAL

65 to 69 70 to 74 75 to 79 80 to 84 85 and older 65 and older

2,597 2,296 1,870 1,134
907 8,804

PERCENT OF TOTAL
POPULATION
4.1% 3.6% 3.0% 1.8% 1.4% 14.0%

Source: Georgia Department of Human Resources, Division of Public Health, Health Assessment Services. (2000). 1998 population estimates: Walker County. Atlanta, Georgia: Author.

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In 1997 life expectancy at birth reached an all-time high of 76.5 years.
National Center for Health Statistics, 1999.

QUA L I T Y O F L I F E - O L D E R A D U LTS

PHYSICAL ACTIVITY AND OLDER ADULTS
Older adults can benefit from regular physical activity-both endurance (aerobic) activity and muscle-strengthening activity.
Physical activity need not be strenuous to achieve health benefits.
Stronger muscles help reduce the risk of falling and improve the ability to perform the routine tasks of daily life.
Older adults should consult with a physician before beginning a new physical activity program.
Source: Centers for Disease Control and Prevention. (1998). Physical activity and health, older adults, http://www.cdc.gov/ nccdphp/sgr/olderad.htm

PERSONS 65 AND OLDER WHO ARE BELOW POVERTY LEVEL FOR 1989
Walker County Georgia

65 Years of Age and Older

18.3%

20.4%

Source: The Cooperative Extension Service, The University of Georgia. (1999). The Georgia county guide, Athens, GA: Author. Based on 1990 census.

AN ESTIMATION OF PERSONS WITH ALZHEIMER'S DISEASE OR
RELATED DISORDERS IN 1994

Walker County

65 Years of Age and Older

1,012

Source: Alzheimer's Association NW GA Chapter. (1999, December). Alzheimer Small Population (unpublished raw data). Dalton, Ga: 1-800669-5252.

PERSONS 65 AND OLDER WHO HAVE LIMITATIONS WITH MOBILITY AND SELF-CARE
Walker County

65 Years of Age and Older

2,659 people or 22.9%

Source: The Cooperative Extension Service, The University of Georgia. (1999). The Georgia county guide, Athens, GA: Author.

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FOR ADDITIONAL INFORMATION CONTACT:
ANNETTE CLAIRY, RN, MSN, Public Health Planner
Northwest Georgia Health District 1.1 1305 Redmond Circle, Building 614 Rome, Georgia 30165 Phone: 706-295-6641 E-mail: alclairy@gdph.state.ga.us
LEADING CAUSES

OF

6DEATH

GLOSSARY OF TERMS
BIRTH DEFECTS: Abnormalities or "congenital anomalies" resulting from faulty development in utero (before birth). Spina bifida is a birth defect of the spine.
CA: Cancer
CEREBROVASCULAR: All cerebrovascular disease caused by blockage of blood flow to the brain or bleeding into the brain (commonly: "stroke or brain attack").
COPD - Chronic Obstructive Pulmonary Disease: A disease process causing a decreased ability of the lungs to perform ventilation. eg. emphysema
HEART ATTACK: The medical term is Acute Myocardial Infarction or Acute MI.
HIV/AIDS: "Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome"
HOMICIDE: Death determined as murder.
MORTALITY: "death"
MVA: Also known as "Motor Vehicle Crash". Includes all injuries where a motor vehicle was involved.

OTHER ACCIDENT: Also referred to as "injuries". Includes injury deaths other than motor vehicle accidents, homicide and suicide. Examples include falls and drowning.
OTHER ISCHEMIC HEART DISEASE: Coronary heart disease such as angina (but not including heart attack).
OTHER HEART DISEASE: Such as infections of the heart (not including heart attack or ischemic heart disease).
PERINATAL PERIOD CONDITIONS: Conditions developing in the perinatal period which extends from the 2th week of gestation or pregnancy through the end of the 28th day after birth. Examples of perinatal period conditions are respiratory distress and birth trauma.
SIDS: "Sudden Infant Death Syndrome". SIDS is a medical term that describes the sudden and unexplained death of an apparently healthy infant (less than one year of age).
SUICIDE: Death determined as a person ending their own life.

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Check out our web site www.NWGAHealth.com providing periodic
updates and additional information.

LEADING CAUSES OF DEATH

HOW ARE LEADING CAUSES OF MORTALITY (DEATH) DETERMINED?"
Death certificates include the cause of death and the county of residence while living. Vital Records compile this data and determine how many deaths were caused by each disease/ condition. The causes are ranked and listed as top causes of mortality for each age group, for blacks and whites, for males and females, for each county and the state. The causes are ranked according to a rate per 100,000 population.
Source: Georgia DHR, Division of Public Health, Epidemiology and Prevention Branch, Health Assessment Services Section. (1998). Planning information report: District 1.1: Rome,1996, Atlanta, Georgia: Author.
WHY USE 10 YEARS OF DATA INSTEAD OF ONE YEAR?
We used 10 years of data and total population to minimize drastic fluctuations in disease rates. The mortality rates used in the following chapter represent an "average" for ten years (1987 to 1996).

ABOUT THIS CHAPTER
The following chapter contains: a bar graph comparing the rates of the top causes of death in Walker County to the rates of those causes in Georgia,
a list of the actual number of deaths in Walker County for those top causes of death,
"Something to Think About"- an illustration of one way to think about the information presented.
DEATH RATES
All mortality data in this section is the average for 1987-1996. Looking at mortality (death) rates helps us see how what is happening in our county compared to what is happening in the rest of Georgia. Remember that death rates are based on deaths per 100,000 population and do not directly represent the number of deaths.
NUMBER OF DEATHS
All mortality data in this section is the average for 1987-1996. Looking at the number of people who have died of a particular cause in Walker County, gives a clearer picture of the impact of that cause of death in our county.

30

2000 WALKER COUNTY COMMUNITY HEALTH STATUS ASSESSMENT

For more information about SIDS call the Back to Sleep Hotline at 1-800-505-2742

YOUNGER THAN 1 YEAR OLD

BACK TO SLEEP
One of the most important things you can do to help reduce the risk of Sudden Infant Death Syndrome (SIDS) is put your healthy baby on their back to sleep...This is new. Now, doctors and nurses believe that fewer babies will die of SIDS if most infants sleep on their back.
Check with your doctor or nurse. Babies with certain health conditions might require them to sleep on their tummy.
TO HELP REDUCE THE RISK OF SIDS:
Be sure your baby sleeps on a firm mattress or other surface; do not use fluffy blankets under the baby. Do not place pillows or stuffed animals in the crib with a young baby.
Keep the temperature in your baby's room so that it feels comfortable to youdo not keep it too warm.
Create a smoke-free zone for your baby.
Take your baby for regular well-baby checks. Call your doctor right away if your baby seems sick.
Get early and regular prenatal care.
If possible, consider breastfeeding your baby. Breast milk helps keep your baby healthy.
Source: U.S. Public Health Service, American Academy of Pediatrics, SIDS Alliance, and Association of SIDS and Infant Mortality Programs. Reduce the risk of sudden infant death syndrome, (brochure), Washington, D.C.: P.O. Box 29111, 20040

LEADING CAUSES OF DEATH FOR AGES YOUNGER THAN 1 RATES FOR ALL RACES IN WALKER COUNTY & GEORGIA

Average rate per 100,000 population during 1987 to 1996

Causes of Death

0123456789

Perinatal Period Conditions Walker County (4.5) Georgia (6.1)

Birth Defects Walker County (2.5) Georgia (2.1)

SIDS Walker (1.5) Georgia (1.5)

NUMBER OF DEATHS
Of the children younger than 1 in Walker County, during 1987-1996:
35 died from perinatal period conditions 20 died from birth defects 12 died from Sudden Death Syndrome (SIDS)
SOMETHING TO THINK ABOUT
Death Rates: Are children in Walker County dying at a lower rate from Sudden Infant Death Syndrome than children in the rest of the state? Is our rate higher? Is our rate about the same? Number of Deaths: In ten years, 12 children younger than 1 year old, in Walker County died from Sudden Infant Death Syndrome. Could some of these deaths have been prevented?
Source: Georgia DHR, Division of Public Health, Epidemiology and Prevention Branch, Health Assessment Services Section. (1998). Planning information report: District 1.1: Rome,1996, Atlanta, Georgia: Author.

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More childhood injuries are associated with bicycles than any other consumer product. Using a
bike helmet can reduce injuries up to 85%. Georgia law requires cyclists under 16 to wear a helmet.

AGES 1-9 YEARS OLD

ACCIDENT PREVENTION
"Other Accidents" (accidents other than motor vehicle accident) are a significant cause of death of children ages 1-9 in Walker County. Other accidents include drowning, fires, poisoning, choking, falls and other accidents. Prevention is the cure for these health risks.
SOME ACCIDENT PREVENTION TIPS
NATIONAL SAFE KIDS CAMPAIGN
Lock away poisonous items like kitchen and bathroom cleaning solutions.
Store sharp kitchen utensils in drawers with child safety locks.
Install guards on stove knobs.
Keep medicines in a locked cabinet.
Supervise children in the bathtub.
Keep poisonous plants out of reach.
Install and maintain working smoke detectors.
Always wear personal flotation devices when boating.
Store tools out of children's reach.
Teach children how to swim and supervise them while near swimming waters.
Make sure children wear helmets for biking and safety gear for sports.
Source: The National SAFE KIDS Campaign. Safe kids gear up guide, (brochure), (W1301), Pennsylvania Ave., NW, Suite 1000, Washington, DC 20004-1707.

