2017 - dayton children's hospital children...funding for the 2017 dayton children’s community...

community health needs assessment2017

Foreword|1

Foreword

DaytonChildren’smissionistoimprovethehealthstatusofallchildreninourregion.Thiscommunityhealthassessmentprovidesuswithasnapshotofchildren’shealthintheGreaterDaytonArea,aswellasourstateandnationsowehaveactionabledatatomovechildren’shealthforward.With20percentofachild’shealthdeterminedbyhisorherenvironmentand40percentdeterminedbybehavior–thereisagreatneedtoensurechildrenhavehealthyandsafeplacestolive,learn,andplay.Thedatapresentedinthisreportprovidevaluableinformationtodevelopstrategiesthatfocusonwellness,accesstocare,andunmetcommunityneeds–elementsimpactingchildren’shealthbeyondthewallsofahospital.Theseinsightsenableourcommunitytoidentifytopareasofconcernandtodeveloporrefineprogramstohelpchildrenthrive.FundedbytheDaytonChildren’sFoundationBoard,thecommunityhealthassessmentisbeingconductedforthefifthtime.Itcomplieswithhealthcarereformrequirementsandprovidesvaluableinsighttodevelopfuturehealthcareprogrammingforchildren.ThroughcollaborationwithTheHospitalCouncilofNorthwestOhioandpublichealthresearchersatTheUniversityofToledo,everyefforthasbeenmadetoassurethatthisreportcontainsvalidandreliabledata.Wethankourmanycommunitypartnerswhoparticipatedintheassessmentandplanningprocess.Partnerscamefromthefivecountiesinourprimaryserviceareaandrepresentedpublichealthdepartments,child‐servingorganizationsandsocialserviceproviders.Wealsothankthehundredsofparentswhotookthetimetocompletetheassessmentastheyarethecriticalvoicefortheirchildren.Itisourhopethatthisassessmentwillfosternewcollaborativeopportunitiesandinitiatequalityprogramstoimprovethelivesofchildreninourregion.Thisassessmenthelpslaythegroundworkforinvestmentsinourcommunity’smostpreciousresource–ourchildren.Sincerely,DeborahA.FeldmanPresidentandCEODaytonChildren’sHospital

Acknowledgements|2

Acknowledgements

Funding for the 2017 Dayton Children’s Community Health Needs Assessment was provided by:

DaytonChildren’sHospitalFoundationBoard

Input Provided by Community Partners:

ClarkCountyCombinedHealthDistrictECHO(EmpoweringChildrenwithHopeandOpportunity)attheUniversityofDayton

GreeneCountyPublicHealthCommunityHealthCentersofGreaterDayton

HealthyCommunitiesConsulting,LLCLearntoEarnDayton

MiamiCountyPublicHealthMiamiValleyChildDevelopmentCenters

MiamiValleyRegionalPlanningCommissionMontgomeryCountyADAMHSBoard

MontgomeryCountyHealthandHumanServicesMontgomeryCountyJobandFamilyServices–ChildrenServiceDivision

PublicHealth‐Dayton&MontgomeryCountySinclairCommunityCollege,DivisionofHealthSciences

UnitedWayofGreaterDaytonWarrenCountyHealthDistrict

WrightStateUniversityDepartmentofPediatricsWrightStateUniversityDepartmentofPopulation&PublicHealthSciences

Contact Information

JessicaSaundersDirector,CenterforChildHealthandWellness

DaytonChildren'sHospitalOneChildren'sPlaza

Dayton,Ohio45404‐1815937‐641‐3385

[email protected]

Acknowledgements|3

Project Management, Secondary Data, Data Collection, and Report Development

Data Collection & Analysis

JosephA.Dake,Ph.D.,MPHProfessorandChairSchoolofPopulationHealthUniversityofToledo

To see Greater Dayton Area data compared to other counties, please visit the Hospital Council of Northwest Ohio’s Data Link website at:

http://www.hcno.org/community/data‐indicator.html

The 2017 Dayton Children’s Community Health Needs Assessment is available on the following websites:

DaytonChildren’sHospitalhttps://www.childrensdayton.org/

HospitalCouncilofNorthwestOhio

http://www.hcno.org/community/reports.html

BritneyL.Ward,MPHDirectorofCommunityHealthImprovement

MargaretWielinski,MPH AssistantDirectorofCommunityHealthImprovement

SelenaColey,MPHCommunityHealthImprovementCoordinator

EmilyA.Golias,MPH,CHESCommunityHealthImprovementCoordinator

TessaElliott,MPH,CHESCommunityHealthImprovementCoordinator

EmilyStearns,MPH,CHESCommunityHealthImprovementCoordinator

DerickSekyere,MPHGraduateAssistant

RachelHoecherlGraduateAssistant

BroghanGasserUndergraduateAssistant

TableofContents|4

Table of Contents

ExecutiveSummary Pages5‐7TrendSummary Pages8‐9

CHILD HEALTH

HealthandFunctionalStatus Pages10‐13HealthCareAccess Pages14‐18EarlyChildhood(0to5Years) Pages19‐23MiddleChildhood(6‐11Years) Pages24‐25FamilyandCommunityCharacteristics Pages26‐32ParentHealth Pages 33‐34

APPENDICES

AppendixI—HealthAssessmentInformationSources Page35AppendixII—AcronymsandTerms Page36AppendixIII—SampleDemographicProfile Pages37AppendixIV—DemographicsandHouseholdInformation Pages38‐44

ExecutiveSummary|5

Executive Summary

Thisexecutivesummaryprovidesanoverviewofhealth‐relateddataforchildren(ages0to11)intheGreaterDaytonAreawhoseparentsparticipatedinaregionalhealthassessmentsurveyduringJanuary‐March2017.Thefindingsarebasedonself‐administeredsurveysusingastructuredquestionnaire.ThequestionsweremodeledafterthesurveyinstrumentsusedbytheNationalSurveyofChildren’sHealth(NSCH)developedbytheChildandAdolescentHealthMeasurementInitiative.TheHospitalCouncilofNorthwestOhiocollectedthedata,guidedthehealthassessmentprocess,andintegratedsourcesofprimaryandsecondarydataintothefinalreport.

Primary Data Collection Methods

DESIGN

Thiscommunityhealthassessmentwascross‐sectionalinnatureandincludedawrittensurveyofparentswithintheGreaterDaytonArea.Fromthebeginning,communityleaderswereactivelyengagedintheplanningprocessandhelpeddefinethecontent,scope,andsequenceofthestudy.Activeengagementofcommunitymembersthroughouttheplanningprocessisregardedasanimportantstepincompletingavalidneedsassessment.

INSTRUMENT DEVELOPMENT

Onesurveyinstrumentwasdesignedandpilottestedforthisstudyforparentsofchildrenages0to11.Asafirststepinthedesignprocess,healtheducationresearchersfromtheUniversityofToledoandstaffmembersfromtheHospitalCouncilofNorthwestOhiomettodiscusspotentialsourcesofvalidandreliablesurveyitemsthatwouldbeappropriateforassessingthehealthstatusandhealthneedsofchildrenages0to11yearsold.ThemajorityofthesurveyitemswerederivedfromtheNSCH.Thisdecisionwasbasedontheabilitytocomparelocaldatawithstateandnationaldata.TheProjectCoordinatorfromtheHospitalCouncilofNorthwestOhioconductedaseriesofmeetingswiththeplanningcommitteefromtheGreaterDaytonArea.Duringthesemeetings,abankofpotentialsurveyquestionsfromtheNSCHsurveywasreviewedanddiscussed.Basedoninputfromtheplanningcommittee,theProjectCoordinatorcomposedadraftofthesurveycontaining89items.ThedraftwasreviewedandapprovedbyhealtheducationresearchersattheUniversityofToledo.

SAMPLING | 0 TO 11 SURVEY

Childrenages0to11residingintheGreaterDaytonAreawereusedasthesamplingframesforthesurveys.UsingU.S.CensusBureaudata,itwasdeterminedthat158,909childrenages0to11resideintheGreaterDaytonArea(92zipcodesinMontgomery,Miami,Greene,Clark,andWarrencounties).Theinvestigatorsconductedapoweranalysisbasedonapost‐hocdistributionofvariationinresponses(70/30split)todeterminewhatsamplesizewasneededtoensurea95%confidencelevelwithacorrespondingconfidenceintervalof5%(i.e.,wecanbe95%surethatthe“true”populationresponsesarewithina5%marginoferror).ThesamplesizerequiredtogeneralizetoallGreaterDaytonAreachildrenages0to11was383.TherandomsampleofmailingaddresseswasobtainedfromMelissaDataCorporationinRanchoSantaMargarita,California.

PROCEDURE | CHILDREN 0 TO 5 AND 6‐11

Priortomailingthesurveytoparents,anadvanceletterwasmailedto3,600parentsintheGreaterDaytonArea.Thisadvanceletterwaspersonalized,printedonDaytonChildren’sletterheadandwassignedbyDeborahA.Feldman,PresidentandCEOofDaytonChildren’s.Theletterintroducedthehealthassessmentprojectandinformedthereadersthattheymayberandomlyselectedtoreceivethesurvey.Theletteralsoexplainedthattherespondents’confidentialitywouldbeprotectedandencouragedthereaderstocompleteandreturnthesurveypromptlyiftheywereselected.

ExecutiveSummary|6

Threeweeksfollowingtheadvanceletter,athree‐wavemailingprocedurewasimplementedtomaximizethesurveyreturnrate.Theinitialmailingincludedapersonalizedhandsignedcoverletter(onDaytonChildren’sletterhead)describingthepurposeofthestudy;aquestionnaire;aself‐addressedstampedreturnenvelope;anda$2incentive.Approximatelythreeweeksafterthefirstmailing,asecondwavemailingincludedanotherpersonalizedcoverletterencouragingthemtoreply,anothercopyofthequestionnaire,andanotherreplyenvelope.Athirdwavepostcardwassentthreeweeksafterthesecondwavemailing.Surveysreturnedasundeliverablewerenotreplacedwithanotherpotentialrespondent.Theresponseratewas13%(n=393:CI=±4.94).

DATA ANALYSIS

Individualresponseswereanonymousandconfidential.Onlygroupdataareavailable.AlldatawereanalyzedbyhealtheducationresearchersattheUniversityofToledousingSPSS21.0.Crosstabswereusedtocalculatedescriptivestatisticsforthedatapresentedinthisreport.

LIMITATIONS

Aswithallhealthassessments,itisimportanttoconsiderthefindingsinthecontextofallpossiblelimitations.First,ifanyimportantdifferencesexistedbetweentherespondentsandthenon‐respondentsregardingthequestionsasked,thiswouldrepresentathreattotheexternalvalidityoftheresults(thegeneralizabilityoftheresultstothepopulation).Iftherewerelittletonodifferencebetweenrespondentsandnon‐respondents,thenthiswouldnotbealimitation.Second,itisimportanttonotethat,althoughseveralquestionswereaskedusingthesamewordingastheNSCHquestionnaire,theparentdatacollectionmethoddiffered.NSCHchilddatawerecollectedusingasetofquestionsfromthetotalquestionbankandparentswereaskedthequestionsoverthetelephoneratherthanasamailsurvey.Finally,thissurveyaskedparentsquestionsregardingtheiryoungchildren.Shouldenoughparentsfeelcompelledtorespondinasociallydesirablemannerwhichisnotconsistentwithreality,thiswouldrepresentathreattotheinternalvalidityoftheresults.

