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Example 4: Health Status of a Rural Community: Health Profile of Ottawa County, Kansas


Knowledge of the current health status of the community is the first step in identifying health problems and developing a plan to deal with those problems. There are many measures or indicators of health status. Some are based on occurrence of disease, some on lifestyle choices, and others on behavioral outcomes. What follows is a compilation of selected health status indicators for Ottawa County. While the data in this section is the most recent available, it is often dependent upon information collected as long five years ago. Care must be exercised in evaluating the data because the numbers in each category are often quite small and a small change can make a relatively large change in the percentages. Reference indicators for the state of Kansas are included to provide a comparative perspective. A process that will track these and other benchmarks is critical to an ongoing community health assessment and planning program.



Table 1

Percentage of All Births to Single Teens

  1991 1992 1993
Ottawa County 1.7% 7.4% 7.1
Kansas 7.2% 8.6% 8.8%

Table 2

Percentage of Babies Born with Low Birth Weights

  1991 1992 1993
Ottawa County 8.3% 7.4% 10.7%
Kansas 6.2% 6.3% 6.5%

Table 3

Live Birth Rate per 1,000 Population

  1991 1992 1993
Ottawa County 10.7 9.7 10.1
Kansas 15.1 15.0 14.1

Table 4

Percentage of Kindergartners Fully Immunized by Age 2

  1990-91 1992-93 1993-94
Ottawa County 53% * 73%
Kansas 51% 53% 55%

*School did not participate this year

Table 5

Percentage of Children in Poverty

  Base Year 1979 1992
Ottawa County 14% 19%
Kansas 11% 14%

 Table 6

Death Rate per 1,000 population

  1991 1992 1993
Ottawa County 14.6 12.4 16.8
Kansas 6.4 6.5 6.0

 Table 7

Alcohol-Related Traffic Accidents and Safety Belt Non-Use

  Ottawa County   Kansas  
  Total % Alcohol-related Total % Alcohol-related
Accidents 120 4.2% 63,694 5.9%
Injuries 37 15.4% 30,061 11.0%
Fatalities 1 0.0% 387 26.9%
People involved in accidents not wearing safety belts 39 28.5% 27,531 21.8%

Table 8

Cause of Death Ranked By Rate per 100,000

  Ottawa Co. 1   Kansas 2   United States 3  
Cause of Death Rank Rate Rank Rate Rank Rate
Heart Disease 1 170 1 309 1 286
Cancer 2 141 2 204 2 206
Cerebrovascular Disease 3 49 3 69 3 58
Unintentional Injury 4 46 5 38 5 34
Chronic Obstructive Pulmonary Disease 5 16 4 45 4 39
Diabetes 6 16 7 20 7 21
Congenital Anomalies 7 11 14 5 14 5
Nephritis, Nephrotic Synd. and Nephrosis 8 7 9 13 9 10
Aortic Aneurysm 9 5 12 7 - -
Hypertension 10 4 - - - -

During the period of the above ranking, Ottawa County had the 13th highest age adjusted average death rate in Kansas.

Morbidity for infections diseases is illustrated in Table 9. In order to make comparison possible, the diseases are reported by incidence rate per 100,000 people, based on the average number of cases per year between 1987 and 1991.

Table 9

Incidence of Infectious Diseases, 1987-1991

Disease Incidence per 100,000 people  
  Ottawa County Kansas
HIV - 11.2
AIDS - 4.5
Chlamydia 35.5 187.5
Gonorrhea 3.5 203.4
Syphilis 0.0 8.2
Hepatitis B 0.0 4.6
Tuberculosis 0.0 2.7
Pertussis 0.0 0.6
Mumps 3.5 5.6
Measles (Rubeola) 7.1 3.1
Rubella 0.0 0.0



As humans our behavior vitally affects the status of our health. In 1990 the Center for Disease Control published the following list of factors contributing to death before the age of seventy five:

Lifestyle: 51%
Environment: 20%
Human Biology: 19%
Health Care System: 10%

The way in which we chose to live (that is, lifestyle) has an important role in determining the length and quality of life. The Kansas Department of Health and Environment has done a study of Kansans that focused on a number of factors which are recognized to be of high risk. A part of the study determined the percentage of the population of the state who have these risk factors:

Table 10

Percentage of Population with Selected Risk Factors

  Kansas National
Sedentary Lifestyle 50% 56%
Safety Belt Non Use 46% 38%
Obesity 26% 24%
Smoking 22% 23%
Hypertension 21% 21%
High Cholesterol 18% 18%
No Health Insurance 13% 14%
Acute/Binge Drinking 10% 14%


While the study was not county-specific, the information does take on greater significance when the five leading causes of death in Ottawa County are considered. Physical inactivity, obesity, smoking, hypertension (high blood pressure), and high blood cholesterol all contribute to heart disease. The chance of developing coronary heart disease is twice as high for people who are physically inactive as for those who are active (i.e., exercise for 20 minutes 3 times a week). Both smoking and obesity increase a person's risk of developing coronary heart disease; in fact, smokers are two to three times more likely to developing heart disease than non-smokers. The relationship of smoking to cancer and lung disease is well recognized. Cerebrovascular disease is closely related to hypertension, and smoking also affects the health of the blood vessels of the brain. The use of alcohol and the non-use of safety belts are often associated with unintentional injury.

A common characteristic of all the factors in Table 10 is that they can be modified. Community programs designed to bring about or assist individuals with changing these factors are increasingly common. A reduction in the number of people with these risk factors could be expected to have a positive affect on individual and community health. Bringing about such a change is an appropriate consideration for health care planners.


These indicators suggest that Ottawa County is an area where the health risks are somewhat lower than the health risks in the state as a whole. The health risks present are to a great extent those associated with an aging population. Behaviors which have a significant influence on health risks are amenable to modification. Designing programs to modify these behaviors offer health and human services planners one of the best opportunities.