LEADING CAUSES OF DEATH FOR AGES 1-9 YEARS OLD RATES FOR ALL RACES IN WALKER COUNTY & GEORGIA

Average rate per 100,000 population during 1987 to 1996

Causes of Death

0 1 2 3 4 5 6 7 8 9 10

All Other Accidents Walker County (9.5) Georgia (8.8)

Motor Vehicle Accidents Walker County (5.4) Georgia (8.6)

NUMBER OF DEATHS
Of the children ages 1 through 9 in Walker County, during 1987-1996:
7 died from all other accidents 4 died in motor vehicle accidents
SOMETHING TO THINK ABOUT
Death Rates: Are children in Walker County dying at a lower rate from other accidents than children in the rest of the state? Is our rate higher? Is our rate about the same? Number of Deaths: In ten years, 7 children (ages 1 to 9) in Walker County died from other accidents. How many of these deaths could have been prevented?
Source: Georgia DHR, Division of Public Health, Epidemiology and Prevention Branch, Health Assessment Services Section. (1998). Planning information report: District 1.1: Rome,1996, Atlanta, Georgia: Author.

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Speeding is one of the leading causes of injury and death for young drivers...
SLOW DOWN AND BUCKLE UP!

AGES 10-19 YEARS OLD

TEENAGE DRIVER RESPONSIBILITY ACT
EFFECTIVE JANUARY 1, 1998
Zero tolerance for alcohol use by drivers under the age of 21.
Mandatory jail time for all DUI (Driving Under the Influence) violations.
"Intermediate" license for eligible 16 year old drivers. The limitations are:
Cannot drive publicly in Georgia between 1 a.m. and 5 a.m. unless traveling from a regular workplace or an activity sponsored by their school or religious organization or in a valid emergency.
Shall not drive publicly in Georgia with more than 3 passengers in the vehicle who are not members of the driver's immediate family and who are under 21 years old.
Driver's licenses for persons under 18 years old will be suspended for school attendance problems.
In order to receive an instruction permit or a driver's license, persons less than 18 years old must be enrolled in and attend school. An alternative is that they must have graduated high school; achieved a GED or special diploma; or have proof of parental permission to withdraw from school.
Source: Georgia Department of Public Safety. (1998). Synopsis of teen-age and adult driver responsibility act house bill 681 of the 1997 session of the Georgia general assembly. www.ganet.org/newservices/teendrv.html

LEADING CAUSES OF DEATH FOR AGES 10-19 YEARS OLD RATES FOR ALL RACES IN WALKER COUNTY & GEORGIA

Average rate per 100,000 population during 1987 to 1996

Causes of Death

0

5

10 15 20 25 30

Motor Vehicle Accidents Walker County (24.0) Georgia (23.7)

Other Accidents Walker County (11.4) Georgia (8.0)

NUMBER OF DEATHS
Of the children ages 10-19 in Walker County, during 1987-1996:
21 died in motor vehicle accidents 10 died in other accidents
SOMETHING TO THINK ABOUT
Death Rates: Are children in Walker County dying at a lower rate from motor vehicle accidents than children in the rest of the state? Is our rate higher? Is our rate about the same? Number of Deaths: In ten years, 21 children between the ages of 10 and 19 in Walker County died from motor vehicle accidents. Could some of these deaths have been prevented?
Source: Georgia DHR, Division of Public Health, Epidemiology and Prevention Branch, Health Assessment Services Section. (1998). Planning information report: District 1.1: Rome,1996, Atlanta, Georgia: Author.

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A woman with HIV infection who is pregnant can receive treatment to greatly reduce
the risk of transmitting HIV to her baby.

AGES 20-44 YEARS OLD

HIV AND AIDS FACTS
AIDS is caused by a virus called HIV.
People infected with HIV may look and feel healthy for a long time.
When signs of illness do appear, they vary from person to person.
Most people with HIV or AIDS got the virus by having sex or sharing needles with someone who was already infected.
You cannot "catch" HIV like you do a cold or flu.
People with HIV live in every one of the 50 states.
It is impossible for a (blood) donor to get HIV from giving blood or plasma in the U.S.
The chances of getting HIV from a blood transfusion in the U.S. are now very low.
There are blood tests for HIV.
So far, there is no vaccine for HIV or a cure for AIDS.
Latex condoms can help prevent HIV infection.
Source: American Red Cross, (1992). HIV and AIDS, (brochure), CDC Cooperative Agreement No. U62/CCU 30303-03, ISBN: 0-86536-088-X.
NUMBER OF DEATHS
Of the adults ages 20-44 in Walker County, during 1987-1996:
62 died in motor vehicle accidents 41 died from from all other accidents 24 died from heart attack 23 died from suicide 18 died from homicides 18 died from HIV/AIDS

LEADING CAUSES OF DEATH FOR AGES 20-44 YEARS OLD RATES FOR ALL RACES IN WALKER COUNTY & GEORGIA

Average rate per 100,000 population during 1987 to 1996

Causes of Death

0

5

10 15 20 25 30

Motor Vehicle Accidents Walker County (28.8) Georgia (27.2)

All Other Accidents Walker County (19.0) Georgia (13.8)

Heart Attack Walker County (11.1) Georgia (6.3)

Suicide Walker County (10.7) Georgia (15.6)

Homicide Walker County (8.4) Georgia (19.7)

HIV/AIDS Walker County (8.4) Georgia (28.5)

SOMETHING TO THINK ABOUT
Death Rates: Are adults in Walker County dying at a lower rate from HIV/AIDS and Homicides than people in the rest of the state? Is our rate higher? Is our rate about the same? Number of Deaths: In ten years, 18 adults (ages 20 to 44) in Walker County died from HIV/AIDS (the number is probably higher due to under-reporting). How could some of these deaths have been prevented?
Source: Georgia DHR, Division of Public Health, Epidemiology and Prevention Branch, Health Assessment Services Section. (1998). Planning information report: District 1.1: Rome,1996, Atlanta, Georgia: Author.

34

2000 WALKER COUNTY COMMUNITY HEALTH STATUS ASSESSMENT

New research suggests that a diet rich in folic acid helps prevent heart disease. Folic acid is
found in multi-vitamins, enriched cereals, green leafy vegetables and other foods.

AGES 45-64 YEARS OLD

WHAT CAN I DO TO ADD MORE MILEAGE TO MY HEART?
Stop smoking. Lower your total blood cholesterol. Maintain a lower blood pressure. Become more physically active. Get your weight into a healthful range. Eat a diet lower in total fat, saturated fat, cholesterol and sodium.
Source: American Heart Association. (1993). How to renew your heart owner's maintenance agreement. In Heart at Work, (Health Education Series).
1995-1997 Cardiovascular Death Rate Ranking
Top 25 highest Counties Counties significantly above state death rate Counties with rates not significantly higher than state
Source: Rowe AK and Hall V. The 1999 Georgia State of the Heart Stroke Report. Georgia Department of Human Resources, Division of Public Health, and the American Heart Association, SE Affiliate, February 1999. Publication number DPH99.3HW

LEADING CAUSES OF DEATH FOR AGES 45-64 YEARS OLD RATES FOR ALL RACES IN WALKER COUNTY & GEORGIA

Average rate per 100,000 population during 1987 to 1996

Causes of Death

0 25 50 75 100 125 150

Heart Attack Walker County (140.4) Georgia (103.1)

Lung Cancer Walker County (131.0) Georgia (99.8)

Other Forms of Heart Walker County (65.5) Georgia (81.4)

Other Ischemic Heart Disease Walker County (64.7) Georgia (52.6)

COPD Walker County (56.2) Georgia (30.3)

NUMBER OF DEATHS
Of the adults ages 45-64 in Walker County, during 1987-1996:
180 died from heart attacks 168 died from lung cancer 84 died from other forms of heart disease 83 died from ischemic heart disease 72 died from chronic obstructive pulmonary disease (COPD)
SOMETHING TO THINK ABOUT
Death Rates: Are adults in Walker County dying at a lower rate from heart attacks than adults in the rest of the state? Is our rate higher? Is our rate about the same? Number of Deaths: In ten years, 180 adults (ages 45 to 64) in Walker County died from heart attacks. How many of these deaths could have been prevented?
Source: Georgia DHR, Division of Public Health, Epidemiology and Prevention Branch, Health Assessment Services Section. (1998). Planning information report: District 1.1: Rome,1996, Atlanta, Georgia: Author.
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If you experience warning signs of stroke seek medical help immediately. Getting
immediate help can make the difference between life and death or disability.

OLDER THAN 64 YEARS OLD

ABOUT HIGH BLOOD PRESSURE
High blood pressure is a leading risk factor for stroke. If your blood pressure is normal, you should have it checked at least every two years. If your blood pressure is 130/85 or over, you should see your health care provider and consider his/her recommendations concerning lifestyle modifications and/or treatment for high blood pressure.
HOW TO KEEP YOUR BLOOD PRESSURE UNDER CONTROL:
Stay active.
Eat less fat.
Do not use tobacco.

LEADING CAUSES OF DEATH FOR AGES OLDER THAN 64 RATES FOR ALL RACES IN WALKER COUNTY & GEORGIA

Average rate per 100,000 population during 1987 to 1996

Causes of Death

0 100 200 300 400 500 600 700 800

Other Form of Heart Disease Walker County (734) Georgia (697)

Heart Attack Walker County (702) Georgia (627)

Stroke Walker County (469) Georgia (482)

Other Ischemic Heart Disease Walker County (435) Georgia (514)

Lung Cancer Walker County (382) Georgia (322)

Control diabetes (if present).
Have periodic blood pressure and cholesterol screening (to see how you are doing)
SIGNS OF STROKE:
Sudden weakness or numbness on one side of the body or face.
Loss of speech or difficulty understanding speech.
Sudden severe headache without a known cause.
Sudden dimness or loss of vision, especially in one eye.
Source: American Heart Association and Georgia Department of Human Resources, Division of Public Health. (1998). 1998 Georgia stroke report. (Pub. No. DPH98.23HW).