ExecutiveSummary|7

Data Summary | Child Health

HEALTH AND FUNCTIONAL STATUS

In2017,50%ofchildrenages0to11wereclassifiedasoverweight(14%)orobese(36%)byBodyMassIndex(BMI)calculations.One‐in‐eleven(9%)parentsreportedtheirchildhadbeendiagnosedwithasthma.Eightpercent(8%)ofparentsreportedtheirchildhadbeendiagnosedwithADD/ADHD.

HEALTH CARE ACCESS In2017,1%ofGreaterDaytonAreaparentsreportedthattheir0to11yearoldchilddidnothavehealthinsurance.Nineoutoften(90%)childrenhadreceivedalltheirrecommendedvaccinations.Morethanhalf(55%)ofchildrenreceivedtheseasonalfluvaccineinthepastyear.

EARLY CHILDHOOD (AGES 0 TO 5)

Thefollowinginformationwasreportedbyparentsof0to5yearolds.Eighty‐ninepercent(89%)ofmothersrecievedprenatalcarewithinthefirstthreemonthsduringtheirlastpregnancy.One‐in‐eleven(9%)motherssmokedorusedtobaccoproductsduringtheirlastpregnancy.Morethanfour‐fifths(86%)ofparentsputtheirchildtosleeponhis/herback.Almostone‐third(30%)ofmothersneverbreastfedtheirchild.

MIDDLE CHILDHOOD (AGES 6 TO 11)

ThefollowinginformationwasreportedbyGreaterDaytonAreaparentsof6to11yearolds.Aboutfour‐fifths(81%)ofparentsreportedtheyfelttheirchildwasalwayssafeatschool.Morethantwo‐fifths(43%)ofparentsreportedtheirchildwasbulliedatsometimeinthepastyear.Eighty‐onepercent(81%)ofparentsreportedtheirchildparticipatedinextracurricularactivities.

FAMILY AND COMMUNITY CHARACTERISTICS

Ninety‐fourpercent(94%)ofparentsreportedtheirneighborhoodwasalwaysorusuallysafe.One‐in‐nine(11%)parentsreportedtheyreceivedbenefitsfromtheSNAP/foodstampsprogram.Thirteenpercent(13%)ofparentsexperiencedfoodinsecurity.

PARENT HEALTH

In2017,18%ofGreaterDaytonAreaparentswereuninsured.Seventeenpercent(17%)ratedtheirmentalandemotionalhealthasfairorpoor.

TrendSummary|8

Child Trend Summary

Child Comparisons

Dayton Ages 0 to 5(n=54)

Outside of Dayton

Ages 0 to 5(n=66)

Greater Dayton

Area 2017Ages 0 to 5

Ohio 2011/12Ages 0 to 5

U.S. 2011/12Ages 0 to 5

Dayton Ages 6‐11 (n=77)

Outside of Dayton Ages 6‐11 (n=157)

Greater Dayton

Area 2017Ages 6‐11

Ohio 2011/12Ages 6‐11

U.S. 2011/12 Ages 6‐11

Health and Functional Status Ratedhealthasexcellentorverygood 87% 97% 93% 89% 86% 96% 94% 95% 86% 83%

Bornpremature(3ormoreweeksbeforeduedate)

4% 17% 11% 12% 13% 13% 10% 11% 11% 12%

Diagnosedwithasthma 9% 5% 7% 6% 6% 9% 11% 10% 10% 10%DiagnosedwithADHD/ADD 4% 3% 4% N/A 2%* 12% 9% 10% 12% 9%Diagnosedwithbehavioralorconductproblems

4% 6% 6% N/A 2%* 3% 5% 4% 5% 4%

Diagnosedwithbone,joint,ormuscleproblems

6% 5% 5% N/A 1% 3% 2% 2% N/A 2%

Diagnosedwithepilepsy 6% 5% 5% N/A <1% 1% 1% 1% N/A 1%Diagnosedwithaheadinjury 4% 3% 4% N/A <1% 1% 4% 3% N/A <1%Diagnosedwithdiabetes 2% 2% 2% N/A N/A 0% 0% 0% N/A <1%Diagnosedwithdepression 2% 2% 2% N/A <1%* 1% 1% 1% N/A 2%

Healthcare Access Hadpublicinsurance 35% 24% 30% 40% 44% 17% 13% 15% 34% 37%Beentodoctorforpreventivecareinpastyear 96% 95% 96% 94% 90% 87% 82% 83% 86% 82%

Receivedallthemedicalcaretheyneeded 96% 92% 93% 99%** 99%** 99% 97% 98% 98%** 98%**

Dentalcarevisitinpastyear 56% 45% 49% 50% 54% 92% 94% 94% 92% 88%Early Childhood (Ages 0 to 5)

Neverbreastfedtheirchild 32% 29% 30% 29% 21% N/A N/A N/A N/A N/AParentreadstochildeveryday 32% 38% 35% 53% 48% N/A N/A N/A N/A N/AN/A–Notavailable*Ages2‐5yearold,**2003nationalandstatedata

TrendSummary|9

Child Comparisons


Outside of Dayton

Ages 0 to 5(n=66)

Greater Dayton

Area 2017Ages 0 to 5


U.S. 2011/12Ages 0 to 5

Dayton Ages 6‐11 (n=77)

Outside of Dayton Ages 6‐11 (n=157)

Greater Dayton

Area 2017Ages 6‐11

Ohio 2011/12Ages 6‐11

U.S. 2011/12 Ages 6‐11

Middle Childhood (Ages 6‐11) Childdidnotmissanydaysofschoolbecauseofillnessorinjury N/A N/A N/A N/A N/A 8% 16% 13% 18% 22%

Childmissedschool11daysormorebecauseofillnessorinjury N/A N/A N/A N/A N/A 3% 2% 2% 7% 5%

Parentfeltchildwasusually/alwayssafeatschool N/A N/A N/A N/A N/A 97% 97% 98% 96% 94%

Family Functioning Familyeatsamealtogethereverydayoftheweek 54% 46% 49% 63% 61% 31% 37% 35% 45% 47%

Childneverattendsreligiousservices 43% 49% 47% N/A N/A 34% 31% 32% 22% 18%

Neighborhoodisusuallyoralwayssafe

83% 94% 89% 88% 86% 92% 99% 97% 86% 86%

Childhad2ormoreadversechildhoodexperiences

9% 6% 7% 23% 26% 13% 7% 9% 23% 26%

Parent Health Mother’smentaloremotionalhealthisfair/poor N/A N/A 19% 7% 7% N/A N/A 13% 10% 8%

Father’smentaloremotionalhealthisfair/poor N/A N/A 11% N/A 3% N/A N/A 19% 7% 5%

N/A–Notavailable

HealthandFunctionalStatus|10

Health and Functional Status

Key Findings In2017,50%ofchildrenages0to11wereclassifiedasoverweight(14%)orobese(36%)byBodyMassIndex(BMI)calculations.One‐in‐eleven(9%)parentsreportedtheirchildhadbeendiagnosedwithasthma.Eightpercent(8%)ofparentsreportedtheirchildhadbeendiagnosedwithADD/ADHD.General Health Status

In2017,94%ofGreaterDaytonAreaparentsratedtheirchild’shealthasexcellentorverygood.Sixpercent(6%)ofparentsratedtheirchild’shealthasfair.

Oneoutofnine(11%)parentsreportedtheirchildwasbornpremature,increasingto21%ofAfricanAmericanparents(Note:PleaseuseAfricanAmericandatawithcautionduetoasmallsamplesizewithinthatparticulardemographic).

Parentsreportedtheirchildslept:7hoursorlesspernight(11%);8hourspernight(22%);9hourspernight(31%);10hourspernight(29%);and11hoursormorepernight(8%).

Weight Status and Nutrition

Overone‐third(36%)ofchildrenwereclassifiedasobesebyBodyMassIndex(BMI)calculations;14%ofchildrenwereclassifiedasoverweight;44%werenormalweight;and6%wereunderweight.

Childrenatefruit:4ormoretimesperday(5%);2to3timesperday(45%);onceperday(21%);4to6timesduringthepastweek(15%);and1to3timesduringthepastweek(13%).Twopercent(2%)ofparentsreportedthattheirchilddidnoteatfruit.

Childrenatevegetables:4ormoretimesperday(3%);2to3timesperday(42%);onceperday(25%);4to6timesduringthepastweek(14%);and1to3timesduringthepastweek(12%).Fourpercent(4%)ofparentsreportedthattheirchilddidnoteatvegetables.

Childrendranksodaorpop:4ormoretimesperday(<1%);2to3timesperday(<1%);onceperday(2%);4to6timesduringthepastweek(4%);and1to3timesduringthepastweek(34%).Sixtypercent(60%)ofparentsreportedthattheirchilddidnotdrinksodaorpop.

Childrenatethefollowingforbreakfast:cereal(76%),milk(64%),eggs(42%),toast(39%),fruit(36%),yogurt(33%),bacon/ham/sausage(28%),oatmeal(28%),PopTart/donut/pastry(26%),fruitjuice(18%),breastmilk(3%),formula(3%),pizza(1%),candy(<1%),andother(8%).One‐in‐eleven(9%)childrenateattheschoolbreakfastprogram.Threepercent(3%)ofchildrenatenothingforbreakfast.

Childrenspentanaverageof1.9hourswatchingTV,1.2hoursreading,0.8hoursplayingvideogames,and0.8hoursonthecomputer/tabletonanaveragedayoftheweek.

36%

14%

44%

6%

2017 Greater Dayton Area Child BMI

Obese Overweight Normal Underweight


Health Conditions

Parentsreportedtheirchildrenhadthefollowingallergies:environmentalallergies(19%),medicineallergies(11%),animalallergies(8%),milk(3%),peanuts(2%),reddye(2%),eggs(1%),bees(1%),gluten(<1%),wheat(<1%),soy(<1%),otherfoodallergies(4%),andother(1%).Ofthosewithallergies,3%hadanEpi‐pen.

Approximatelyone‐third(34%)ofparentsreportedtheirchildhadbeentestedforleadpoisoning,increasingto44%ofchildrenenrolledinapublicinsuranceprogramsuchasMedicaid.Onepercent(1%)ofparentsreportedtheirchildwastested,levelswereelevated,andmedicalfollow‐upwasneeded.Overhalf(52%)ofparentshadnothadtheirchildtestedforleadpoisoning,and13%didnotknow.

