Hamilton County's 2019 "Picture of Our Health" report sparked much discussion Monday as it was revealed during the Regional Health Council meeting.
Among some of the more troubling statistics were the higher rates of disease and mortality among black residents in Hamilton County compared to white residents and a continuing rise in opioid-related drug overdoses.
The report will serve as a resource for the council and other agencies, organizations and individuals in the county as they look for areas to focus their public health priorities, said Rae Bond, chairwoman of the Regional Health Council.
"[Health disparities] deserve a lot of our concentrated time and effort," Bond said, adding that substance abuse likely will remain a priority, as well as some new areas yet to be identified.
Chris Ramsey, health council member and president of the Southeast Tennessee Health Consortium, said he's "taking it on as a personal responsibility" to engage the community and address health disparities, because "people are dying." He pointed to other local strategic initiatives — Chattanooga 2.0, Velocity 2040, Thrive 2055 — that aim to improve education, workforce and economic development.
"None of those are possible if the people aren't healthy," he said.
And while the overall life expectancy in Hamilton County has hovered around 77.5 in recent years, between 2013 and 2017, the life expectancy for white people increased from 77.9 to 78.5. During that same period, the life expectancy for black people fell from 73.4 to 72.8, according to the report.
Council and community members on Monday went over the more-than 100-page report, which was compiled by the Chattanooga-Hamilton County Health Department using data from local, state and federal sources. Topics range from life expectancy and disease rates to substance use and environmental health.
The Regional Health Council is comprised of 25 various public health, medical and community leaders. It serves as a conduit among regional public, private and nonprofit health sectors and creates work groups, such as the senior health and aging committee, that target specific issues.
Other key takeaways from the report include:
While opioid prescriptions in Hamilton County dropped 15 percent over the last three years, overdose rates continue to rise. Opioids accounted for almost one in four of the county's overdose-related emergency department visits and hospitalizations in 2016.
In 2017, there were 85 fatal drug overdoses in Hamilton County. Of these deaths, 60 involved opioids. Both the total number of drug overdose deaths and the number of overdose deaths due to opioids have increased every year since 2013, when 53 people in Hamilton County died from drug overdoses, including 35 deaths due to opioids.
The potent opioid fentanyl was associated with 19 of Hamilton County's overdose deaths in 2017.
INFANT AND MATERNAL HEALTH
Hamilton County saw a 34 percent decrease in teen birth rates from 2010 to 2016. In 2016, there were 253 babies born to females age 15 to 19, compared to 407 babies born in 2010 for that age group.
Rates of smoking during pregnancy in Hamilton County fell 33 percent between 2010 and 2016. In 2010, 15 percent of mothers reported smoking during pregnancy compared to 10 percent in 2016.
Between 2014 and 2016, the infant mortality rate for white babies was 5 per 1,000 births, compared to 13 per 1,000 births for black babies in Hamilton County.
The percent of Hamilton County residents with health insurance has grown to 91 percent in 2017 from 86 percent in 2010, when the Affordable Care Act was passed.
An estimated 32,303 Hamilton County residents in 2017 still don't have health insurance. Most of them are working adults in low-income families, and 13,183 — or 41 percent — potentially could be covered by TennCare if Tennessee expanded Medicaid.
Many childless adults are unable to afford health insurance because they make too much money to qualify for financial assistance under the Affordable Care Act. In 2018, the average monthly premium for unsubsidized enrollees in Hamilton County was $674, compared to $26 for subsidized enrollees.
Bond said the report is the first step toward raising awareness of concern spots in the community. Some additional trouble spots include rising STD rates and a violent crime rate 75 percent higher than the national rate in 2016.
"Behind every one of these numbers, there are people, there are real lives, people who are struggling, people who are trying to do their very best," she said. "We as a community have a really strong role to play in trying to pull people together."
As a result of the report, Bond said, the council plans to form a committee focused on health disparities.
Contact staff writer Elizabeth Fite at firstname.lastname@example.org or 423-757-6673.