NUMBER OF DEATHS
Of the adults over the age of 64 in Walker County, during 1987-1996:
577 died from other forms of heart disease 552 died of heart attack 369 died of stroke 342 died of other ischemic heart disease 300 died of lung cancer
SOMETHING TO THINK ABOUT
Death Rates: Are older adults in Walker County dying at a lower rate from strokes than older adults in the rest of the state? Is our rate higher? Is our rate about the same? Number of Deaths: In ten years, 369 older adults in Walker County died from strokes. How many of these deaths could have been prevented? How much disability could be prevented?
Source: Georgia DHR, Division of Public Health, Epidemiology and Prevention Branch, Health Assessment Services Section. (1998). Planning information report: District 1.1: Rome,1996, Atlanta, Georgia: Author.

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People's behavior whether they use tobacco
products, whether they exercise and what they eat can indicate risk factors for certain illnesses. The use of tobacco products is associated with heart disease and certain cancers. Lack of physical activity is a risk
factor for heart disease.
B E H AV I O R A L

RISK

7F A C T O R S

HOW CAN YOU ESTIMATE BEHAVIOR RISK FACTOR?
WHAT IS MARKETING DATA?
WHY IS MARKETING DATA USEFUL TO THE COMMUNITY?
Source: Georgia Department of Human Resources, Division of Public Health. (1996). Marketing data directory and Cluster health profiles, Claritas Company Marketing Data.

You can make an estimate from marketing data.
Marketing data is an inventory of statistics used to describe consumer habits of the American public.
A key marketing concept is "lifestyle" - the idea that groups distinguish themselves on the basis of demographic variables and "way of life." The "way of life" may include dietary habits, tobacco and alcohol consumption, recreation patterns and other indicators. This type of information gives clues to the group behaviors and health "risk factors." Thus, we can get an idea of smoking and exercise habits of Walker County adults by analyzing marketing data.

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Researchers have identified more than 40 chemicals in tobacco smoke that cause
cancer in humans and animals.

TOBACCO CONSUMPTION ESTIMATES

TOBACCO USE IN THE UNITED STATES
"Today, nearly 3,000 young people across our country will begin smoking regularly. Of these 3,000 young people, 1,000 will lose that gamble to the diseases caused by smoking. The net effect of this is that among children living in America today, 5 million will die an early preventable death because of a decision made as a child."
Source: Donna E. Shalala, PhD, Secretary, U.S. Department of Health and Human Services. Testimony before the Senate Labor and Human Resources Committee, September 25, 1997
The CDC states that "89% of persons who ever smoke daily first tried a cigarette at or before age 18".
Source: CDC, (June 1997). CDC prevention guidelines for preventing tobacco use and addiction. Atlanta, Georgia: Author.

HOW CAN YOU ESTIMATE HOW MUCH PEOPLE IN COUNTY USE TOBACCO PRODUCTS?
You can make an estimate from marketing data.
WHAT DOES THE MARKETING DATA SHOW ABOUT WALKER COUNTY RESIDENTS AND TOBACCO CONSUMPTION?
An analysis of the marketing data for Walker County reveals that, in general, the adult population of Walker County is:
15% more likely as the average American to purchase cigarettes.
These smokers are: 48% more likely than the average American smoker to use non-filter cigarettes.
46% more likely than the average American smoker to smoke 40+ cigarettes per day.
In addition, the adult population of Walker County is: 24% more likely than the average American to purchase pipe tobacco.
33% more likely than the average American to purchase cigars.
90% more likely than the average Amercian to purchase chewing tobacco.
Source: Georgia Department of Human Resource, Division of Public Health, (1996). Marketing data directory and cluster health profiles, Claritas Company Marketing Data, Atlanta, Georgia, Author.

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Contact your nearest American Heart Association or call 1-800-AHA-USA1.
Visit online at http://www.amhrt.org.

TOBACCO SALES LAW FOR MINORS IN THE UNITED STATES
It is federal law that merchants must check the picture I.D. of customers under the age of 27 before selling them cigarettes. It is illegal to sell cigarettes to minors (under the age of 18). You can report stores that are selling cigarettes to minors by phoning the FDA Children and Tobacco Hotline at 1-800-FDA-4KIDS.

TOBACCO CONSUMPTION ESTIMATES

TOBACCO USE: THE BAD NEWS

Smoking causes: Chronic lung disease Stroke Cancer of the larynx Cancer of the mouth

Coronary heart disease Cancer of the lung Cancer of the esophagus Cancer of the bladder

Smoking is known to contribute to: Low birthweight babies to women who smoke while pregnant, which is a leading cause of death among infants. Cancer of the cervix Cancer of the pancreas Cancer of the kidney

Smokeless tobacco and cigars contribute to:

Cancer of the lung

Cancer of the larynx

Cancer of the esophagus

Oral Cancer

Environmental tobacco smoke (ETS) contributes to: Lung cancer in non-smokers Lower respiratory tract infections in children Increased risk of coronary heart disease in non-smokers

TOBACCO USE: THE GOOD NEWS

According to the American Cancer Society, people who quit smoking:
Live longer than people who continue to smoke Substantially decreases the risk of associated cancers Reduce risk for other major diseases such as coronary heart
disease and cardiovascular disease.

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Contact your nearest American Heart Association or call 1-800-AHA-USA1.
Visit online at http://www.amhrt.org.

RECREATIONAL PHYSICAL ACTIVITY ESTIMATE

REDUCE THE RISK WITH PHYSICAL ACTIVITY
Physical activity helps reduce the risk of heart disease, stroke and other diseases and conditions.
The American Heart Association recommends 30 minutes of moderate to vigorous physical activity at least 3-4 times per week.
Some people get adequate moderate to vigorous physical activity through their work/occupation.
Other people accomplish physical activity through recreation.
For more information contact your nearest American Heart Association or call 1-800-AHA-USA1

HOW CAN YOU ESTIMATE HOW MUCH PEOPLE IN WALKER COUNTY EXERCISE?
You can make an estimate from marketing data. Remember, the available marketing data show recreational physical activity and does not take into account work-related physical activity.
WHAT DOES THE MARKETING DATA SHOW ABOUT WALKER COUNTY RESIDENTS AND RECREATIONAL PHYSICAL ACTIVITY?
An analysis of the marketing data for Walker County reveals that, in general, the adult population of Walker County is:
22% less likely to hike
27% less likely to jog
11% less likely to walk
10% less likely to swim
24% less likely to lift weights
22% less likely to do aerobics
24% less likely to golf
4% less likely to play softball
38% less likely to play tennis and
60% more likely to hunt ... than the average American
Source: Georgia Department of Human Resource, Division of Public Health. (1996). Marketing data directory and cluster health profiles, Claritas Company Marketing Data, Atlanta, Georgia: Author.

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Other health indicators could
include the number of children with asthma or the number of
specific cancers diagnosed. Data for these indicators are not
available at this time.
OT H E R H E A LT H

8I N D I C A T O R S

TRANSPORTATION ACCIDENT EXPERIENCE
In Walker County, 6.5% of all transportation accidents were alcohol/drug related.
In Georgia, 3.6% of all transportation accidents were alcohol/drug related.
Source: Cooperative Extension Service, The University of Georgia. (1999). The 1999 Georgia County Guide, Athens, Georgia.

TRANSPORTATION ACCIDENT EXPERIENCE IN WALKER COUNTY
Accident experience: all reporting agencies

1997
Alcohol/Drug Related Accidents for 1997

Accidents 1,289
84

Injuries Deaths

843

13

79

3

FIRE DEATHS
Source: Safe Kids of Georgia, 9th Annual Injury Prevention Conference. (1999, February). Statistics provided by the Georgia State Fire Marshall's Office. In Safe Kid's of Georgia's champions of children: Setting a winning course for child safety, Atlanta, Georgia: Author.
POISONING IN CHILDREN
Source: Safe Kids of Georgia, 9th Annual Injury Prevention Conference. (1999, February). Statistics provided by the Georgia Poison Center (404-616-9235). In Safe Kid's of Georgia's Champions of children: Setting a winning course for child safety, Atlanta, Georgia: Author.

NUMBER OF FIRE DEATHS IN WALKER COUNTY

1996 1997 1998

Walker County 2 1 3

POISONING IN CHILDREN UNDER THE AGE OF 15

1997

Walker County 443

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Not all cases of Notifiable Diseases are reported even though it is the law to do so.

NOTIFIABLE DISEASES

WHAT ARE "NOTIFIABLE DISEASES"?
Certain infectious and other diseases have been identified as "Notifiable Diseases." There are over 40 "Notifiable Diseases" in Georgia.
WHAT HAPPENS TO "NOTIFIABLE DISEASE" REPORTS?
The Notifiable Disease Unit systematically collects, analyzes, interprets and shares data on notifiable diseases in Georgia. the purpose of notifiable disease reporting is to:
Identify in a timely way any diseases or conditions that may require immediate public health intervention and follow-up.
Monitor trends or patterns in disease occurrence. Identify areas or communities that require special
public health response as a result of changes in disease patterns. Evaluate control and prevention interventions.
HOW MANY INCIDENCES OF THESE DISEASE WERE REPORTED IN THE PAST 5 YEARS?
If 1, 2, 3 or 4 cases of a disease are reported in one year, that number is represented as "<5." It is reported that way to protect the confidentiality of the report. Thus, five year totals of diseases with a "<5" report, will be reported as a range (e.g. 1-4, 2-8).
Remember, not all cases of notifiable diseases are reported, even though it is the law to do so.

WHAT "NOTIFIABLE DISEASES" HAVE BEEN REPORTED IN WALKER COUNTY OVER THE PAST FIVE YEARS?
AIDS Campylobacteriosis Chlamydia genital infection Cryptosporidiosis E. Coli 0157:H7 Giardiasis Gonorrhea Haemophilus influenza (invasive) Hepatitis A (acute) Meningococcal Disease (invasive) Rabies - animal Rocky Mountain Spotted Fever Salmonellosis Shigellosis Streptococcal Disease Group A (invasive) Streptococcal Disease Group B (invasive) Syphilis Tuberculosis

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Children can begin getting vaccinations at birth. They need several more during their first 12-
18 months of life and at different times for the rest of their lives.