GreaterDaytonAreaparentsweretoldbyadoctorthattheirchildhadthefollowingconditions:

Nearlyone‐in‐five(19%)childrenhadmorethanonetypeofhealthcondition.

Ofchildrendiagnosedwithautism/ASDorDevelopmentalDelay,9%hadreceivedtherapyservicestomeethisorherdevelopmentalneeds,suchasearlyintervention,occupationaltherapy,orbehavioraltherapy.

Sixpercent(6%)ofparentsreportedtheirchildhadanasthmaattackinthepastyear.

— Developmentaldelay/physicalimpairment(11%) — Hearingproblems(3%)

— Asthma(9%) — Autism(3%)

— ADD/ADHD(8%) — Epilepsy(3%)

— Anxietyproblems(7%) — Intellectualdisability/mentalretardation(2%)

— Learningdisability(7%) — Geneticdisease(2%)

— Pneumonia(7%) — Digestivetractinfections(2%)

— Urinarytractinfection(5%) — Cerebralpalsy(2%)

— Behavioral/conductproblem(5%) — Appendicitis(1%)

— Birthdefect(4%) — Depressionproblems(1%)

— Headinjury(3%) — Diabetes(1%)

— Bone/joint/muscleproblems(3%)


Asthma

ThefollowinggraphshowsthattheGreaterDaytonAreahadaslightlyhigherpercentageofchildrenages0to5whowerediagnosedwithasthmathanbothOhioandtheU.S.

Sources:NationalSurveyofChildren’sHealthand2017DaytonChildren’sCommunityHealthNeedsAssessment

Behavioral and Emotional Health

Aboutone‐in‐eight(13%)parentsreportedtheirchildhadanemotional,developmental,orbehavioralproblemforwhichtheyneededtreatmentorcounseling.

Childrenhaddifficultiesinthefollowingareas:concentration(11%),emotions(11%),behavior(9%),andbeingabletogetalongwithpeople(2%).

Parentsreportedthatdifficultiesweremanagedinthefollowingways:familyandfriendstookcareofit(32%);professionalhelp(29%);school/daycare(24%),andin‐homecare(1%).Forty‐sevenpercent(47%)saidtheydidnotneedhelpmanagingdifficulties.

7%

10%

6%

10%

6%

10%

0%

5%

10%

15%

Ages 0‐5 Ages 6‐11

Children Diagnosed with Asthma

Greater Dayton Area 2017 Ohio 2011/12 U.S. 2011/12


Child Comparisons

Dayton Ages 0 to 5 (n=54)

Outside of Dayton

Ages 0 to 5 (n=66)

Greater Dayton Area

2017 Ages 0 to 5

Ohio 2011/12 Ages 0 to 5

U.S. 2011/12 Ages 0 to 5

Ratedhealthasexcellentorverygood 87% 97% 93% 89% 86%Bornpremature(3ormoreweeksbeforeduedate) 4% 17% 11% 12% 13%

Diagnosedwithasthma 9% 5% 7% 6% 6%DiagnosedwithADHD/ADD 4% 3% 4% N/A 2%*Diagnosedwithbehavioralorconductproblems 4% 6% 6% N/A 2%*


6% 5% 5% N/A 1%

Diagnosedwithepilepsy 6% 5% 5% N/A <1%Diagnosedwithaheadinjury 4% 3% 4% N/A <1%Diagnosedwithdiabetes 2% 2% 2% N/A N/ADiagnosedwithdepression 2% 2% 2% N/A <1%*N/A–Notavailable*Ages2‐5yearold

Child Comparisons


Outside of Dayton

Ages 6 to 11 (n=157)

Greater Dayton Area

2017 Ages 6 to 11


U.S. 2011/12 Ages 6 to 11

Ratedhealthasexcellentorverygood

96% 94% 95% 86% 83%

Bornpremature(3ormoreweeksbeforeduedate)

13% 10% 11% 11% 12%

Diagnosedwithasthma 9% 11% 10% 10% 10%DiagnosedwithADHD/ADD 12% 9% 10% 12% 9%Diagnosedwithbehavioralorconductproblems

3% 5% 4% 5% 4%


3% 2% 2% N/A 2%

Diagnosedwithepilepsy 1% 1% 1% N/A 1%Diagnosedwithaheadinjury 1% 4% 3% N/A <1%Diagnosedwithdiabetes 0% 0% 0% N/A <1%Diagnosedwithdepression 1% 1% 1% N/A 2%N/A–Notavailable

HealthCareAccess|14

Health Care Access

Key Findings

In2017,1%ofGreaterDaytonAreaparentsreportedthattheir0to11yearoldchilddidnothavehealthinsurance.Nineoutoften(90%)childrenhadreceivedalltheirrecommendedvaccinations.Morethanhalf(55%)ofchildrenreceivedtheseasonalfluvaccineinthepastyear.

Health Insurance

1%ofparentsintheGreaterDaytonAreareportedthattheirchilddidnotcurrentlyhavehealthinsurance.

Childrenhadthefollowingtypesofhealthinsurance:parent’semployer(50%);someoneelse’semployer(21%);Medicaidorotherpublichealthbenefits(15%);self‐paid(4%);Tri‐care(3%);Medicare(2%);InsuranceMarketplace(1%);orsomeothersourceofinsurance(1%).

Parentsreportedtheirchild’shealthinsurancecoveredthefollowing:doctorvisits(98%),prescriptioncoverage(97%),wellvisits(97%),immunizations(97%),hospitalstays(96%),dental(90%),vision(80%),mentalhealth(78%)andtherapies(69%).

Access and Utilization

Ninety‐sixpercent(96%)ofchidrenreceivedallthemedicalcaretheyneededinthepastyear.

Parentsreportedtheirchilddidnotgetallofthemedicalcaretheyneededinthepastyearforthefollowingreasons:cost(3%);noreferral(2%);inconvenienttimes/couldnotgetanappointment(1%);toolongofawaitforanappointment(1%);healthplanproblem(1%);notavailableinarea/transportationproblems(1%);dissatisfiedwithdoctor(<1%);dissatisfiedwithofficestaff(<1%);specialistwerenotavailable(<1%);couldnotfindadoctorwhoacceptedchild’sinsurance(<1%);andotherreasons(4%).

Elevenpercent(11%)ofparentsreportedtheirfamilyhadproblemspayingorwereunabletopayanyoftheirchild’smedicalbills.

Fourpercent(4%)ofparentsreportedtheirchild’shealthsufferedbecauseofnotbeingabletoaffordthecostofanyneededcareinthepast12months,increasingto17%ofparentswithincomeslessthan$25,000.

Morethanhalf(55%)ofchildrenrecievedtheseasonalfluvaccineinthepastyear.

Nineoutoften(90%)childrenhadreceivedalloftheirrecommendedvaccinations.

Parentsreportedtheirchilddidnotgetalloftheirrecommendedvaccinationsforthefollowingreasons:childhadreceivedsome,butnotallrecommendedvaccinations(5%);parentschosetonotvaccinatetheirchild(4%);fearofnegativeeffects(2%);alternatevaccinationscheduleused(2%);religiousorculturalbeliefs(1%);doctoradvisedagainstvaccination(<1%);notsurewhicharereccomended(<1%);andotherreasons(2%).

Ninepercent(9%)ofGreaterDaytonAreachildrenreceivedmentalhealthcareorcounselinginthepastyear,increasingto17%ofthosewithincomeslessthan$25,000.

HealthCareAccess|15

Parentstooktheirchildtothehospitalemergencyroomforthefollowing:fever/cold/flu(12%);accidents,injuryorpoisoning(10%);earinfections(5%);doctortoldthemtogo(5%);brokenbones(3%);asthma(2%);mentalhealth(1%);dentalissue(1%);andothersickvisits(8%).

Fivepercent(5%)ofparentstooktheirchildtothehospitalemergencyroomforprimarycare,increasingto18%parentswithincomeslessthan$25,000.

Fivepercent(5%)ofparentsreportedhavingtransportationissues,increasingto28%ofparentswithincomeslessthat$25,000.Parentsreportedthefollowingtransportationissues:couldnotaffordgas(2%);nocar(1%);suspended/nodriver’slicense(1%);disabled(<1%);limitedpublictransportationavailableoraccessible(1%);nocarinsurance(1%);andothercarissues/expenses(4%)

Medical Home

Eighty‐sevenpercent(87%)ofparentsreportedtheyhadoneormorepeopletheythinkofastheirchild’spersonaldoctorornurse,decreasingto63%ofthosewithincomeslessthan$25,000.

Approximatelynineoutoften(88%)childrenhadvisitedtheirhealthcareproviderforpreventivecareinthepastyear,increasingto96%of0to5yearolds.

Nearlyall(98%)parentsreportedthattheirchildhadoneparticularplacetheyusuallywentiftheyweresickorneededadviceabouttheirhealth.Theyreportedthefollowingplaces:aprivatedoctor’soffice(87%);anurgentcarecenter(4%);acommunityhealthcenter(1%);ahealthdepartment(1%);ahospitalemergencyroom(1%);andsomeotherkindofplace(2%).Onepercent(1%)reportedmultipleplacesand2%didnotknow.

Childrenwerereferredandwenttothefollowingspecialists:ophthalmologist(eyedoctor)(23%);ear,nose,andthroat(ENT)doctor(22%);allergist(10%);dermatologist(skindoctor)(9%);psychiatrist/mentalhealthprovider(7%);cardiologist(heartdoctor)(6%);neurologist(braindoctor)(6%);developmentalpediatrician(5%);endocrinologist(kidneydoctor)(3%);oncologist(cancerdoctor)(1%);andotherspecialist(15%).

82%ofchildrenages2andolderhadbeentothedentistinthepastyear,increasingto94%of6to11yearolds.

Parentsgavethefollowingreasonsfornotgettingdentalcarefortheirchild:childwasnotoldenoughtogotothedentist(17%);cost(3%);couldnotfindadentistwhoacceptedthechild’sinsurance(2%);noinsurance(2%);noconvenienttimes/couldnotgetappointment(1%);didnotknowwheretogofortreatment(1%);healthplanproblem(1%);notavailableinarea/transportationproblems(<1%);missedanappointmentandnotallowedtogobacktotheclinic(<1%);dissatisfactionwithdentist(<1%);childrefusedtogo(<1%);andother(3%).

HealthCareAccess|16

Child Comparisons


Outside of Dayton

Ages 0 to 5 (n=66)

Greater Dayton Area

2017 Ages 0 to 5


U.S. 2011/12 Ages 0 to 5

Hadpublicinsurance 35% 24% 30% 40% 44%Beentodoctorforpreventivecareinpastyear 96% 95% 96% 94% 90%

Receivedallthemedicalcaretheyneeded

96% 92% 93% 99%* 99%*

Dentalcarevisitinpastyear 56% 45% 49% 50% 54%*2003stateandnationaldata

Child Comparisons

Dayton Ages 6 to 11

(n=77)

Outside of Dayton

Ages 6 to 11(n=157)

Greater Dayton Area

2017 Ages 6 to 11


U.S. 2011/12Ages 6 to 11

Hadpublicinsurance 17% 13% 15% 34% 37%Beentodoctorforpreventivecareinpastyear

87% 82% 83% 86% 82%

Receivedallthemedicalcaretheyneeded

99% 97% 98% 98%* 98%*

Dentalcarevisitinpastyear 92% 94% 94% 92% 88%*2003stateandnationaldata

HealthCareAccess|17

Source:CentersforDiseaseControlandPrevention,ImmunizationSchedulesforInfantsandChildren,2017.

