McLennan Community Health Assessment Project

McLennan County
Community Health
Assessment 2016
Executive Summary

2016 MCLENNAN COUNTY
COMMUNITY HEALTH ASSESMENT
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EXECUTIVE SUMMARY
1. Table of Contents
Map of Waco-McLennan County Regions……………………………………………3
Community Health Assessment Overview……………………………………………4
Summary of Findings……………………………………………………………………5
Health Ranking Summary tables and interpretation…………………………………6
Community profile………………………………………………………………………. 7
Social Determinants of Health………………………………………………………… 8
Leading causes of Death Tables and interpretation…………………………………9-11
Health Disparities………………………………………………………………………12-14
Behaviors and Lifestyles associated with Area……………………………………...15
Recommendations to address disparities……………………………………………16
Sources…………………………………………………………………………………..17

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EXECUTIVE SUMMARY
Map of Waco-McLennan County Regions

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EXECUTIVE SUMMARY
2. Overview
Purpose
The McLennan County’s goal is to assess the community’s health and risk
factors, and to identify access to care issues. Improving health for the county
consists of learning to promote, prevent, and protect. This is important so that the
community has a better living, working, and playing area. Other counties have
different health issues and it is important to make it a better place to live in by
addressing:
 Health issues
 Economic issues
 Uninsured issues
 Lifestyle problems
 Socioeconomic status issues
 Physical Environment
 Leading causes of death
History
 Located in Edward Plateau in Central Texas.
 Home of Baylor University
 Created by the Texas Legislature in 1850 and it is known as “Waco
Village”
 The Baptist and Methodist churches were among the earliest to be
organized in the county.

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EXECUTIVE SUMMARY
Summary Findings
Access & Affordability
Approximately 15% of respondents remain uninsured. Race is a factor to why
someone had health insurance or not. Although people are uninsured in this area
they did not have a problem accessing a health professional in their area. Most
people in McLennan show to have a routine checkup making sure that there are
no health risks going on. Socioeconomic status is a major factor to why people
are uninsured. People that have a lower socioeconomic status have less access
to healthcare.
Wellness & Prevention
Only a small part of the population is health focused. Daily physical activity is
limited and people have bad eating habits. The reason to why many people are
not health focused in McLennan County is because of the lack of education
about healthy lifestyle choices.
Health Concerns & Risks
Obesity is a major concern that leads to other health problems that people in
McLennan county struggle with. Obesity leads to people having diabetes and
diabetes causes heart problems and high blood pressure.

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EXECUTIVE SUMMARY
Responded Being Overweight in their Household
The table below shows “The Community Health Status Indicators” that determine
the ranks of each county according to the Centers for Disease Control and
Prevention (CDC). Each of these indicators can potentially affect the overall
health of the community, either positively or negatively. In the “Areas Thriving,”
each indicator has a positive effect on the community, such as having low rates
of adults smoking and longer life expectancies in male and females. The “Areas
That Needs Help” and “Areas That Need Attention” can have a negative effect on
the overall health of the community, like the number of citizens uninsured and the
amount of adult binge drinking.
Health Ranking Summary Table
Areas Thriving
Areas That Needs
Help
Areas That Need
Attention
Morality
 Chronic lower
respiratory disease
(CLRD) deaths
 Female life expectancy
 Male life expectancy
 Unintentional injury
(including motor
vehicle)
 Alzheimer’s disease
deaths
 Cancer deaths
 Chronic kidney disease
deaths
 Coronary heart disease
 Diabetes deaths
 Motor vehicle deaths
Morbidity  Syphilis  Adult diabetes
 Adult obesity
 Adult overall health

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EXECUTIVE SUMMARY
 Cancer
 HIV
 Older adult asthma
 Older adult depression
 Preterm births
 Alzheimer’s
diseases/dementia
 Gonorrhea
Health Care
Access & Quality
 Older adult preventable
hospitalizations
 Primary care provider
access
 Cost barrier to care
 Uninsured
Health Behaviors
 Adult smoking  Adult binge drinking
 Adult female routine
pap test
 Adult physical inactivity
 Teen births
Social Factors
 On time high school
graduation
 Children in single-
parent households
 Poverty
 Unemployment
 Violent crime
 High housing cost
 Inadequate social support
Physical
Environment
 Access to parks  Annual average PM2.5
concentration
 Living near highways
 Housing stress
 Limited access to healthy
food
Source: Centers for Disease Control and Prevention,2016
3. Community Profile
Population Distribution
In 2011 In 2016 Trend
Population 233,378 243,441 Increase
% below 18 25.6% 24.8% Decrease
% between 18 and 65 62.2% 61.8% Decrease
% 65 and older 12.2% 13.4% Increase
% Female 51.1% 51.2% Increase
% Male 48.9 48.8% Decrease
% not proficient in
English
7.9% 4% Decrease
% Rural 24.9% 23.4% Decrease
 This chart shows the demographic of McLennan county from 2011 to 2016.
Of the population distribution, above there has been an increase in the
population, an 1.2% increase of the elderly population, and an .1% increase