NOTIFIABLE DISEASES

"All Georgia physicians, laboratories and other health care providers are required by law to report patients with certain conditions (notifiable disease) to their County Public Health Department or District Public Health Office. Cases may also be reported to the Notifiable Disease Unit of the Epidemiology and Prevention Branch (of Georgia's Division of Public Health)." However, public health does not have regulatory authority to make sure this gets done. Therefore, not all cases of notifiable diseases are reported.
"State Law OCGA 31-12-2: The department (DHR, The Division of Public Health) is empowered to declare certain diseases and injuries to be diseases requiring notice and to require the reporting thereof to the county board of health and the department in a manner and at such times as may be prescribed. The department shall require that such data be supplied as are deemed necessary and appropriate for the prevention of certain diseases and accidents as are determined by the department. All such reports and data shall be deemed confidential and shall not be open to inspection by the public; provided, however, the department may release such reports and data in statistical form or for valid research purposes."
Source: Epidemiology Section, Epidemiology and Prevention Branch, Division of Public Health, Georgia Department of Human Resources (1997). Notifiable disease surveillance: Georgia 1995-1996, (page 6), Atlanta, Georgia: Author.

PREVENTING INFECTIOUS DISEASE
Many infectious diseases are preventable through vaccines. There has been a marked decline in pertussis (whooping cough) and other childhood illnesses in the past 40 years due to immunizations.
Immunizing your child will protect them from harmful diseases such as:
Hepatitis B Diphtheria Tetanus (lockjaw) Pertussis (whooping cough) Hib (H. influenza type b disease) Polio Measles Mumps Rubella Varicella Zoster (chicken pox)
The immunization rate for Walker County Health Department, 1999 shows that 95% of children (24 months of age to 35 months of age and seen at the health department) were up-to-date with their immunizations.

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In the U.S., an estimated 10 to 20 percent of the population contracts influenza (flu) each year.
Immunizing yourself is the single best way to protect yourself against flu.

NOTIFIABLE DISEASES IN WALKER COUNTY FROM 1994-1998
New Cases, Total All Races, Male and Female

AIDS** Campylobacteriosis Chlamydia genital infection Cryptosporidiosis E. Coli O157:H7 Giardiasis Gonorrhea Haemophilus influenzae (invasive) Hepatitis A (acute) Meningococcal Disease (invasive) Rabies - Animal Rocky Mountain Spotted Fever Salmonellosis Shigellosis Streptococcal Disease Group A (invasive) Streptococcal Disease Group B (invasive) Syphilis-Primary Syphilis-Secondary Syphilis-Early Latent Syphilis-Other*** Tuberculosis

1994 5 17
N/A* N/A* N/A* N/A* N/A*
0 0 <5 0 0 6 6 N/A* 5 0 0 6 0 7

1995 7 14
N/A* N/A* N/A* N/A* 44 <5
0 <5 0 <5 10 26 N/A* 0 <5 <5 <5 0 13

1996 8 6 63 <5 <5 5 25 <5 <5 <5 0 <5 10 83 0 0 0 0 <5 0 5

1997 <5 7 58 <5 0 <5 15 0 <5 <5 <5 0 <5 16 0 <5 0 0 <5 <5 <5

1998 <5 10 54 0 <5 <5 15 <5 <5 <5 0 0 8 <5 <5 <5 0 0 <5 <5 6

TOTAL 22-28
54 175 2-8 2-8 7-13 99 3-12 3-12 5-20 1-4 2-8 35-38 132-135 1-4 7-13 1-4 1-4 10-22 2-8 32-35

N/A* = data not available ** = AIDS numbers shown here represent cases reported to the Division of Public Health and may not reflect all
cases of AIDS in Georgia. *** = Other syphilis includes latent (unknown duration), late latent, late with symptomatic manifestations, and
neurosyphilis.
Source: Epidemiology Section, Epidemiology and Prevention Branch, Division of Public Health, Georgia Department of Human Resources. (1999). Notifiable diseases, www.ph.dhr.state.ga.us

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Services for HIV prevention and testing are available in all county health departments in
Georgia and in state funded substance abuse centers.

NOTIFIABLE DISEASES

AIDS (new cases)
1994 1995 1996 1997 1998 TOTAL

5

7

8 <5 <5 22-28

Georgia, the tenth most populated state in the United States, ranks eighth in both cumulative AIDS cases and in reported case rates per 100,000 population. In general, the majority of AIDS cases were reported from the 8 county metropolitan area of Atlanta. "Young adults ages 20 to 29 years have accounted for 22 percent of all AIDS cases reported in Georgia from 1981 through December 1995. Because AIDS symptoms may not appear for 10 years or more after infection with the HIV virus, most of these young people are likely to have been infected during adolescence."
Sources:Georgia Department of Human Resources (GA DHR), Division of Public Health (DPH), Epidemiology and Prevention Branch. (1999). Teenagers, AIDS and sexually transmitted diseases in Georgia, www2.state.ga.us/Departments/DHR/facstdte.html

CAMPYLOBACTERIOSIS
1994 1995 1996 1997 1998 TOTAL

17 14 6

7 10 54

Campylobacter is a cause of diarrheal disease in humans. The illness is usually mild and often without treatment. It has been associated with commercially distributed raw milk, eating chicken and contact with a cat.
Source: GA DHR, DPH, Epidemiology and Prevention Branch, Notifiable Disease Unit. (1999). Health statistics, www.ph.dhr.state.ga.us

CHLAMYDIA GENITAL INFECTION
1994 1995 1996 1997 1998 TOTAL
N/A N/A 63 58 54 175
Chlamydia trachomatis is a sexually transmitted disease which, if left untreated, can lead to complications such as Pelvic Inflammatory Disease which is associated with infertility, chronic debilitating pelvic pain, life-threatening tubal pregnancy and problems with newborns. Chlamydia trachomatis is often asymptomatic in women and men.
Source: Centers for Disease Control and Prevention (CDC). (March 1997). Some facts about chlamydia, CDC update, Atlanta, GA: Author.
CRYPTOSPORIDIOSIS
1994 1995 1996 1997 1998 TOTAL
N/A N/A <5 <5 0 2-8
Cryptosporidiosis is an illness caused by the protozoan Cryptosporidium parvum and characterized by diarrhea, abdominal cramps, loss of appetite, low-grade fever, nausea, and vomiting. Infected persons may not have symptoms. The disease can be prolonged and life-threatening in severly immunocompromised persons.
Source: GA DHR, DPH, Epidemiology and Prevention Branch, Notifiable Disease Unit. (1998). Health statistics, www.ph.dhr.state.ga.us

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The number of Haemophilus Influenzae type b infections has decreased in recent years
because of the increase use of Hib vaccines.

NOTIFIABLE DISEASES

E. COLI 0157:H7
1994 1995 1996 1997
N/A N/A <5 0

1998 TOTAL <5 2-8

E. coli 0157:H7 is among the three most frequently isolated bacterial pathogens responsible for bloody diarrhea in the U.S. The infection can cause Hemolytic Uremic Syndrome, and is the most common cause of renal (kidney) failure in children. Transmission usually occurs through eating contaminated food, most often poorly cooked beef (especially ground beef ) and raw milk. Transmission can occur through direct contact in high risk populations (such as in custodial institutions).
Source: DHR, DPH, Epidemiology and Prevention Branch. (January 1996). Outbreak of escherichi coli 0157:H7 infection in Georgia and Tennessee, 1995, In Georgia Epidemiology
Report, (Vol. 12, No.1), Atlanta, GA: Author.

GIARDIASIS
1994 1995 1996 1997 1998 TOTAL
N/A N/A 5 <5 <5 7-13
Giardiasis is an illness caused by the protozoan Giardia lambdia. The illness is characterized by diarrhea, abdominal cramps, bloating, weight loss, or malabsorption. Infected persons may not have any symptoms. Giardiasis can be a problem in areas where sanitation is poor, in settings in which there may be problems with personal hygiene, such as institutions or day-care centers, or when unfiltered water supplies are contaminated with the organism. A Giardia infection can be acquired when you ingest food or water which has been contaminated with the parasite. The parasite multiplies in the small intestine and is passed out with a bowel movement. Any food or drink which has become contaminated with infected stool can transmit the parasite. The infection can also be spread person-toperson when hands, which are contaminated with an infected person's stool, are brought in contact with the mouth.
Source: Massachusetts Department of Public Health. (1998) Public health fact sheet: Giardiasis, www.vh.org/Patients/ IHB/IntMed/Infectious/Giardiasis.html

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A simple blood test measures the amount of lead in blood. CDC recommends that most
children be tested at one year of age; or at 6 months of age if they are at risk of exposure from
lead based paint used in construction before 1978.