HealthCareAccess|18

Source:CentersforDiseaseControlandPrevention,ImmunizationSchedulesforPreteensandTeens,2017.

EarlyChildhood(Ages0to5)|19

Early Childhood (Ages 0 to 5)

Key Findings

Thefollowinginformationwasreportedbyparentsof0to5yearolds.Eighty‐ninepercent(89%)ofmothersrecievedprenatalcarewithinthefirstthreemonthsduringtheirlastpregnancy.One‐in‐eleven(9%)motherssmokedorusedtobaccoproductsduringtheirlastpregnancy.Morethanfour‐fifths(86%)ofparentsputtheirchildtosleeponhis/herback.Almostone‐third(30%)ofmothersneverbreastfedtheirchild.

Early Childhood

Duringtheirlastpregnancy,mothersdidthefollowing:receivedprenatalcarewithinthefirst3months(89%);tookaprenatalvitaminwithfolicacidduringpregnancy(85%);tookaprenatalvitaminwithfolicacidpre‐pregnancy(77%);hadadentalexam(61%);tookfolicacidduringpregnancy(23%);receivedWICservices(25%);experienceddepressionduringorafterpregnancy(20%);tookfolicacidpre‐pregnancy(15%);smokedcigarettesorusedothertobaccoproducts(9%);consumedalcoholicbeverages(6%);usedmarijuana(5%);usedopioids(4%);experienceddomesticviolence(3%);usedanydrugsnotprescribedforthem(4%);lookedforoptionsforanunwantedpregnancy(2%);andreceivedopiatereplacementtherapy(1%).Threepercent(3%)ofmothersreporteddoingnoneoftheseduringpregnancy.

Whenparentswereaskedhowtheyputtheirchildtosleepasaninfant:86%saidontheirback;18%saidinbedwiththem;14%saidontheirside;10%saidontheirstomach;and3%saidinbedwithanotherperson.

Parentsreportedputtingtheirchildtosleepinthefollowingplaces:crib/bassinettewithoutbumper,blankets,orstuffedanimals(78%);packn’play(50%);swing(37%);inbedwiththem(34%);carseat(29%);crib/bassinettewithbumper,blankets,orstuffedanimals(23%);inbedwithanotherperson(7%);floor(6%);andcouchorchair(5%).

Mothersbreastfedtheirchild:3monthsorless(17%);4to6months(8%);7to9months(8%);10to12months(12%);morethanoneyear(14%);stillbreastfeeding(8%);andneverbreastfed(30%).

Morethanhalf(53%)ofmothersonapublicinsuranceprogram,suchasMedicaid,neverbreastfed.

Parentsgavethefollowingreasonswhytheirchildwasnotbreastfedforayear:didnotproduceenoughmilk(30%);didnotwantto(12%);medicalissuewithbaby(9%);inconvenient(4%);didnothavetime(4%);didnothaveworkplacesupport(3%);didnothaveadequatesupport(3%);didnothaveabreastpump(1%);andother(26%).

Parentsreportedtheyorsomeoneintheirfamilyreadtotheirchild:everyday(35%);almosteveryday(21%);afewtimesaweek(25%);afewtimesamonth(13%);andafewtimesayear(2%).Twopercent(2%)reportedneverreadingtotheirchild.


30%

29%

21%

70%

71%

79%

0% 20% 40% 60% 80% 100%

Greater Dayton Area 2017

Ohio 2011/12

U.S. 2011/12

Children Breastfed

Breastfed Never Breastfed

Child Comparisons


Outside of Dayton

Ages 0 to 5 (n=66)

Greater Dayton Area

2017 Ages 0 to 5

Ohio 2011/12

Ages 0 to 5

U.S. 2011/12

Ages 0 to 5

Neverbreastfedtheirchild 32% 29% 30% 29% 21%

Parentreadstochildeveryday 32% 38% 35% 53% 48%

Breastfeeding

ThefollowinggraphshowsthepercentofinfantswhohadbeenbreastfedorgivenbreastmilkfromGreaterDaytonArea,Ohio,andU.S.

TheU.S.hadalargerpercentofchildrenwhohadbeenbreastfedforanylengthoftime,comparedtoOhioandGreaterDaytonArea.

Sources:NationalSurveyofChildren’sHealthand2017DaytonChildren’sCommunityHealthNeedsAssessment


1620 1587 1561 1594 1630 1528

1776 1783 1780 1824 1891 1812

1128 1111 1183 1224 1186 1225

6600 6756 6752 6592 6653 6580

2457 2425 2363 2397 2354 2403

1,000

2,000

3,000

4,000

5,000

6,000

7,000

2011 2012 2013 2014 2015 2016**

Number of Live Births

Greater Dayton Area Total Live Births

Clark Greene Miami Montgomery Warren

Facts about Breastfeeding

Thepercentofinfantswhowereeverbreastfedis65%inOhio,comparedto77%intheU.S. Humanmilkprovidesvirtuallyalltheprotein,sugar,andfatyourbabyneedstobehealthy,anditalso

containsmanysubstancesthatbenefityourbaby’simmunesystem,includingantibodies,immunefactors,enzymes,andwhitebloodcells.Thesesubstancesprotectyourbabyagainstawidevarietyofdiseasesandinfectionsnotonlywhileheisbreastfeedingbutinsomecaseslongafterhehasweaned.Formulacannotofferthisprotection.

Withregardstoallergyprevention,thereissomeevidencethatbreastfeedingprotectsbabiesborntofamilieswithahistoryofallergies,comparedtothosebabieswhoarefedeitherastandardcow’smilkbasedformulaorasoyformula.

Recentresearchevenindicatesthatbreastfedinfantsarelesslikelytobeobeseinadolescenceandadulthood.Theyarealsolessvulnerabletodevelopingbothtype1andtype2diabetes.

TheAmericanAcademyofPediatrics(AAP)recommendsthatbreastfeedingcontinueforatleast12months,andthereafterforaslongasmotherandbabydesire.TheWorldHealthOrganizationrecommendscontinuedbreastfeedingupto2yearsofageorbeyond.

Source:CDC,Breastfeeding,July,31,2013&HealthyChildren,BreastfeedingBenefitsYourBaby’sImmuneSystem,5/11/2013

Pregnancy Outcomes

*Pleasenotethatthepregnancyoutcomesdataincludesallbirthstoadultsandadolescents.

From2011‐2016,therewasanaverageof6,656livebirthsperyearinMontgomeryCounty,ascomparedtoanaverageof1,176birthsperyearinMiamiCounty.

(Sourceforgraphs:ODHInformationWarehouseUpdated3/26/2017)

**‐Indicatespreliminarydatathatmaychange


ABCs of Safe Sleep

EveryweekinOhio,3babiesdieinunsafesleepenvironments.

Source:OhioDepartmentofHealth,InfantSafeSleep


84

146165

150

7255

43

14 1911 9 2

0

20

40

60

80

100

120

140

160

180

200

<1 1 2 3 4 5 6 7 8 9 10 11

Number of Deaths

Age in Months

Ohio Sleep‐Related Infant Deaths by Age in Months, 2011‐2015 (n=770)

Sleep‐Related Infant Death Factors

ThefollowingchartsshowthepercentageofOhioinfantdeathsbylocationwhentheinfantwasfoundandtheageofinfantattimeofdeath.

Morethantwo‐fifthsofthesleep‐relatedinfantdeathsinOhiowerefoundinanadultbed.

Bedsharingwasreportedatthetimeofthedeathin53%ofthecasesthatwerereviewed.

Three‐fifthsofthesleep‐relateddeathsinvolvedinfantsbetweenonemonthandthreemonthsold.

Sourceforcharts:ODH,OhioChildFatalityReview,SixteenthAnnualReport

Adult Bed, 43%

Crib, 16%

Couch, 14%

Other, 14%

Bassinet, 7%Unknown, 6%

Reviews of Ohio Sleep‐Related Infant Deaths by Incident Location, 2011‐2015 (n=770)

MiddleChildhood(Ages6to11)|24

Middle Childhood (Ages 6 to 11)

Key Findings

ThefollowinginformationwasreportedbyGreaterDaytonAreaparentsof6to11yearolds.Aboutfour‐fifths(81%)ofparentsreportedtheyfelttheirchildwasalwayssafeatschool.Morethantwo‐fifths(43%)ofparentsreportedtheirchildwasbulliedatsometimeinthepastyear.Eighty‐onepercent(81%)ofparentsreportedtheirchildparticipatedinextracurricularactivities.

Middle Childhood

Aboutfour‐fifths(81%)ofparentsreportedtheirchildparticipatedinextracurricularactivitiesinthepastyear.Theirchildparticipatedinthefollowing:asportsorintramuralprogram(71%);exercisingoutsideofschools(58%);achurchorreligiousorganization(49%);aschoolcluborsocialorganization(42%);volunteerinthecommunity(17%);tutoring(13%);achurchyouthgroup(13%);summerschoolprogram(9%);takecareofsiblingsafterschools(4%);takecareofparentsorgranparents(2%);babysitforotherkids(2%);andsomeotherorganizedactivity(20%).

Childrenmissedschoolanaverageof2.7daysperyearbecauseofillnessorinjury.

GreaterDaytonAreachildrenwereenrolledinthefollowingtypesofschools:public(77%),private(15%),home‐schooled/onlineschooled(5%),andcharter(3%).

Four‐fifths(81%)ofparentsreportedtheyfelttheirchildwasalwayssafeatschool;17%reportedusually;1%reportedsometimes;and<1%reportedtheyfelttheirchildwasneversafeatschool.

Parentsfelttheirchildwasnotsafeatschoolduetothefollowingreasons:fearofbullying(8%);afraidofotherkidswhoshowunusualbehavior(6%);buildingsarenotsecure(3%);andbombthreats(2%).

Morethantwo‐fifths(43%)ofparentsreportedtheirchildwasbulliedinthepastyear.Thefollowingtypesofbullyingwerereported:

Parentsreportedtheyhadcontactedthefollowingagenciestohelpwithproblemsconcerningtheirchild:child’sschool(9%),mentalhealthagency(5%),faith‐basedagency(2%),non‐profitagency(2%),juvenilecourt(1%),lawenforcement(1%),andChildren’sServices(1%).Eighty‐eightpercent(88%)ofparentsreportedtheyhavenevercalledanagencyforhelpwiththeirchild.