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EXECUTIVE SUMMARY
in the female population. The most significant decrease on this table is the
number of persons not proficient in English by 3.9%.
Ethnic Diversity
In 2011 In 2016 Trend
% Non-Hispanic
African American
14.9% 14.2% Decrease
% American Indian
and Alaskan Native
0.6% 1.1% Increase
% Asian 1.5% 1.6% Increase
% Native Hawaiian/
Other Pacific Islander
0.1% 0.1% Same
% Hispanic 22.5% 25.2% Increase
% Non-Hispanic
White
60.4% 57.3% Decrease
 In the ethnic diversity table above, the most significant changes from 2011
to 2016 for McLennan county is the non-Hispanic whites by 3.1%, non-
Hispanic African American by a .7% decrease, and an increase in American
Indian population by.5%.
Social Determinants of Health
The number of citizens living in poverty in McLennan County 19.8%, compared to the
national median of 16.3%, meaning 48,201 persons live in low-income homes. The
number of adults reporting that they do not have adequate emotional fulfilment or feel

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EXECUTIVE SUMMARY
some type of social exclusion is 25%, compared to the national median of 19.6%.
McLennan county access to healthy food is 12.5% which is almost double compared the
national average of 6.2%. This means the low-income families or individuals do not live
close to a grocery store. These affected individuals have limited access to nutritional
foods, so fast food and other unhealthier options are a part of their diets. 33.7% of the
population in McLennan has high housing cost. Along with the high housing cost, the
percent of people having stress to their housing is 35.1, compared to the national
median of 28.1. This takes a toll on the mental and physical well-being of this county.
The on-time graduation rate for McLennan is 86.7%, which is on the better side
compared to the median range of 83.8. Unfortunately, the percent of adults 25 or older
that does not have a high school diploma is 18.2%, which probably contributes to the
number of persons living in poverty and incidences of violent crimes. The
unemployment rate is 6.1%. The median house-hold income is $43,000, which is lower
than the US that is $53,000. 55% of children in McLennan are eligible for free lunches at
school and 28% children in total live in poverty, which means the households of these
children have the potential to lack in adequate food resources. 20.8% of McLennan is in
poor health due to stresses like housing, employment, and the inability to afford health
care. This county does have public transit system in place that is three dollars per ride,
that can be expensive for families that have low income. Of the ones who drives, 82%
drive alone and 15% of those drivers must drive at least 30 minutes. 39% of the
population of McLennan lives within a half mile of a park, which is better than the US
median of 14%. 4.4% live near a highway and the air pollution is at 10.4 (ug/m3). 24.5%
of the county is uninsured and 22.8% who do not have insurance will not go to the
doctor due to cost which is around $9,016.
4. Leading Causes of Death
Rankings of McLennan compared to other counties.

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EXECUTIVE SUMMARY

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EXECUTIVE SUMMARY
Source: County Health Rankings & Roadmaps,2016
The tables above show the different rankings of McLennan compared to different
countries. In some circumstances the rankings of McLennan county are higher than
other counties. For example, the data shows that sexually transmitted infections are
higher in McLennan county.

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EXECUTIVE SUMMARY
The diagrams above show how there are gender, race, and ethnicity disparities in new
HIV infections. Which is a common disease in McLennan county.

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EXECUTIVE SUMMARY
5. Disparities
Health disparities affect health care and some groups are at higher risk. Health
disparities are caused by:
 Disturbances
 Making policies
 Lifestyle (the number one cause of health disparities in the U.S.
 Socioeconomic status
 Education
 Where you live
 Lower socioeconomic people
How to eliminate health disparities:
 Ensure strategies in communities at lower risk and lower health care.
 Reduce differences and access to quality healthcare.
 Increase the capacity of the prevention workforce to identify and address
disparities.
 Support research
 Collect data to better identify and address disparities.

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EXECUTIVE SUMMARY
Adult Obesity
Adult Obesity is the percentage of those with the age of 20 and older that have a body
mass index greater than or equal to 30 kg/m². Obesity is the result of poor diet and
limited physical activity. Obesity can be the leading cause of other health risks such as
heart disease, cancer and many others.