NOTIFIABLE DISEASES

GONORRHEA
1994 1995 1996 1997 1998 TOTAL
N/A* 44 25 15 15 99
Gonorrhea is a sexually transmitted disease commonly manifested by urethritis, cervicitis or salpingitis. Infection may be asymptomatic. "If a person is not treated for gonorrhea, there is a good chance complications will occur. Women frequently suffer from pelvic inflammatory disease (PID), a painful condition that occurs when the infection spreads through the reproductive organs. PID can lead to sterility. Men may suffer from painful swelling of the testicles. Both sexes may suffer from arthritis, skin problems and other organ infections caused by the spread of gonorrhea within the body." N/A* = Data not available
Source: Massachusetts Department of Public Health. (1998). Public health fact sheet: Gonorrhea, www.vh.org/ Patients/IHB/IntMed/Infectious/STDs/Gonorrhea.html

HAEMOPHILUS INFLUENZA (INVASIVE)
1994 1995 1996 1997 1998 TOTAL
0 <5 <5 0 <5 3-12
Invasive disease due to Haemophilus influenza may produce any of several clinical syndromes including meningitis, bacteremia, epiglottitis, or pneumonia. In Georgia and in the United States as a whole, the majority of reported cases are among children. The number of reported cases have been decreasing since 1989 probably because of increased use of Hib vaccines for the Haemophilus influenza type b disease.
Source: GA DHR, DPH, Epidemiology and Prevention Branch, Notifiable Disease Unit. (1999). Health statistics, www.ph.dhr.state.ga.us

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Up to 10% of all adults carry the bateria that causes meningococcal meningitis
in their noses and throats but do not become ill.

NOTIFIABLE DISEASES

HEPATITIS A (ACUTE)
1994 1995 1996 1997 1998 TOTAL

0

0 <5 <5 <5 3-12

Hepatitis is an inflammation of the liver due to viral infection transmitted by fecal-oral (type A) or blood (type B). Hepatitis C, formerly non-A and non-B hepatitis, is a recently identified bloodborne virus. Laboratories differentiate between Hepatitis A, Hepatitis B, and Hepatitis C by laboratory tests.
Source: GA DHR, DPH, Epidemiology and Prevention Branch, Notifiable Disease Unit. (1999.) Health Statistics, www.ph.dhr.state.ga.us

MENINGOCOCCAL DISEASE (INVASIVE)
1994 1995 1996 1997
<5 <5 <5 <5

1998 TOTAL <5 5-20

Meningococcal meningitis is a severe bacterial infection of the blood stream and meninges. It is relatively rare. Generally, 70-100 sporadic cases of meningococcal disease occur in Georgia each year, and approximately 5-10% are fatal. The onset of meningitis is typically evident by headache, nausea, stiff neck, chills and fever. Meningococcal meningitis can occur at any time of the year, but is most common in the winter and spring. It mainly strikes children and young adults. Around 100 sporadic cases are reported in Georgia each year, but outbreaks are extremely rare. Even with treatment, about 5 to 10% are fatal. Meningococcal meningitis is not highly contagious. In fact, statistics show that a child is more likely to die in a car accident than to die of this disease. The bacteria that cause meningococcal meningitis spread through intimate contact, such as deep kissing with exchange of saliva, or sharing drinks. The bacteria cannot live outside the human body, and animals do not carry the bacteria. Even close family members of a meningococcal meningitis patient have only a 1 in 300 chance of contacting the disease from the infected person. Up to 10% of all adults carry the bacteria in their noses and throats but do not become ill. Antibiotics are prescribed for anyone with prolonged or intimate exposure to an active case of meningococcal meningitis, which dramatically decreases the risk of infection.
Source: GA DHR, DPH, Epidemiology and Prevention Branch. (1998). Meningitis fact sheet, www.ph.dhr.state.ga.us/epidisease/ mfactsheet.htm

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Handwashing with soap and running water is the single most important protective
measure in preventing the spread of shigellosis.

NOTIFIABLE DISEASES

RABIES - ANIMAL
1994 1995 1996 1997

0

0

0 <5

1998 TOTAL 0 1-4

Animal rabies was detected in 100 of the 159 counties in Georgia. Only 7% of the positive animals were domestic species (cats 3%, dogs 3%, and horses 1%). The positive animals of wild species were raccoons (69%), skunks (11%), foxes (6%), bats (4%), and bobcats (3%). Rabid bats, a particular concern, were found throughout the state.
Source: GA DHR, DPH, Epidemiology and Prevention Branch. (1999.) www.ph.dhr.state.ga.us

ROCKY MOUNTAIN SPOTTED FEVER
1994 1995 1996 1997
0 <5 <5 0

1998 TOTAL 0 2-8

Rocky Mountain Spotted Fever occurs throughout the United States during the spring, summer and fall. Exposure is through infected ticks.
Source: GA DHR, DPH, Epidemiology and Prevention Branch, Notifiable Disease Unit. (1999). Health statistics, www.ph.dhr.state.ga.us

SALMONELLOSIS
1994 1995 1996 1997
6 10 10 <5

1998 TOTAL 8 35-38

Salmonellosis is an illness of variable severity commonly evidenced by diarrhea, abdominal pain, nausea and sometimes vomiting. Sometimes there are no symptoms. According to the CDC (1998) "Eggassociated salmonellosis is an important public health problem in the United States and several European countries. A bacterium, Salmonella enteritidis, can be inside perfectly normal-appearing eggs, and if the eggs are eaten raw or undercooked, the bacterium can cause illness."
Source: CDC. (1998). Salmonella fact sheet, www.cdc.gov/ncidod/diseases/foodborn/salmon.htm

SHIGELLOSIS
1994 1995 1996 1997 1998 TOTAL
6 26 83 16 <5 132-135
Shigellosis is an illness of variable severity characterized by diarrhea, fever, nausea and cramps. Sometimes there are no symptoms. Most cases of Shigella infection, as well as most of the deaths, occur in children under 10 years of age. According to the CDC (1998) "Transmission of Shigella is through direct contact with an infected person, or from food or water contaminated by an infected person. Handwashing with soap and running water is the single most important preventive measure to interrupt transmission of shigellosis, especially during an outbreak."
Source: CDC. (1999). Shigella fact sheet, www.cdc.gov/ncidod/diseases/foodborn/shigella.htm

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A dults should have a tetanus booster every ten years.

NOTIFIABLE DISEASES

STREPTOCOCCAL DISEASE GROUP A (INVASIVE)
1994 1995 1996 1997 1998 TOTAL

N/A N/A 0

0 <5 1-4

STREPTOCOCCAL DISEASE GROUP B (INVASIVE)
1994 1995 1996 1997 1998 TOTAL

5

0

0 <5 <5 7-13

Pneumococci may cause many clinical syndromes depending on the site of infection (e.g. otitis media, pneumonia, bacteremia, or meningitis). For the purposes of national surveillance, "invasive" pneumococcal disease refers only to bacteremia and/or meningitis. "DRSP" refers to drug resistant Streptococcal pneumonia.
Source: GA DHR, DPH, Epidemiology and Prevention Branch, Notifiable Disease Unit. (1999). Health statistics, www.ph.dhr.state.ga.us

SYPHILIS-PRIMARY
1994 1995 1996 1997

0 <5 0

0

1998 TOTAL 0 1-4

SYPHILIS-SECONDARY
1994 1995 1996 1997 1998 TOTAL

0 <5 0

0

0 1-4

SYPHILIS-LATENT
1994 1995 1996 1997
6 <5 <5 <5

1998 TOTAL <5 10-22

SYPHILIS-OTHER
1994 1995 1996 1997

0

0

0 <5

1998 TOTAL <5 2-8

Syphilis is a sexually transmitted disease. Symptoms range from a chancre sore (primary syphilis) to skin lesions and malaise (secondary) to the latent stage where there is a potentially damaging effect on multiple organs if left untreated. Inadequate treatment of syphilis in pregnant females, may result in stillbirth or a variety problems for infants (which continue to manifest as they grow).
Source: GA DHR, DPH, Epidemiology and Prevention Branch, Notifiable Disease Unit. (1998). Health statistics, www.ph.dhr.state.ga.us

TUBERCULOSIS
1994 1995 1996 1997
7 13 5 <5

1998 TOTAL 6 32-35

Tuberculosis is spread from person to person by airborne particle and the illness is commonly manifested in the lungs.
Source: GA DHR, DPH, Epidemiology and Prevention Branch, Notifiable Disease Unit. (1998). Health statistics, www.ph.dhr.state.ga.us
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There is not strong local data for some
health issues, such as illicit drug use. Thus, this section contains a mixture of
data, national trends and resources.
OT H E R H E A LT H

9I S S U E S

GLOSSARY OF TERMS
CHILD ABUSE: Child abuse includes non-accidental physical injury, physical neglect, sexual abuse and emotional abuse. Child abuse is against the law.
DRUG-RELATED VIOLENT CRIME: Violent crime includes offenses such as homicide, sexual assault, robbery and assault. "Drug-Related Violent Crime" includes offenders reporting being under the influence of illicit drugs and/or alcohol at the time they committed the crime.
ILLICIT DRUGS: Illicit drugs includes marijuana, cocaine (all forms), methamphetamine, heroin, methadone, inhalants, hallucinogens, or nonmedical use of psychotherapeutics.
INDIGENT MEDICAL CARE: Medical indigence is commonly defined as a lack of public or private health insurance coverage coupled with an inability to pay for medical expenses. A better way to describe a medically indigent population is "medically underserved" population.

MENTAL HEALTH ISSUES: Mental health issues range from mental retardation to depression; from conduct disorders to schizophrenia. Risk factors contributing to mental health problems are variedranging from an interaction of genetics, prenatal conditions, social risk factors, economic risk factors and other factors.
RAPE: According to the U.S. Department of Justice, National Crime Victimization Survey, rape is a type of sexual assault which involves forced sexual intercourse including both psychological coercion, as well as physical force. Sexual assault refers not just to rape, but to many unwanted behaviors such as grabbing, fondling or verbal threats.
SUBSTANCE USE DURING PREGNANCY: Substance use during pregnancy refers to using alcohol, tobacco or illicit drug.

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Contact Georgia Child Abuse Council at their GCAC Helpline 1-800-532-3208.
Visit their web site at www.gcca.org/

CHILD ABUSE

WHAT DOES THE DATA SHOW ABOUT CHILD ABUSE IN OUR COUNTY?

CHILD ABUSE CASES 1998 Walker County

Cases Investigated

272

% of Investigated Cases Substantiated

20%

Source: The Cooperative Extension Service, The University of Georgia. (1999). The Georgia county guide, Athens, Georgia: Author.