— 28%wereverballybullied(teased,tauntedorcalledharmfulnames)

— 12%wereindirectlybullied(spreadmeanrumorsaboutorkeptoutofa“group”)

— 4%werephysicallybullied(theywerehit,kicked,punchedorpeopletooktheirbelongings)

— <1%weresexuallybullied(hadnudeorsemi‐nudepicturesusedtoblackmail,intimidate,exploit,orpressurethemtohavesexwhentheydidnotwantto)

— 1%ofparentsreportedtheydidnotknowiftheirchildwasbullied.

MiddleChildhood(Ages6to11)|25

Almostone‐fifth(18%)ofparentsreportedtheirchildhadasocialmediaorothervirtualnetworkaccount.Ofthosewhohadanaccount,theyreportedthefollowing:theyhadtheirchild’spassword(86%);theyknewallofthepeopleintheirchild’s“myfriends”(57%);theirchild’saccountwascheckedprivate(56%);andtheirchildhadaproblemasaresultoftheiraccount(2%).

Parentsreportedtheyorsomeoneintheirfamilyreadstotheirchild:everyday(19%);almosteveryday(24%);afewtimesaweek(14%);afewtimesamonth(7%);andafewtimesayear(1%).Almostone‐third(32%)ofparentsreportedtheirchildreadtohim/herself,and1%reportedneverreadingtotheirchildduetolackofinterestfromthechild.

Parentsdiscussedthefollowingtopicswiththeirchild:eatinghabits(80%);screentime(TVorcomputer)(78%);bullyingandviolence(68%);empathy(59%);cyber/internetsafety(45%);bodyimage(44%);culturalsensitivity(40%);negativeeffectsoftobacco(40%);negativeeffectsofalcohol(33%);negativeeffectsofmarijuanaandotherdrugs(27%);marijuanaandotherdrugs(26%);negativeeffectsofheroin/opiates(24%);respectforgenderidentity/sexualorientation(21%);refusalskills(18%);prescriptiondrugmisuse(15%);datingandpositiverelationships(14%);abstinenceandhowtorefusesex(13%);birthcontrol(3%);andcondoms,safersexandSTDprevention(2%).Fourpercent(4%)ofparentsreportedtheydidnotdiscussanyoftheabovetopicswiththeirchild.

Child Comparisons


Outside of Dayton Ages 6 to 11 (n=157)

Greater Dayton Area

2017 Ages 6 to 11


U.S. 2011/12Ages 6 to 11

Childdidnotmissanydaysofschoolbecauseofillnessorinjury 8% 16% 13% 18% 22%

Childmissedschool11daysormorebecauseofillnessorinjury

3% 2% 2% 7% 5%

Parentfeltchildwasusually/alwayssafeatschool 97% 97% 98% 96% 94%

How to Help Increase Your School‐Aged Child's Social Ability

Considerthefollowingaswaystofosteryourschool‐agedchild'ssocialabilities:

Setandprovideappropriatelimits,guidelines,andexpectationsandconsistentlyenforceusingappropriateconsequences.

Modelappropriatebehavior. Offercomplimentsforyourchildbeingcooperativeandforanypersonalachievements.

Helpyourchildchooseactivitiesthatareappropriateforyourchild'sabilities. Encourageyourchildtotalkwithyouandbeopenwithhisorherfeelings.

Encourageyourchildtoreadandreadwithyourchild.

Encourageyourchildtogetinvolvedwithhobbiesandotheractivities. Encouragephysicalactivity.

Encourageself‐discipline;expectyourchildtofollowrulesthatareset.

Teachyourchildtorespectandlistentoauthorityfigures. Encourageyourchildtotalkaboutpeerpressureandhelpsetguidelinestodealwithpeerpressure.

Spenduninterruptedtimetogether—givingfullattentiontoyourchild. Limittelevision,video,andcomputertime.

Source:eClinicalWorks,TheGrowingChild:SchoolAge(6to12Years),2017

FamilyandCommunityCharacteristics|26

Family and Community Characteristics

Key Findings

Ninety‐fourpercent(94%)ofparentsreportedtheirneighborhoodwasalwaysorusuallysafe.One‐in‐nine(11%)parentsreportedtheyreceivedbenefitsfromtheSNAP/foodstampsprogram.Thirteen(13%)percentofparentsexperiencedfoodinsecurity.

Family Functioning

Two‐fifths(40%)ofparentsreportedthateveryfamilymemberwholivedintheirhouseholdateamealtogethereverydayoftheweek.Familiesateamealtogetheranaverageof5.3timesperweek.

Threeoutoften(30%)parentsreportedtheirchildattendedareligiousserviceonetothreetimespermonth;34%reportedfourormoretimespermonth.Morethanone‐third(37%)ofparentsreportedtheirchildhadneverattendedareligiousservice.Parentsreportedtheirchildattendedreligiousservicesanaverageof3.3timespermonth.

Parentsreportedthefollowingformsofdisciplinetheyusedfortheirchild:takeawayprivileges(78%);timeout(60%);yelling(30%);grounding(28%);spanking(28%);washmouthout(3%);andothermethod(9%).

Parentsreportedthefollowingchallengestheyfacedinregardstotheday‐to‐daydemandsofparenthood/raisingchildren:demandsofmultiplechildren(40%);financialburdens(19%);workinglonghours(14%);beingasingleparent(10%);managingchild’sbehavior(9%);childhasspecialneeds(8%);metalhealth/depression/anxiety(7%);lackofparentalsupport(5%);difficultywithlifestylechanges(5%);lossoffreedom(4%);affordablehousing(4%);movealot(1%);post‐partumdepression(1%);andalcoholand/ordrugabuse(<1%).Thirty‐one(31%)ofparentsreportedhavingmorethanonedifficulty,increasingto47%ofparentswithincomesoflessthan$25,000.

Family Dinners

ThefollowinggraphshowsthepercentofGreaterDaytonAreafamiliesthatateamealtogethereverydayoftheweekalongwiththepercentofOhioandU.S.families.

U.S.familieseatamealtogethereverydayoftheweekmorefrequentlythanGreaterDaytonAreaandOhiofamilies.

Source:NationalSurveyofChildren’sHealth&2017DaytonChildren’sCommunityHealthNeedsAssessment

40%34%

53%

0%

20%

40%

60%

80%

100% Families that Eat Together Everyday of the Week



Five Ways That Family Meals Keep Kids Healthy

1.Familymealspreventexcessiveweightgain:Eating3ormorefamilymeals(meaningatleastoneparentispresentandthemealispreparedathome)resultsina12%lowerlikelihoodofchildrenbeingoverweight.

2.Familymealsteachhealthyfoodchoices:Theeatinghabitsofchildhoodoftenlastalifetime.Familiesthatateatleastthreemealstogethereachhada20%decreaseinunhealthyfoodchoices.Teachingyourchildrentoenjoyhealthyfoodsratherthanjunkfoodsisagiftthatwillstaywiththemthroughadulthood.

3.Familymealspreventeatingdisorders:Childrenandadolescentswhoatefamilymealsatleastthreetimesperweekhada35%reductionindisorderedeatinghabitssuchasanorexiaandbulimia.

4.Familydinnerimprovessocial‐emotionalhealth,too:Theabilitytounderstandemotions,expressempathy,demonstrateself‐regulation,andformpositiverelationshipswithpeersandadultsiscalledsocial‐emotionalhealth.Youngchildrenwithhighsocial‐emotionalhealthadaptwelltotheschoolenvironmentandperformwellacademically,eveninlongtermstudies.Guesswhichkidshadthebestsocial‐emotionalhealth?Theoneswhoatefamilydinnertogetherregularlyandtalkedabouttheirday,toldstories,etc.

5.Familydinnercanhelpkidsdealwithcyberbullying:Aboutone‐fifthofadolescentsarevictimsofcyberbullying,puttingthematriskfordepression,substanceabuse,andahostofotherconcerns.Butadolescentswhoeatregularfamilydinnershandlecyberbullyingbetterandarelesslikelytoengageinsubstanceabuseordeveloppsychiatrichealthconcerns,evenaftertheirinvolvementinface‐to‐facebullyingistakenintoaccount.

Source:TheBenefits&TrickstoHavingaFamilyDinner,HealthyChildren.org,2017

Home Environment

Inthepastyear,5%ofparentsreportedsomeoneintheirfamilyhadtoquitajob,nottakeajoborgreatlychangejobsbecauseofthefollowingproblemsconcerningchildcarefortheirchild:cannotaffordchildcare(4%);medicallyfragile(1%);orchildwasremovedfromdaycare(1%).

Sixpercent(6%)ofchildrenlivedwithhouseholdmemberswhohadthreeormoredifferentlastnames.

Theprimarylanguagespokeninchild’shomeswere:English(98%),Spanish(1%)oranotherlanguage(1%).

Parentsreportedtheirchildlivedwiththem:0daysperweek(1%);1to2daysperweek(1%);3to4daysperweek(6%);5to6daysperweek(3%);and7daysperweek(89%).

Parentsofchildrenwere:married(79%);divorced(8%);nevermarried(7%);amemberofanunmarriedcouple(3%);seperated(2%);andwidowed(1%).

Twopercent(2%)ofchildrenhadatleastoneparentinactivemilitaryduty.

Childrenhadmovedtoanewaddress:onetime(32%),twotimes(15%),andthreeormoretimes(12%).


GreaterDaytonAreaparentsreportedtheirchildexperiencedthefollowingadversechildhoodexperiences(ACEs):theirparentsbecameseparatedorweredivorced(14%);livedwithsomeonewhohadaproblemwithalcoholordrugs(7%);livedwithsomeonewhowasmentallyillorsuicidal,orseverelydepressedformorethanacoupleofweeks(5%);seenorheardanyparentsoradultsintheirhomehit,beat,kicked,orphysicallyhurteachother(3%);beenthevictimofviolenceorwitnessviolenceintheirneighborhood(3%);livedwithaparent/guardianwhoservedtimeorwassentencedtoservetimeinprisonorjailaftertheywereborn(2%);livedwithaparent/guardianwhodied(1%);andwastreatedorjudgedunfairlybecausehis/herethnicgroup(1%).

One‐in‐11(9%)childrenexperiencedtwoormoreadversechildhoodexperiences.

Aboutone‐eigth(13%)ofGreaterDaytonAreaparentsreportedexperiencinganyofthefollowingissuesinthepast12months:theyworriedfoodwouldrunoutbeforetheygotmoneyorfoodstampstobuymore(8%);theirfoodassistancewascut(6%);theyhadtochoosebetweenpayingbillsandbuyingfood(6%);lossofincomeledtofoodinsecurityissues(4%);theywenthungry/atelesstoprovidemorefoodfortheirfamily(4%);thefoodthatwasboughtdidnotlastandtheydidnothavemoneytobuymore(3%);theywerehungry,butdidnoteatbecausetheydidnothavemoneyforfood(2%).Sevenpercent(7%)ofparentsexperiencedmorethanonetypeoffoodinsecurity,increasingto33%ofparentswithincomeslessthat$25,000.