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EXECUTIVE SUMMARY
Adult Smoking
Source: Centers for Disease Control and Prevention,2016
Adult smoking is the percentage of the adult population that has smoked at least 100
cigarettes in their lifetime. Adult smoking is also the leading cause of premature deaths
in McLennan. Each year about 443,000 premature deaths occur due to adult smoking.
Different diseases are also caused by cigarette smoking. For example, different
cancers, cardiovascular disease, respiratory disease, and different respiratory
conditions.

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EXECUTIVE SUMMARY
Gonorrhea
McLennan county is founded in Waco, Texas which is home to Baylor University.
Sexual transmitted infections are mostly common in young adults. McLennan county
has a high rank of sexual transmitted infections and one of them is Gonorrhea.
Gonorrhea is a bacterial infection that can be founded in the genitals, rectum, and
throat. This is a major health concern in McLennan county.

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EXECUTIVE SUMMARY
HSDA stands for Health Service Delivery Area and targets HIV case management
programs in McLennan county but also in other parts of Texas. The diagram above
shows how 74% of people living in McLennan county with HIV where retained in care and
treatment. The program was more effective at a county level than a state level.
6. Health Behaviors and Lifestyle
The health behaviors and lifestyle of any community is important to give some attention
to because personal choices that are made can contribute to the overall health of the
community. Some of those health behaviors that affect McLennan County will be
discussed in this section will be: smoking, binge drinking, routine pap test, physical
inactivity, sexually transmitted infections, and teen births.
The amount of the adults that smoke in McLennan is about 21%, comparing this to the
national median of 21.7%, this isn’t bad nor good. Looking at the health profile from the
Texas Department of State Health Services, the death rates per 100,000 from lung
cancer and heart disease is 44.4 and 181.1 respectively. These rates are higher than
the state death rates of lung cancer and heart disease, 38.4 and 170. Smoking may not
be the direct cause of these deaths, but it is a strong contributing factor.
The amount of binge drinking alcohol, including underage, at about 13 percent. This
lower than the US median of 16.3 percent, but this stands as a moderate problem. Per
County Rankings, 32% of driving death was associated with alcohol impaired driving. In
a county where there is a college, risky behaviors are escalated due to an “youth
invincibility” complex.
Along with this “youth invincibility” complex is sexually transmitted diseases and teen
births. Chlamydia has an incidence rate of 637.7 per 100,00, when the national rate is

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EXECUTIVE SUMMARY
473.1. The rate of new cases of gonorrhea is 220.7 which almost doubled the national
rate of 125.2. The amount of teen births compared to the total births in McLennan is
3.4%. This is .2% higher than the rate of Texas. These rates are high due to the lack of
sex education and individuals having unprotected sex.
75.7 percent of adult females’ report having routine pap test within the last three years.
This is not too far behind the US median of 77.3 percent, but this is an area where the
county can improve by promoting early screenings for potential disease.
Physical inactivity in McLennan county is at 27.6%. This mean that 66,459 people do
not engage in physical activity outside of work or errands. This could be due to people
feeling exhausted after work and poor food choices can lead to lethargy, making
physical activity unattractive. Inactivity could contribute to the amount of deaths due to
diabetes, heart disease, and strokes.
7. Recommendations to Address Disparities
To address and to improve these disparities is mainly education and community
involvement. McLennan county has Baylor University, but not everyone in this county
goes to college. The towns in these counties are molded around college students. The
focus should shift from the college students to the residents of McLennan county. As
stated earlier, the rate of persons without a high school diploma over the age of 25 is
18.2%. This number can come down if getting a GED is promoted, this could also
reduce the amount of unemployment.
Programs should be implemented on the education of nutrition. This program can have
a rewards system. For example, the community centers in McLennan county can
provide classes on nutrition and exercise to combat obesity. The reward for the citizens
taking these classes can be a discount of fresh fruit and vegetables at local participating
grocers.

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EXECUTIVE SUMMARY
8. Sources
“Community Health Needs Assessment - Waco-texas.com." N.p., n.d. Web. 20 Nov.
2016.
"6. Environmental Health - Waco, Texas." N.p., n.d. Web. 20 Nov. 2016.
http://www.waco-texas.com/userfiles/cms-healthdepartment/file/AR2015final2.pdf
http://www.countyhealthrankings.org/app/texas/2014/overview
http://wwwn.cdc.gov/CommunityHealth/homepage.aspx?j=1
https://www.dshs.state.tx.us/chs/datalist.shtm
http://phpartners.org/health_stats.html
http://www.healthindicators.gov/Indicators/Selection
https://www.healthdata.gov/

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