HOW MUCH CHILD ABUSE GOES UNREPORTED?

Not all cases of child abuse or neglect are reported. Thus, local and national statistics do not show the full extent of this "hidden" problem.
A national report released in April 1998 by the United States Department of Health and Human Services shows record high levels of child abuse and neglect in the United States. According to the report, "Child Maltreatment 1996: Reports from the States to the National Child Abuse and Neglect Data System," almost 1 million children were identified as victims of abuse or neglect in 1996. An estimated 1,077 children died in 1996 as a result of abuse or neglect.

To report child abuse, call the Walker County Family and Children Services at 706-375-0726.

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Contact Georgia Child Abuse Council at their GCAC Helpline 1-800-532-3208.
Visit their web site at www.gcca.org/

CHILD ABUSE and NEGLECT NATIONAL STATISTICS

WHAT OTHER INFORMATION SHOULD I KNOW ABOUT CHILD ABUSE AND NEGLECT?
Source: U.S. Department of Health and Human Services. Child Maltreatment 1997: Reports from the States to the National Child Abuse and Neglect Data System. (Washington, DC: U.S. Government Printing Office, 1999.)

These Child Maltreatment 1997 highlights are based on States' responses to the 1997 Summary Data Component Survey.
VICTIMS
The national rate of victimization was 13.9 per 1,000 children in the population.
More than half (54%) of all victims suffered neglect Almost a quarter (24%) suffered physical abuse 6% suffered psychological abuse 2% suffered medical neglect 67% of all victims were White 29.5% of all victims were Black 13% of all victims were of Hispanic origin 2.5% of all victims were American Indian/Alaska Native 1.0% of all victims were Asian/Pacific Islander
The proportions of victims who were African American or American Indian/Alaska Native were two times greater than the proportions of these children in the general population.
PERPETRATORS
It is estimated that over 75% of perpetrators were parents and an additional 10% were other relatives of the victim.
It is estimated that over 80% of all perpetrators were under age 40 and almost two-thirds were females.
An estimated three-quarters of sexual abuse cases were associated with male perpetrators.
FATALITIES
An estimated 1,196 child fatalities were attributed to maltreatment with children 3 and younger accounting for 77% of these fatalities.

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As drug use increases, so does the amount of crime a person commits.

DRUG-RELATED VIOLENT CRIME

IS VIOLENT CRIME RELATED TO DRUG USE?
Source: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics. (1994, September). Fact sheet: Drug-related crime, Rockdale, MD: ONDCP Drugs & Crime Clearinghouse.
IS THERE A PROBLEM WITH DRUGS & VIOLENT CRIME IN OUR COUNTY?

The U.S. Department of Health and Human Services (HHS) National Household Survey on Drug Abuse provisional data (1991) shows that 97.3% of violent criminals (between the ages of 18 to 49 years old) used one or all of the following drugs in the last year: alcohol, cannabis (marijuana) and/or cocaine.
The Office of National Drug Control Policy states that: Drug users are more frequently involved in crime than nonusers. As drug use increases, so does the number of crimes a person commits. Drug use is especially high among persons imprisoned for violent crimes.
We do not have local statistics that capture the extent of the relationship between drug use and violent crimes. However, ask a local law enforcement official or district attorney. The ones we have talked to answer the question "yes."

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Studies show there is an unmet need for substance abuse treatment and although the problem
is greater among men, it remains a serious problem for Georgia women, particularly young women.
1999 Report on the Status of Women's Health in Georgia

WHAT DOES ILLICIT DRUG USE DURING PREGNANCY DO?
HOW IS DRINKING ALCOHOL DURING PREGNANCY HARMFUL?
Source: Serbanescu F, Rochat R. (1996). Georgia women's health survey-1995. Atlanta, Georgia: Georgia Department of Human Resources, Division of Public Health, Epidemiology & Prevention Branch, Office of Perinatal Epidemiology. For more information contact: 404-657-6448
HOW IS SMOKING CIGARETTES DURING PREGNANCY HARMFUL?
Source: Serbanescu F, Rochat R. (1996). Georgia women's health survey-1995. Atlanta, Georgia: Georgia Department of Human Resources, Division of Public Health, Epidemiology & Prevention Branch, Office of Perinatal Epidemiology. For more information contact: 404-657-6448

SUBSTANCE USE DURING PREGNANCY
Babies born to mothers who abused drugs during pregnancy are at higher risk for being born too early and too small and may have other problems as well.
Fetal Alcohol Syndrome (FAS) is a birth defect that occurs in infants exposed prenatally to large amounts of alcohol. FAS is associated with brain damage and is the leading preventable cause of mental retardation. Since the 1980's health officials have recommended no drinking during pregnancy, warning that no safe level of prenatal drinking is known, and the more a woman drinks the more likely her unborn baby will be affected.
The Surgeon General has reported that infants born to women who smoke during pregnancy weigh, on the average, 200 grams less than infants born to comparable women who do not smoke. Maternal smoking during pregnancy is also associated with an increased risk of neonatal death, spontaneous abortion, and Sudden Infant Death Syndrome (SIDS).

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For more information, visit the National Institute on Drug Abuse web site at:
www.nida.nih.gov/DRUGABUSE.html

SUBSTANCE USE DURING PREGNANCY

IS THERE A PROBLEM WITH SUBSTANCE USE DURING PREGNANCY IN OUR COUNTY?
Source: Mathias, R . (1998). NIDA survey provides first national data on drug use during pregnancy. http://www.165.112.78.61/NIDA_Notes NNVol10N1/NIDASurvey.html

Locally-specific information regarding drug pregnancy is limited. The National Institute on Drug Abuse conducted a National Pregnancy and Health Survey during 1992. This is the first national survey of drug use among pregnant women in the United States. The survey collected data from a representative sample of the 4 million women who delivered babies in the U.S. in 1992. What did the data show?
18.8% consumed alcohol. 20.4% smoked cigarettes. 5.5% of pregnant women reported using illicit drugs. 2.9% used marijuana. 1.1% used cocaine.
Hutcheson Medical Center (HMC) reports approximately 1,040 babies were born there in 1999. Of these, none were identified as "narcotic affected newborn." Source: HMC, Medical Records, D. Simpson, Fort Oglethorpe, GA

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The medically indigent or medically underserved may be our own friends and neighbors.

INDIGENT MEDICAL CARE

WHAT IS INDIGENT CARE? The Uninsured
The Under-Insured The Mis-Insured

Medical indigence has been commonly defined in literature as a lack of public or private health insurance coverage-coupled with an inability to pay for medical expenses. This lack of health insurance coverage can mean that the person has some insurance, but the insurance is not adequate. Thus, the medically indigent may be our own friends and neighbors who fall into the following categories:
Adults and children who do not have health insurance and who do not qualify for Medicaid. The adults may have jobs that do not offer health insurance or that offer health insurance at too great a purchase cost. This may be a college student who is too old to be on his/her parents' insurance, but cannot afford buying his/her own insurance.
Children who do not have health insurance and who qualify for Medicaid or PeachCare for Kids. These children are uninsured because their families are not aware of how to acquire insurance for their children, or they choose not to.
Refugees
Pregnant non-citizen women are not insured prenatally. Their babies, born American citizens, do not benefit from proper prenatal care.
People who have health insurance, but cannot afford to pay their deductible. These people may delay health care services (such as treatment for a sore throat) and preventive service (such as cancer screening).
People who have health insurance, but cannot afford to pay their co-payment for services-thus they delay seeking services.
People who have health insurance, but are unable to access their "assigned" provider due to undo distance to travel or other access problems. These people are unable to choose a provider that is accessible to them, because that provider is not on their insurance plan.

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The cost of human suffering resulting from delayed or no medical care is immeasurable.

INDIGENT MEDICAL CARE

HOW MUCH DOES INDIGENT CARE COST US?
HOW MANY PEOPLE LACK MEDICAL INSURANCE IN MY COMMUNITY?
Source: Morbidity and Mortality Weekly Report. (1998). State-specific prevalence estimates of uninsured and underinsured person: Behavioral risk factor surveillance system, 1995, Vol. 47/No.3.

Last year, Hutcheson Medical Center reported spending nearly $4,213,960 on indigent care for Walker, Catoosa and Dade counties. $2,580,813 was spent on indigent care for Walker County residents for the fiscal year (10-1-98 to 9-30-99). There is no way to measure the amount of "indigent care" other medical care providers foot the bill for. Undoubtedly, the financial cost of "indigent care" is high. The cost of human suffering resulting from delayed or no medical care is immeasurable. Source: Hutcheson Medical Center, David Gaither, Ft. Oglethorpe

We do not have good local statistics to show how many people are uninsured in Georgia counties. But we do have some information at state and national levels.

PERCENT OF PERSONS AGED 18-64 WHO WERE ADEQUATELY INSURED, UNDERINSURED OR
UNINSURED BY STATE
United States Behavioral Risk Factor Surveillance System, 1995

Adequately Insured Underinsured

Georgia

79.9%

8.8%

United States

79.2%

5.5%

Uninsured 11.3% 14.0%

WHAT DOES THIS MEAN?

Georgians are more likely to be underinsured than the average American; they are less likely to be uninsured.

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Depression is the leading cause of disability worldwide among persons age five and older.
(National Institute of Mental Health)

INDIGENT MEDICAL CARE

Source: Morbidity and Mortality Weekly Report. (1998). State-specific prevalence estimates of uninsured and underinsured person: Behavioral risk factor surveillance system, 1995, Vol. 47/No.3.

PERCENT OF PERSONS AGED 18-64 EMPLOYED FOR WAGES WHO WERE ADEQUATELY
INSURED, UNDERINSURED OR UNINSURED

Adequately Insured Underinsured

Georgia

83.4%

8.4%

United States

81.2%

5.1%

Uninsured 8.2% 11.2%

WHAT DOES THIS MEAN?