Inthepastyear,23%ofparentsreportedthatsomeoneinthehouseholdreceivedthefollowing:freeorreducedcostbreakfastorlunchesatschool(14%);SNAP/foodstamps(11%);benefitsfromWICprogram(6%);mentalhealthtreatment(3%);cashassistancefromawelfareprogram(3%);HelpMeGrow(3%);HeadStart/EarlyHeadStart(1%);andsubsidizedchildcarethroughGreaterDaytonAreaJFS(1%).

Adverse Childhood Experiences (ACE)

Childhoodabuse,neglect,andexposuretoothertraumaticstressorswhichwetermadversechildhoodexperiences(ACE)arecommon.Themostcommonareseparatedordivorcedparents,verbal,physicalorsexualabuse,witnessofdomesticviolence,andhavingafamilymemberwithdepressionormentalillness.

AccordingtotheCDC,59%ofpeoplesurveyedin5statesin2009reportedhavinghadatleastoneACEwhile9%reportedfiveormoreACEs.

Theshortandlong‐termoutcomesofthesechildhoodexposuresincludeamultitudeofhealthandsocialproblemssuchas:— Depression — Alcoholismandalcoholabuse— Fetaldeath — COPD— Illicitdruguse — Unintendedpregnancies— Liverdisease — Suicideattempts— STD’s— Multiplesexualpartners

— Earlyinitiationofsmoking— Riskforintimatepartnerviolence

GiventhehighprevalenceofACEs,additionaleffortsareneededatthestateandlocallevelto

reduceandpreventchildhoodmaltreatmentandassociatedfamilydysfunctionintheUS.Source:CDC,AdverseChildhoodExperiences(ACE)Study,&AdverseChildhoodExperiencesReportedbyAdults,LastReviewed:June3,2011


Average Distance to Locations in Neighborhoods

Child Comparisons

Dayton (n=131)

Outside of Dayton (n=221)

Greater Dayton Area 2017

Grocery Store

SchoolParks/Green Space

Grocery Store

SchoolParks/ Green Space

Grocery Store

SchoolParks/Green Space

Lessthan¼mile 17% 15% 39% 16% 17% 42% 16% 16% 41%Between¼mileto½mile 15% 14% 26% 13% 10% 15% 14% 12% 19%Between½mileto1mile 24% 17% 20% 17% 15% 14% 20% 16% 16%Between1mileto2miles 28% 22% 9% 23% 23% 19% 25% 23% 15%Twoormoremiles 16% 31% 4% 32% 34% 11% 27% 33% 8%Numbersmaynotequal100%duetorespondentsmarking“don’tknow”.

Child Safety Characteristics

Parentsreportedtheirchildspentthefollowingunsupervisedtimeafterschoolonanaverageschoolday:nounsupervisedtime(79%);lessthanonehour(16%);1to2hours(4%);3to4hours(1%);andmorethan4hours(1%).

Ninety‐fourpercent(94%)ofparentsreportedtheirchildalwaysornearlyalwaysrodeinacarseatwhenapassengerinacar.

Seventy‐threepercent(73%)ofparentsreportedtheirchildalwaysornearlyalwaysrodeinaboosterseatwhenapassengerinacar;23%ofparentsreportedtheirchildneverrodeinaboosterseat.

Four‐fifths(80%)ofparentsreportedtheirchildalwaysornearlyalwaysrodewithaseatbelt(withnoboosterseat)whenapassengerinacar;12%ofparentsreportedtheirchildneverworeaseatbelt.

Greater Dayton Area Helmet Use in the Past Year

Did not ride during the past 12 months

Always wore a helmet

Most of the time wore a

helmet

Sometimes wore a helmet

Rarely wore a helmet

Never wore a helmet

Bike/Scooter 20% 35% 19% 9% 6% 11%ATV 90% 7% 2% 0% 0% 1%SnowMobile 98% 1% 0% 0% 0% 1%Skateboard 88% 5% 1% 1% 2% 3%

Neighborhood Safety and Community Characteristics

Parentsreportedtheirneighborhoodwas:alwayssafe(60%),usuallysafe(34%),sometimessafe(5%),andneversafe(1%).

Parentsreportedthefollowingreasonstheydidnotfeeltheirneighborhoodwassafe:heavytrafficarea(14%);drugs/alcoholactivity(6%);crime(5%);noaccessiblesidewalks(5%);loud/disrespectfulnoiselevels(5%);noplaceforkidstoplay(5%);bullying(2%);badweatherconditions(1%);gangs(<1%);andother(6%).


89%

97%

88%86%86% 86%

70%

80%

90%

100%

Ages 0‐5 Ages 6‐11

Parents Feel their Neighborhood is Always or Usually Safe


Parentsreportedtheirchildwasexposedtosecondhandsmokeorvapingproductsinthefollowingplaces:otherrelative’shome(11%),home(6%),car(4%),friend’shome(3%),park/ballfield(2%),fairgrounds(1%),andother(3%).

Parentsreportedtheirchildregularlyattendedthefollowing:childcareoutsideoftheirhome(35%),childcareintheirhomeprovidedbyarelativeotherthanaparent/guardian(26%),childcarecenter(23%),andHeadStartorEarlyStartprogram(6%).

Parentsobtainedtheirfruitsandvegetablesfromthefollowingplaces:largegrocerystore(96%);localgrocerystore(31%);farmer’smarket(29%);garden/grewtheirown(28%);DollarGeneral/DollarStore(16%);corner/conveniencestores(9%);mailorderfoodservice(3%);foodpantry(3%);veggiemobile(2%);consumersupportedagriculture(1%);communitygarden(<1)%);andotherplaces(3%).

Neighborhood Safety

ThefollowinggraphshowsthepercentofGreaterDaytonArea,Ohio,andU.S.parentswhofelttheirneighborhoodisalwaysorusuallysafe.

GreaterDaytonAreahadthelargestpercentofparentsforboththe0to5agegroupandthe6to11agegroupwhofeltthattheirneighborhoodisalways/usuallysafeascomparedtoOhioandU.S.parents.

Source:NationalSurveyofChildren’sHealth&2017DaytonChildren’sCommunityHealthNeedsAssessment

Children and Smoking

63%ofOhiochildrenages0to5donothaveanyonethatsmokesintheirhousehold.27%hassomeoneintheirhouseholdthatsmokes,butdoesnotsmokeinsidethechild’shouse.10%havesomeonethatsmokesintheirhouseholdandsmokesinsidethechild’shouse.

66%ofOhiochildrenages6to11donothaveanyonethatsmokesintheirhousehold.18%havesomeonethatsmokesintheirhousehold,butdoesn’tsmokeinsidethechild’shome.16%havesomeonethatsmokesinthehousehold,andsmokesinsidethehomeofthechild.

ForU.S.childrenages0to5,74%havenoonethatsmokesintheirhousehold.21%havesomeonethatsmokesintheirhousehold,butdoesnotsmokeinsidethehouse.5%havesomeonethatsmokesinthehousehold,andsmokesinsidethechild’shome

ForU.S.childrenages6to11,75%havenoonethatsmokesintheirhousehold.18%havesomeonethatsmokesintheirhousehold,butdoesnotsmokeinsidethehouse.8%havesomeonethatsmokesinthehousehold,andsmokesinsidethechild’shouse.

Source:NationalSurveyofChildren’sHealth,DataResourceCenter


Child Comparisons

Dayton Ages 0 to

5 (n=54)

Outside of Dayton

Ages 0 to 5(n=66)

Greater Dayton Area

2017 Ages 0 to 5

Ohio 2011/12Ages 0 to

5

U.S. 2011/12Ages 0 to

5

Childdidnotmissanydaysofschoolbecauseofillnessorinjury

N/A N/A N/A N/A N/A

Childmissedschool11daysormorebecauseofillnessorinjury

N/A N/A N/A N/A N/A

Childhad2ormoreadversechildhoodexperiences 9% 6% 7% 23% 26%

Parentfeltchildwasusually/alwayssafeatschool

N/A N/A N/A N/A N/A

Familyeatsamealtogethereverydayoftheweek 54% 46% 49% 63% 61%

Childneverattendsreligiousservices 43% 49% 47% N/A N/ANeighborhoodisusuallyoralwayssafe 83% 94% 89% 88% 86%N/A–Notavailable

Child Comparisons


Outside of Dayton Ages 6 to 11 (n=157)

Greater Dayton Area

2017 Ages 6 to 11

Ohio 2011/12Ages 6 to

11

U.S. 2011/12Ages 6 to

11 Childdidnotmissanydaysofschoolbecauseofillnessorinjury

8% 16% 13% 18% 22%

Childmissedschool11daysormorebecauseofillnessorinjury 3% 2% 2% 7% 5%

Childhad2ormoreadversechildhoodexperiences 13% 7% 9% 23% 26%

Parentfeltchildwasusually/alwayssafeatschool 97% 97% 98% 96% 94%

Familyeatsamealtogethereverydayoftheweek

31% 37% 35% 45% 47%

Childneverattendsreligiousservices 34% 31% 32% 22% 18%Neighborhoodisusuallyoralwayssafe 92% 99% 97% 86% 86%

N/A–Notavailable


Students Eligible for Free and Reduced‐Price Lunches by Food Deserts in the Greater Dayton Area

(Source:2014/2015NationalCenterforEducationStatistics,CommonCoreofDataandUSDepartmentofAgriculture,EconomicResearchService,USDA–FoodAccessResearchAtlas,2015,ascompiledbyCommunityCommons)

ParentHealth|33

Parent Health

Key Findings

In2017,18%ofGreaterDaytonAreaparentswereuninsured.Seventeenpercent(17%)ratedtheirmentalandemotionalhealthasfairorpoor.

Parent Health

Thosefillingoutthesurveyhadthefollowingrelationshiptothechild:mother(72%),father(20%),grandparent(7%),aunt/uncle(1%),andothernon‐relative(<1%).

Overfour‐fifths(84%)ofparentsratedtheirhealthasexcellentorverygood,decreasingto56%ofparentswithincomeslessthan$25,000.Sixteenpercent(16%)ofparentshadratedtheirhealthasfairorpoor.

Eighty‐threepercent(83%)ofparentsratedtheirmentalandemotionalhealthasexcellentorverygood,decreasingto47%ofparentswithincomeslessthan$25,000.Seventeenpercent(17%)ratedtheirmentalandemotionalhealthasfairorpoor.

Nearlyone‐fifth(19%)ofmothersand11%offathersof0to5yearoldsratedtheirmentalandemotionalhealthasfairorpoor.Thirteenpercent(13%)ofmothersand19%offathersof6to11yearoldsratedtheirmentaloremotionalhealthasfairorpoor.

Nearlyone‐fifth(18%)ofparentswereuninsured.

Intimesofneed,parentsreportedtheycouldcounton:atleastoneperson(6%);2people(13%);3or4people(32%);and5ormorepeople(49%).

Parentsmissedworkanaverageof1.1daysperyearduetotheirchildbeingillorinjured.

N/A–Notavailable

Child Comparisons

Greater Dayton

Area 20170 to 5 Years

Ohio 2011/120 to 5 Years

U.S. 2011/120 to 5 Years

Greater Dayton

Area 2017 6 to 11 Years

Ohio 2011/126 to 11 Years

U.S. 2011/126 to 11 Years

Mother’smentaloremotionalhealthisfair/poor 19% 7% 7% 13% 10% 8%

Father’smentaloremotionalhealthisfair/poor 11% N/A 3% 19% 7% 5%

ParentHealth|34

Parent’s Health

57%ofU.S.childrenhavemotherswhoareinexcellentorverygoodphysicalandmentalhealth,increasingto61%ofmothersof0to5yearolds(ofchildrenwithalivingmotherintheirhousehold).

62%ofU.S.childrenhavefatherswhoareinexcellentorverygoodphysicalandmentalhealth,increasingto66%offathersof0to5yearolds(ofchildrenwithalivingfatherintheirhousehold).

83%ofU.S.parentsindicatedtheywerecompletelyhappyorveryhappywiththeirspouse/partner,increasingto86%ofparentsof0to5yearolds.

7%ofU.S.parentsreporteditwasveryhardtogetbyontheirfamily'sincomeveryoften. 11%ofU.S.parentsindicatedtheyusually/alwaysfeltstressfromparenting,decreasingto9%of

parentsof0to5yearolds.(Source:NationalSurveyofChildren’sHealth,DataResourceCenterforChild&AdolescentHealth,2012)

AppendixI:HealthInformationSources|35

Appendix I: Health Information Sources

Source Data Used Website

CenterforDiseaseControlandPrevention(CDC)

Attention‐Deficit/HyperactivityDisorder(ADHD)

BreastfeedingFacts

www.cdc.gov

CommunityCommons ChildreninPoverty FreeandReducedLunchesby

FoodDeserts

www.communitycommons.org/

MarchofDimes DangersofBedSharingwww.marchofdimes.org/baby/co‐sleeping.aspx

NationalSurveyofChildren’sHealth,2011/12,ChildandAdolescentHealthMeasurementInitiative

ChildrenandSmoking FamilyHealthandActivities HealthCareAccessandQuality HealthInsuranceCoverage NeighborhoodSafetyand

Support PhysicalandDentalHealth

www.childhealthdata.org

OhioDepartmentofHealth,MaternalandChildHealth,EarlyChildhood,2014

Sleep‐RelatedInfantDeathsRiskFactors

www.odh.ohio.gov/~/media/ODH/ASSETS/Files/data%20statistics/maternal%20and%20child%20health/ec_Sleeprelatedinfant.ashx

OhioDepartmentofHealth,InfantSafeSleep

ABCsofSafeSleep www.odh.ohio.gov/safesleep

OhioDepartmentofHealth,OhioChildFatalityReview,SixteenthAnnualReport

Sleep‐RelatedDeaths www.odh.ohio.gov/‐/media/ODH/ASSETS/Files/cfhs/Ohio‐Childhood‐Fatality‐Review‐16th‐Annual‐Report.pdf?la=en

OhioDepartmentofHealth,PublicHealthDataWarehouse

LiveBirths http://publicapps.odh.ohio.gov/EDW/DataCatalog

U.S.DepartmentofCommerce,CensusBureau;BureauofEconomicAnalysis

AmericanCommunitySurvey5yearestimate,2015

OhioandCounty2015CensusDemographicInformation

SmallAreaIncomeandPovertyEstimates

FederalPovertyThresholds

www.census.gov

AppendixII:AcronymsandTerms|36

Appendix II: Acronyms and Terms

BMI BodyMassIndexisdefinedasthecontrastingmeasurement/relationshipofweighttoheight.

CDC CentersforDiseaseControlandPrevention.

CY CalendarYear

HCNO HospitalCouncilofNorthwestOhio

HP2020 HealthyPeople2020,acomprehensivesetofhealthobjectivespublishedbytheOfficeofDiseasePreventionandHealthPromotion,U.S.DepartmentofHealthandHumanServices.

HealthIndicator Ameasureofthehealthofpeopleinacommunity,suchascancermortalityrates,ratesofobesity,orincidenceofcigarettesmoking.

IID ImmunizationsandInfectiousDiseases,TopicofHealthyPeople2020objectives

N/A Dataisnotavailable.

NSCH NationalSurveyofChildren’sHealth

ODH OhioDepartmentofHealth

Race/Ethnicity Census2010:U.S.CensusdataconsiderraceandHispanicoriginseparately.Census2010adheredtothestandardsoftheOfficeofManagementandBudget(OMB),whichdefineHispanicorLatinoas“apersonofCuban,Mexican,PuertoRican,SouthorCentralAmerican,orotherSpanishcultureororiginregardlessofrace.”Dataarepresentedas“HispanicorLatino”and“NotHispanicorLatino.”Census2010reportedfiveracecategoriesincluding:White,BlackorAfricanAmerican,AmericanIndian&AlaskaNative,Asian,NativeHawaiianandOtherPacificIslander.Datareported,“Whitealone”or“Blackalone”,meanstherespondentsreportedonlyonerace.

AppendixIII:GreaterDaytonAreaSampleDemographicProfile|37

Appendix III: Greater Dayton Area Sample Demographic Profile*

*Thepercentsreportedaretheactualpercentwithineachcategorywhorespondedtothesurvey.Thedatacontainedwithinthereporthoweverarebasedonweighteddata(weightedbyage,race,sex,andincome).Percentsmaynotaddto100%duetomissingdata(non‐responses).

Variable 2016 Survey Sample

ChildAge0‐5 34%6‐11 66%

ChildGenderMale 52%Female 48%

ChildRace/EthnicityWhite 89%BlackorAfricanAmerican 8%NativeHawaiianorOtherPacificIslander 1%AmericanIndianandAlaskaNative 1%Asian 3%HispanicOrigin(maybeofanyrace) 5%

ParentMaritalStatusMarriedCouple 79%Neverbeenmarried/memberofanunmarriedcouple 10%Divorced/Separated 10%Widowed 1%

ParentEducationLessthanHighSchoolDiploma 2%HighSchoolDiploma 13%Somecollege 27%Collegegraduate/Post‐graduate 58%

Income(Families)$14,999andless 5%$15,000to$24,999 5%$25,000to$49,999 12%$50,000to$74,999 19%$75,000ormore 59%

AppendixIV:DemographicsandHouseholdInformation|38

Appendix IV: Demographics and Household Information

Greater Dayton Area Population by Age Groups

U.S. Census 2010

Clark County

Greene County

Miami County

Montgomery County

Warren County

Number Percent of Total

Population


Population

Number Percent ofTotal

Population


Population


Population Totalpopulation(allages) 138,333 100 161,573 100 102,506 100 535,153 100 212,693 100

Under5years 8,672 6.3 9,069 5.6 6,315 6.2 33,446 6.2 14,285 6.7

Under1year 1,650 1.2 1,763 1.1 1,204 1.2 6,700 1.3 2,581 1.2

1year 1,686 1.2 1,782 1.1 1,284 1.3 6,603 1.2 2,727 1.3

2years 1,831 1.3 1,849 1.1 1,239 1.2 6,715 1.3 2,871 1.3

3years 1,776 1.3 1,825 1.1 1,277 1.2 6,832 1.3 3,043 1.4

4years 1,729 1.2 1,850 1.1 1,311 1.3 6,596 1.2 3,063 1.4

5to9years 8,844 6.4 9,777 6.1 6,872 6.7 33,681 6.3 17,288 8.1

5years 1,703 1.2 1,926 1.2 1,276 1.2 6,631 1.2 3,261 1.5

6years 1,756 1.3 1,920 1.2 1,365 1.3 6,646 1.2 3,473 1.6

7years 1,705 1.2 1,977 1.2 1,395 1.4 6,588 1.2 3,419 1.6

8years 1,843 1.3 1,958 1.2 1,402 1.4 6,823 1.3 3,463 1.6

9years 1,837 1.3 1,996 1.2 1,434 1.4 6,993 1.3 3,672 1.7

10to14years 9,229 6.7 9,852 6.1 7,099 6.9 34,295 6.4 17,355 8.2

10years 1,920 1.4 1,952 1.2 1,415 1.4 6,945 1.3 3,661 1.7

11years 1,843 1.3 2,010 1.2 1,404 1.4 6,985 1.3 3,455 1.6

12years 1,817 1.3 1,917 1.2 1,424 1.4 6,815 1.3 3,567 1.7

13years 1,865 1.3 2,019 1.2 1,405 1.4 6,724 1.3 3,279 1.5

14years 1,784 1.3 1,954 1.2 1,451 1.4 6,826 1.3 3,393 1.6


Greater Dayton Area Profile

Clark County

Greene County

Miami County

Montgomery County

Warren County

Number Percent Number Percent Number Percent Number Percent Number Percent TotalPopulation 2016TotalPopulationEstimate(July1) 134,789 164,765 104,679 531,239 227,063 2010TotalPopulation 138,333 161,573 102,506 535,153 212,693

PopulationByRace/Ethnicity TotalPopulation 136,827 164,192 103,517 533,763 219,916 WhiteAlone 118,001 86.2% 141,418 86.1% 97,699 94.4% 393,236 73.7% 197,206 89.7%HispanicorLatino(ofanyrace) 4,113 3.0% 4,232 2.6% 1,525 1.5% 13,466 2.5% 5,379 2.4%AfricanAmerican 11,648 8.5% 11,867 7.2% 2,251 2.2% 110,227 20.7% 7,601 3.5%Asian 991 0.7% 4,919 3.0% 1,360 1.3% 10,534 2.0% 9,922 4.5%Twoormoreraces 4,207 3.1% 5,056 3.1% 1,886 1.8% 14,665 2.7% 3,581 1.6%Other 1,768 1.3% 686 0.4% 174 0.2% 3,666 0.7% 1,389 0.6%AmericanIndianandAlaskaNative 273 0.2% 225 0.1% 126 0.1% 1,303 0.2% 179 0.1%

PopulationByAge2010 Under5years 8,144 6.0% 9,031 5.5% 6,108 5.9% 33,093 6.2% 13,415 6.1%5to17years 23,397 17.1% 25,286 15.4% 18,115 17.5% 87,537 16.4% 44,203 20.1%18to24years 12,178 8.9% 21,673 13.2% 7,867 7.6% 50,707 9.5% 16,054 7.3%25to44years 31,333 22.9% 39,406 24.0% 24,844 24.0% 131,306 24.6% 57,398 26.1%45to64years 38,175 27.9% 44,332 27.0% 29,399 28.4% 144,116 27.0% 61,137 27.8%65yearsandmore 23,808 17.4% 24,629 15.0% 17,287 16.7% 86,470 16.2% 27,269 12.4%Medianage(years) 41.0 37.7 41.4 39.4 38.7