Working Georgians are more likely to be underinsured than the average working American; they are less likely to be uninsured.

One-fifth of Georgia women aged 18 to 64 are without health insurance coverage.
1999 Report on the Status of Women's Health in Georgia

Source: National Institute of Mental Health. (1998). Plain talk about depression. www.nimh.nih.gov/publicat/ptdep.htm#top

M E N TA L H E A LT H
"During any 1 year perioid, 17.6 million American adults or 10% of the population suffer from a depressive illness... Depressive illnesses often interfere with normal functioning and cause pain and suffering not only to those who have a disorder, but also to those who care about them. Serious depression can destroy family life as well as the life of the ill person.
Possibly the saddest fact about depression is that much of this suffering is unnecessary. Most people with a depressive illness do not seek treatment, although the great majority--even those with the severest disorders--can be helped."

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National Institute of Mental Health
http://www.nimh.nih.gov

M E N TA L H E A LT H

WHAT DOES THE DATA SHOW ABOUT MENTAL HEALTH IN OUR COUNTY?
WHAT IS THE IMPACT OF MENTAL HEALTH ISSUES?
Source: Nation Institute of Mental Health. 1995. A plan for prevention for the national institute of mental health. http://yates.coph.usf.edu/research/psmg/doc4. html
WHERE CAN I GET INFORMATION ABOUT LOCAL MENTAL HEALTH ISSUES?
To obtain more information from the MHMRSA web site at http://www2.state.ga.us/Departments/DHR /mhmrsa.html

Comprehensive local data concerning mental health is limited. However, mental health is an important community health consideration.
"The economic costs that our nation bears because of mental disorders is extraordinarily high. In 1990 alone, mental disorders cost our nation $147.8 billion. This cost is more than that attributed to cancer ($104 billion in 1987), respiratory disease ($99 billion in 1990), AIDS ($66 billion in 1991), or coronary heart disease ($43 billion in 1987).
Direct treatment and support costs comprise 45.3 percent of the total economic costs of mental disorders.
The value of reduced or lost productivity comprises 42.7 percent.
Mortality costs comprise 8 percent Other related costs, including expenditure for criminal
justice, comprise 4 percent. We must invest in prevention to reduce both the human suffering of mental disorders and the enormous financial costs to our nation."
Georgia's Department of Human Resources: Division of Mental Health, Mental Retardation and Substance Abuse (MRSA) has set-up thirteen regional boards across the state to plan and coordinate activities. The Northwest Georgia Regional MHMRSA (Region 1) meets the first Thursday of each month at 6:30 p.m. You may attend meetings, but you need to call for the meeting location. 770-387-5411.

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Georgia Advocates for Battered Women and Children
Phone: 404-524-3847

REGION 1 COMMUNITY SERVICE BOARDS SERVICING NORTHWEST GEORGIA

M E N TA L H E A LT H
Walker County contact: Servicing Walker, Dade, Catoosa, Chattooga Counties Lookout Mountain Community Services P.O. Box 1027, LaFayette, Georgia 30728 Phone: 706-638-5445

WHAT DOES THE LOCAL DATA SHOW ABOUT RAPE?
Note: You can request the most recent crime data from your local police department.
HOW MANY RAPES GO UNREPORTED?

RAPE

GEORGIA CRIME INFORMATION CENTER LOCAL DATA FOR RAPES REPORTED

Year

Walker County

1995

7

1996

3

1997

4

1998

7

Source: GA Bureaus of Investigation, Crimes Statistics 1998. www.ganet.org/GBI/GBISTAT1.html

According to The Sexual Assault Center of Northwest Georgia: national statistics show 1 out of 4 women are expected to be sexually assaulted at some point in her lifetime.
Sexual assault is the least reported of all crimes (less than 1 out of 10 are reported), we do not hear about the majority of assaults which leads many people to think that assaults do not occur often.

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National Domestic Violence Hotline 1-800-799-SAFE.
For emergencies, call your local police or 911.

RAPE

WHAT OTHER INFORMATION SHOULD I KNOW ABOUT SEXUAL ASSAULT?
WHAT CAN BE DONE TO PREVENT SEXUAL ASSAULT?

In 29% of rapes, the offender used a weapon. In 47% of rapes, the victim sustained injuries other than
rape injuries. Nearly 31% of rape victims develop Rape Related Post
Traumatic Stress Disorder. The cost of one rape (in lost wages and fees from medical
and psychological treatment) averages $47,000. Almost 50% of all rapes happen in the home. One out of every four rapes takes place in a public area or a
parking garage. At least 45% of rapists were under the influence of alcohol
or drugs. 75 to 80% of date rapes occur when one or both persons have
been drinking. According to the U.S. Justice Department, one in two rape
victims are under the age of 18; one in six are under the age of 12.
Source: The Sexual Assault Center of Northwest Georgia. (1998.) (706) 292-9024
For more information and for prevention tips, contact:
Family Crisis Center: Walker, Dade, Catoosa and Chattooga Counties 1-800-334-2836

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S 10 ome environmental issues are specific to one county - such as radon; other environmental issues do not have distinct boundaries - we share air and water.
ENVIRONMENTAL ASSESSMENT

FISH CONSUMPTION GUIDELINES
What are health benefits of eating fish?
How did some of the fish in Georgia's waters become contaminated?
Source: Georgia Department of Natural Resources, Environmental Protection Division and Wildlife Resources Division (1998). Guidelines for eating fish from Georgia waters, Atlanta, Georgia.

Fish provide a high-protein, low-fat diet that is low in saturated fats. Many scientists also suggest that eating a half-pound of fish a week can help prevent heart disease.
Many fish in Georgia's waters are contaminated with PCBs (polychlorinated biphenyls). In the past, PCBs were used regularly as fluids for electrical transformers, cutting oils, and carbonless paper. The use of PCBs was banned in 1976. PCB contamination is still a problem because the chemicals are able to remain in water sediment for many years. Over time the levels of PCB contamination will decrease.
Mercury has also contaminated many of Georgia's fish. Mercury occurs naturally and moves through the land, water, and air. As mercury cycles through the environment, it is ingested and absorbed by plants and fish. It is not known where the mercury in Georgia's fish originated. Mercury may be present in fish because of the high mercury content of soils and rocks in the southeast, from municipal and industrial sources, or from fossil fuel use. It is also possible that mercury contamination is related to global atmospheric transport.

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Georgia's fish consumption guidelines are based on eating fish with a similar
contamination for 30 years or more.

WHAT ARE THE HEALTH RISKS OF EATING CONTAMINATED FISH?
Source: Georgia Department of Natural Resources, Environmental Protection Division and Wildlife Resources Division (1998). Guidelines for eating fish from Georgia waters, Atlanta, Georgia.
WHAT HEALTH RISKS ARE ASSOCIATED WITH PCB AND MERCURY CONSUMPTION?
Source: Georgia Department of Natural Resources, Environmental Protection Division and Wildlife Resources Division (1998). Guidelines for eating fish from Georgia waters, Atlanta, Georgia.
GENERAL GUIDELINES TO REDUCE YOUR HEALTH RISK:
Source: Georgia Department of Natural Resources, Environmental Protection Division and Wildlife Resources Division (1998). Guidelines for eating fish from Georgia waters, Atlanta, Georgia.

Georgia Department of Natural Resources (GA DNR) (1998) states: "PCBs, chlordane, and methyl mercury build up in your body over time. It may take months or years of regularly eating contaminated fish to accumulate levels that would affect your health. Georgia's fish consumption guidelines are based on eating fish with similar contamination over a period of 30 years or more. If you follow these guidelines, the contamination in the fish you eat may not increase your cancer risk at all. At worst, using the U.S. Environmental Protection Agency's estimates of contaminant potency, your cancer risk from fish consumption should be less than 1 in 10,000 (p5)."
Georgia Department of Natural Resource (GA DNR) (1998) states: "PCBs can cause cancer in laboratory animals and may cause cancer in humans. Non-cancer effects include developmental problems in children whose mothers were exposed to PCBs before becoming pregnant. PCBs can also cause changes in human blood, liver and immune function of adults. Small amounts of methyl mercury can be safely eliminated from your body but larger amounts may damage the nervous system. The fetus is especially sensitive to mercury poisoning (p5-6)."
Keep smaller fish for eating. Vary the kinds of fish you eat. Eat smaller meals when you eat fish and eat them less often. Clean and cook your fish properly. Remove the skin from fillets or steaks. Trim off the fatty areas such as the belly fat, side fat and the
flesh along the top of the back. Cook fish so that fat drips away.

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One meal is equal to 1/4 to 1/2 pound (4-8 ounces) of fish for a 150 lb.person.
Add 1 ounce for every 20 pounds of body weight over 150 pounds. Subtract 1 ounce for every 20 pounds of body weight under 150 pounds.

GEORGIA RIVERS FISH CONSUMPTION GUIDELINES

SELECTED WATERS

Chattanooga Creek Ga. Hwy. 193

Chickamauga Creek East and West Ga. Hwy. 2

Daniels Creek Cloudland Canyon
State Park

Ponder Branch Villanow
Ga. Hwy. 136

Species

Recommendation Chemicals Recommendation Chemicals Recommendation Chemicals Recommendation Chemicals

Bluegill Sunfish

No restriction

No restriction

Northern Hogsucker

No restriction

Redbreast Sunfish

No restriction

Redeye Bass

No restriction

Rock Bass

No restriction

No restriction

Spotted Bass

1 meal/month Mercury

WHERE TO GET MORE INFORMATION

"Georgia has one of the most extensive fish monitoring programs in the Southeast. This is not because Georgia has highly contaminated fish, but because the Department of Natural Resources has made a serious commitment to evaluate fish quality and provide detailed information to the people of Georgia...the quality of fish in Georgia's lakes is similar to that in other southern states."
Source: Georgia Department of Natural Resources, Environmental Protection Division and Wildlife Resources Division (1999). Guidelines for eating fish from Georgia waters, Atlanta, Georgia. www.dhr.state.ga.us
The Georgia Department of Natural Resources Environmental Protection Division 404-656-4713 and Wildlife Resources Division 770-918-6418.
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Food-related illness can produce symptoms from mild to very serious. Illness can occur from
30 minutes to two weeks after eating food containing harmful bacteria.