Clark County

Greene County

Miami County

Montgomery County

Warren County

Number Percent Number Percent Number Percent Number Percent Number PercentHouseholdByType TotalHouseholds 54,809 64,182 41,135 222,687 78,359FamilyHouseholds(families) 35,980 65.6% 42,229 65.8% 27,826 67.6% 133,872 60.1% 58,919 75.2%

Withownchildren<18years 14,736 26.9% 17,423 27.1% 11,502 28.0% 57,399 25.8% 27,493 35.1%Married‐CoupleFamilyHouseholds 25,299 46.2% 33,381 52.0% 21,472 52.2% 90,061 40.4% 49,902 63.7%

Withownchildren<18years 8,514 15.5% 12,445 19.4% 7,509 18.3% 32,339 14.5% 22,218 28.4%FemaleHouseholder,NoHusbandPresent 7,976 14.6% 6,682 10.4% 4,214 10.2% 33,723 15.1% 6,055 7.7%

Withownchildren<18years 4,778 8.7% 3,870 6.0% 2,651 6.4% 19,649 8.8% 3,620 4.6%Non‐familyHouseholds 18,829 34.4% 21,953 34.2% 13,309 32.4% 88,815 39.9% 19,440 24.8%

Householderlivingalone 15,778 28.8% 18,239 28.4% 10,958 26.6% 76,314 34.3% 15,882 20.3%Householder65yearsand> 6,893 12.6% 6,730 10.5% 4,774 11.6% 28,164 12.6% 6,337 8.1%

HouseholdsWithIndividuals<18years 16,663 30.4% 19,103 29.8% 12,640 30.7% 65,134 29.2% 29,207 37.3%HouseholdsWithIndividuals65yearsand> 16,706 30.5% 17,245 26.9% 11,941 29% 62,621 28.1% 18,286 23.3%

AverageHouseholdSize 2.44 2.41 2.49 2.32 2.73AverageFamilySize 2.97 2.96 3.02 2.98 3.18

MaritalStatus Population15YearsandOver 110,924 135,869 83,598 433,929 172,368NeverMarried 31,391 28.2% 43,206 31.8% 20,565 24.6% 141,895 32.7% 41,196 23.9%NowMarried,ExcludingSeparated 53,687 48.4% 69,836 51.4% 45,059 53.9% 190,929 44.0% 103,938 60.3%Separated 2,329 2.1% 1,495 1.1% 1,087 1.3% 9,980 2.3% 2,068 1.2%Widowed 8,430 7.6% 7,609 5.6% 5,768 6.9% 30,375 7.0% 8,101 4.7%Female 6,388 11.0% 11,549 8.5% 8,443 10.1% 45,563 10.5% 12,583 7.3%

Divorced 15,197 13.7% 13,728 10.1% 11,118 13.3% 60,750 14.0% 16,892 9.8%Female 8,725 15.0% 14,946 11.0% 11,787 14.1% 68,127 15.7% 18,960 11.0%

DisabilityStatusoftheCivilianNon‐institutionalizedPopulation TotalCivilianNoninstitutionalizedPopulation 135,060 160,236 102,709 525,410 213,931WithaDisability 22,154 16.4% 19,583 12.2% 13,459 13.1% 80,706 15.4% 19,587 9.2%

Under18years 31,425 34,359 24,191 120,288 57,756WithaDisability 1,752 5.6% 1,554 4.5% 998 4.1% 6,643 5.5% 1,655 2.9%

18to64years 81,030 102,027 61,737 322,160 129,564WithaDisability 11,915 14.7% 9,470 9.3% 6,968 11.3% 43,813 13.6% 9,687 7.5%

65YearsandOver 22,605 23,850 16,781 82,962 26,611WithaDisability 8,487 37.5% 8,559 35.9% 5,493 32.7% 30,250 36.5% 8,245 31%


Clark County

Greene County

Miami County

Montgomery County

Warren County

Number Percent Number Percent Number Percent Number Percent Number Percent SchoolEnrollment Population3YearsandOverEnrolledInSchool

33,496 48,847 25,249 141,736 60,523

Nursery&Preschool 1,763 5.3% 2,682 5.5% 1,551 6.1% 8,703 6.1% 4,289 7.1%Kindergarten 1,638 4.9% 1,725 3.5% 1,210 4.8% 6,771 4.8% 3,434 5.7%ElementarySchool(Grades1‐8) 14,467 43.2% 15,624 32% 11,551 45.8% 52,863 37.3% 27,404 45.3%HighSchool(Grades9‐12) 7,254 21.7% 7,837 16% 5,665 22.4% 28,388 20% 13,834 22.9%CollegeorGraduateSchool 8,374 25% 20,979 43% 5,272 20.9% 45,011 31.8% 11,562 19.1%

EducationalAttainment Population25YearsandOver 93,110 108,078 71,468 362,413 146,044<9thGradeEducation 3,226 3.5% 2,648 2.5% 1,538 2.2% 10,617 2.9% 2,693 1.8%9thto12thGrade,NoDiploma 9,078 9.7% 5,788 5.4% 6,591 9.2% 28,696 7.9% 7,622 5.2%HighSchoolGraduate(IncludesEquivalency) 33,922 36.4% 27,712 25.6% 26,364 36.9% 104,439 28.8% 39,117 26.8%SomeCollege,NoDegree 21,964 23.6% 22,474 20.8% 15,488 21.7% 91,017 25.1% 25,865 17.7%AssociateDegree 8,105 8.7% 9,314 8.6% 6,774 9.5% 34,440 9.5% 12,925 8.9%Bachelor’sDegree 10,691 11.5% 21,014 19.4% 9,517 13.3% 55,492 15.3% 36,576 25%GraduateOrProfessionalDegree 6,124 6.6% 19,128 17.7% 5,196 7.3% 37,712 10.4% 21,246 14.5%

PercentHighSchoolGraduateorHigher 86.8% 92.2% 88.6% 89.2% 92.9%PercentBachelor’sDegreeorHigher*(X)–Notavailable 18.1% 37.1% 20.6% 25.7% 39.6%


Clark County

Greene County

Miami County

Montgomery County

Warren County

Number Percent Number Percent Number Percent Number Percent Number PercentIncomeIn2015 Households 54,809 64,182 41,135 222,687 78,359<$10,000 4,923 9% 4,886 7.6% 2,150 5.2% 21,398 9.6% 2,117 2.7%$10,000to$14,999 3,193 5.8% 2,844 4.4% 2,419 5.9% 14,269 6.4% 2,162 2.8%$15,000to$24,999 7,500 13.7% 5,654 8.8% 4,212 10.2% 28,267 12.7% 5,208 6.6%$25,000to$34,999 6,450 11.8% 5,433 8.5% 4,794 11.7% 26,645 12% 5,551 7.1%$35,000to$49,999 8,680 15.8% 8,167 12.7% 6,318 15.4% 33,056 14.8% 8,668 11.1%$50,000to$74,999 9,812 17.9% 11,443 17.8% 8,149 19.% 39,248 17.6% 15,791 20.2%$75,000to$99,999 6,661 12.2% 8,315 13% 5,716 13.9% 24,135 10.8% 11,262 14.4%$100,000to$149,999 5,075 9.3% 10,124 15.8% 5,002 12.2% 22,607 10.2% 13,934 17.8%$150,000to$199,999 1,686 3.1% 3,991 6.2% 1,499 3.6% 7,229 3.2% 6,964 8.9%$200,000ormore 829 1.5% 3,325 5.2% 876 2.1% 5,833 2.6% 6,702 8.6%MedianHouseholdIncome $43,625 $60,113 $51,569 $43,829 $74,379

IncomeIn2015 Families 35,980 42,229 27,826 133,872 58,919<$10,000 2,215 6.2% 1,742 4.1% 1,072 3.9% 8,860 6.6% 824 1.4%$10,000to$14,999 1,175 3.3% 1,067 2.5% 860 3.1% 5,545 4.1% 843 1.4%$15,000to$24,999 3,249 9% 2,290 5.4% 1,752 6.3% 12,175 9.1% 2,044 3.5%$25,000to$34,999 3,513 9.8% 3,013 7.1% 2,526 9.1% 12,895 9.6% 3,329 5.7%$35,000to$49,999 5,933 16.5% 4,554 10.8% 4,057 14.6% 19,000 14.2% 5,466 9.3%$50,000to$74,999 7,656 21.3% 7,590 18% 6,185 22.2% 26,363 19.7% 11,621 19.7%$75,000to$99,999 5,548 15.4% 6,529 15.5% 4,615 16.6% 18,671 13.9% 9,492 16.1%$100,000to$149,999 4,473 12.4% 8,851 21% 4,664 16.8% 18,730 14% 12,365 21%$150,000to$199,999 1,499 4.2% 3,556 8.4% 1,323 4.8% 6,451 4.8% 6,450 10.9%$200,000ormore 719 2% 3,037 7.2% 772 2.8% 5,182 3.9% 6,485 11%MedianHouseholdIncome(families) 55,198 78,588 62,745 56,990 88,824

MedianValueofOwner‐OccupiedUnits $103,600 $159,400 $136,800 $109,900 $190,900MedianMonthlyOwnerCosts(WithMortgage) $1,076 $1,416 $1,173 $1,199 $1,580

MedianMonthlyOwnerCosts(NotMortgaged) $393 $530 $407 $470 $540MedianGrossRentforRenter‐OccupiedUnits $675 $848 $730 $728 $923MedianRoomsPerHousingUnit 5.7 6.1 6 5.6 6.5

TotalHousingUnits 61,241 68,953 44,266 254,415 82,922NoTelephoneService 1,163 2.1% 1,406 2.2% 996 2.4% 4,543 2% 1,198 1.5%LackingCompleteKitchenFacilities 573 1% 331 0.5% 345 0.8% 1,653 0.7% 340 0.4%LackingCompletePlumbingFacilities 241 0.4% 147 0.2% 87 0.2% 746 0.3% 150 0.2%


Federal Poverty Thresholds in 2016 by Size of Family and Number of Related Children Under 18 Years of Age

(Source:U.S.CensusBureau,FederalPovertyThresholds,2016)

Size of Family Unit No

Children

One

Child

Two

Children

Three

Children

Four

Children

Five

Children

1Person<65years $12,486 1Person65and> $11,511

2peopleHouseholder<65years

$16,072 $16,543

2PeopleHouseholder65and>

$14,507 $16,480

3People $18,774 $19,318 $19,337 4People $24,775 $25,160 $24,339 $24,424 5People $29,854 $30,288 $29,360 $28,643 $28,205 6People $34,337 $34,473 $33,763 $33,082 $32,070 $31,4707People $39,509 $39,756 $38,905 $38,313 $37,208 $35,9208People $44,188 $44,578 $43,776 $43,072 $42,075 $40,809

9Peopleor> $53,155 $53,413 $52,702 $52,106 $51,127 $49,779


Children in Poverty

(Source:CommunityCommons,ascompiledby2014CountyHealthRankings)

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