FOOD SERVICE INSPECTIONS

WHO PERFORMS FOOD SERVICE INSPECTIONS?
Source: Georgia Department of Human Resources (1998). Food service establishment inspection report, form 3807, (Rev. 9-86), Atlanta, Georgia.

Environmentalists from each County Health Department
are responsible for performing food service inspections of restaurants and other food service facilities (schools, hospitals, mobile food carts, churches, etc.).

A LIST OF ITEMS CAREFULLY INSPECTED INCLUDE:
Source: Georgia Department of Human Resources (1998). Food service establishment inspection report, form 3807, (Rev. 9-86), Atlanta, Georgia.
INSPECTING NEW RESTAURANTS OR FOOD SERVICE OPERATIONS
Source: Georgia Department of Human Resources (1998). Food service establishment inspection report, form 3807, (Rev. 9-86), Atlanta, Georgia.
INSPECTION SCORING

Food acquisition Personnel hygiene Food protection, handling and storage Temperature control regarding food Equipment and utensils Water Sewage Plumbing Toilet and handwashing facilities Garbage and refuse disposal Physical facilities Other operations such as pest control, laundry, etc.
The environmentalists also inspect each new food service operation. If a new restaurant or food service operation does not meet the necessary food safety requirements, the environmentalist will not issue a permit. If a food service operation does not have a permit, they are unable to legally open for business.
Each food service operation is legally required to post their most recent food inspection score in their facility. Contact the Walker County Environmental Health Office at (706) 639-2574.

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Home Hazard Prevention Tip: Store pesticides container in a plastic bucket to prevent spills.
Keep pesticide separate to avoid cross-contamination.

WALKER COUNTY'S HAZARDOUS SITES
Source: Environmental Protection Division, Georgia Department of Natural Resources. (1998). Hazardous site inventory, Atlanta, Georgia: Author.
WHERE TO GET MORE INFORMATION

HAZARDOUS SITE INVENTORY
The Hazardous Site Inventory (HSI) is a list of hazardous sites in Georgia where there has been a known or suspected release of a regulated chemical above a reportable quantity. The sites have yet to show they meet state clean-up standards found in the Rules for Hazardous Site Response. The number of HSI sites identified in Walker County is 8.
Hazardous Sites Response Program 404-657-8600
Check with your local library or courthouse for the publication:
Hazardous Site Inventory Environmental Protection Division Georgia Department of Natural Resources

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Pre-1978 construction may have lead based paint.

LEAD POISONING

WHAT IS LEAD POISONING? It is a disease caused by swallowing or inhaling lead.

COMMON SOURCES OF LEAD EXPOSURE:

Paint Water Industrial pollution

Soil Auto exhaust Contaminated food

EFFECTS OF LEAD POISONING: Nervous system damage
Hearing loss Behavior problems Coma

Interference with growth
Lower IQ scores Convulsions Death

SIGNS OF LEAD POISONING:

Frequent Vomiting
Headache Poor appetite Irritability

Constipation
Sleep disorder Clumsiness Fatigue

LOWERING THE RISK IN CHILDREN:
WHERE TO GET MORE INFORMATION

Test your child for high lead levels at 12 months of age Follow-up tests should be done based on physician
recommendations Be alert for chipping and flaking paint Have old paint tested for lead Make sure your child puts only safe, clean items in their mouth Use safe interior paints on toys, walls, and furniture Use pottery only for display if you are unsure about the glaze Store food in glass, plastic, or stainless steel containers,
not in open cans Have your water tested for lead Have child wash their hands before eating Don't try to remove lead paint yourself Keep your house clean of dust
Call National Lead Information Center at 1-800-LEAD-FYI.

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If you are planning on buying a home or selling your home, have it tested for radon. For new
homes, ask if radon resistant construction features have been used. Home radon detectors are available for purchase at hardware stores.

RADON

WHAT IS RADON?
Source: United States Environmental Protection Agency (EPA) (September, 1993). Air and radiation: Map or radon zones. Washington DC: (Publication #402-R-93-030): Author
ZONING:
WALKER COUNTY'S RADON ACTION LEVEL

"Radon is a colorless, odorless, radioactive gas. It comes from the natural decay of uranium that is found in nearly all soils. It typically moves through the ground to the air above and into homes and other buildings through cracks and openings in the foundation. Any home, school or workplace may have a radon problem, regardless of whether it is new or old, wellsealed or drafty, or with or without a basement." (US EPA, pg. 1-1)
Exposure to radon increases an individual's risk for lung cancer.
Zone 1 county: predicted average indoor radon screening level more than 4pCi/L ACTION LEVEL
Zone 2 county: predicted average indoor radon screening level between 2pCi/L and 4pCi/L
Zone 3 county: predicted average indoor radon screening level less than 2pCi/L
Georgia Radon Zone for Walker County is 3. The Environmental Protection Agency recommends that all homes be tested for radon, regardless of geographic location.

FOR MORE INFORMATION

Georgia State Radon Contact 1-800-745-0037 or 404-657-6534

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Our web site www.NWGAHealth.com provides periodic updates and additional
information.

TOXIC RELEASES

TOXIC RELEASE INVENTORY CHEMICALS MUST BE KNOWN TO CAUSE ONE OF THE FOLLOWING:
FOR MORE INFORMATION

Every year since 1988, the Georgia Emergency Response Commission has gathered information about the presence and release of toxic chemicals into air, water and/or soil in Georgia communities. The information is summarized in the toxic air release report.
Significant adverse immediate health effects. Cancer, teratogenic effects, serious or irreversible reproduction
problems, brain disorders, genetic mutations, or other long-term health effects. Significant adverse effects on the environment.
Environmental Protection Agency Right-to-Know Office 404-656-6905

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11 APPENDIX SELECTED RESOURCES

APEX-PH: Assessment Protocol for Public Health Excellence We used an adapted APEX-PH: Assessment Protocol for Excellence in Public Health model (National Association of City and County Health Officials (NACCHO). (1991, March). Assessment protocol for excellence in public health (APEXPH), Washington, D.C.: Author).
APEX-PH includes a model for a community needs assessment. The model suggests key data to collect such as specific demographics information and Years of Potential Life Lost, optional information such as birth and death statistics and other information of interest such as substance use in pregnancy.
The local public health department chose additional data and information to include in this assessment.
Community health assessments are intended for use by communities as a tool to help identify community health problems which can then be prioritized, analyzed and approached for improvement.
GENERAL SOCIOECONOMIC, EDUCATION AND TRANSPORTATION: We obtained this infor-

mation from the University of Georgia (Athens) Georgia County Guide. The data in the 1999 Georgia County Guide is collected in different years for different categories. Thus, you will notice some data is from earlier years than other data.
LEADING CAUSES OF MORTALITY: For the purpose of mortality (death) statistics, every death is attributed to one underlying condition, based on information reported on the death certificate and utilizing the international rules for selecting underlying cause of death from reported conditions.
Death rate is calculated by dividing the number of deaths in a population in a year by the mid-year resident population.
Mortality information was extracted from the Georgia DHR, Division of Public Health, Epidemiology and Prevention Branch, Health Assessment Services Section, (1998) Planning information report: District 1.1, Rome, 1996, Atlanta, Georgia: Author.

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LOCAL EDUCATION: The local education data came from Georgia's Department of Education "Report Card". You can access the information directly through the Department of Education's web site at http://www.doe.k12.ga.us/
NOTIFIABLE DISEASES: Notifiable Disease information came from Georgia Public Health's Epidemiology Section. You can access the information through Georgia Public Health's web site at http://www.ph.dhr.state.ga.us. Link to "Health Statistics, Epidemiology". The data represents only what is reported to GA DHR Division of Public Health. Many cases of Notifiable Diseases are not reported even though reporting is required by the Georgia State Code.

POPULATION: The population data is from the U.S. Census Bureau, Washington, D.C. You can find census data, estimates, and projections on the U.S. Census Bureau web site at: < www.census.gov >.
NOTE: Use caution when making comparisons among county birth rates and death rates because counties with small populations are more likely to have wide variations in rates from year to year due to probability.
TOBACCO CONSUMPTION AND RECREATIONAL ACTIVITY: Northwest Georgia Health District 1.1, Office of Health Planning, derived tobacco consumption and recreational activity estimates from Claritas Company marketing data.

PERINATAL INDICATORS: This information came from the Georgia Department of Human Resources, Division of Public Health, Epidemiology and Prevention Branch, Health Assessment Services Section. You can access the information directly through Georgia Public Health's web site at http://www.ph.dhr.state.ga.us.
Birth rate is calculated by dividing the number of live births in a population in a year by the mid-year resident population. It is expressed as the number of live births per 1,000 population.
An infant death is the death of a liveborn child before his or her first birthday. Infant death is calculated by dividing the number of infant deaths during a year by the number of live births reported in that same year.

YEARS OF POTENTIAL LIFE LOST (YPLL): Northwest Georgia Health District 1.1, Office of Health Planning calculated the Years of Potential Life Lost (YPLL) using mortality data from the Georgia Department of Human Resources, Division of Public Health, Epidemiology and Prevention Branch, Health Assessment Services Section. (1997) 1996 planning information report. (released in 1997).

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