Population Health Data Brief Essay

Sociodemographic Profile

Key Findings

Houston County, located in Texas, is less populated, with about 22,000 people and a population density of 17.9 per square mile. Whites dominate her population, but Latinos and Africana Americans are also notable races in this county. Outstanding sociodemographic in comparison with national data are low health insurance rates, low literacy levels, higher disability rates, and higher poverty rates,

Figure 1

Map of Houston County, Texas, United States of America

Note. Houston County, Texas, United States County Map (Maps of the World, 2022)

Introductory Paragraph

Houston county, whose county seat is at Crockett, is located in Texas and was founded in 1837. It is one of the 254 counties in Texas. Apart from Crockett, the other urban regions in Houston County are Grapeland city, Kennard city, Latexo city, and Lovelady city. Sociodemographic data presented about Houston County in table 1 below were adopted from the United States Census Bureau census.gov website. The census.gov website is the official website of the United States government that contains demographic data. This website derives its data from sources that include but are not limited to census reports, community surveys, health insurance estimates, population estimates, and non-employer statistics. Most data are represented as percentages that are used as proportions to compare with the national data.

In 2021, this county had about 22,000 people. This represented a 0.8% increase from the estimates of the previous year. The proportion of underage individuals (below 18 years) is slightly lower than the national estimates. However, the percentage of persons aged 65 years and above is higher than the national proportions. Whites dominate this county’s overall population at about 70% and males at more than 50%. African American proportion in Houston is higher than the national percentage. The other common race in Houston County is pure Hispanics or Latinos. The proportion of uninsured persons (health insurance) is more than twice the national percentage. This county also performs poorer than the national estimates in literacy level and home ownership of computers. Poverty levels and disability rates are also higher than national rates. Lastly, the population density of this county is five times lower than the national density.

Sociodemographic Profile Table

Table 1

Sociodemographic Profiles for Houston County, Texas, and the United States

Population Characteristics	County	United States
Population Estimates	22,241	331,893,745
Population Percent Change from April 1, 2020, to July 1, 2021	0.8%	0.1%
Percent of Persons Under the Age of 18	19.8%	22.2%
Percent of Persons 65 Years and Over	22.5%	16.8%
Percent of Female Persons	46.1%	50.5%
Percent White alone	71.8%	75.8%
Percent Black or African American alone	24.9%	13.6%
Percent American Indian and Alaska Natives alone	0.8%	1.3%
Percent Asian alone	0.8%	6.1%
Percent Native Hawaiian and Other Pacific Islanders alone	Above zero but negligible	0.3%
Percent Two or More Races	1.6%	2.9%
Percent Hispanic or Latino alone	12.7%	18.9%
Percent White alone, not Hispanic or Latino	60.5%	59.3%
Language Other Than English Spoken at Home, Percent of  persons 5 years +	8.5%	21.5%
Percent of Houses with a Computer	83.9%	91.9%
Percent with High School Graduate or Higher	81.2%	88.5%
Percent with a Disability, Under Age 65 Years (2016-2020)	13.9%	8.7%
Percent without Health Insurance, Under Age 65 Years	19.0%	9.8%
Percent in Civilian Labor Force Age 16 Years+	43.9%	63.0%
Percent of Females in Civilian Labor Force aged 16 Years+	48.7%	58.4%
Total Healthcare and Social Assistance Revenue in 1000 US dollars (2017)	41,939	2,527,903,275
Total Retail Sales Per Capita	$7,892	$15,224
Per Capita Income in the Past 12 Months (in 2020)	$21,669	$35,384
Percent of Persons in Poverty	20.0%	11.6%
Population Per Square Mile (2020)	17.9	93.8

 

County Health Trends and Rankings

 

Introductory Paragraph

Changes in health outcomes and trends over time are equally important as sociodemographics snapshot data in health planning, health monitoring, and health policymaking. Health outcomes reflect the current health of a population, while health trends reflect the outcome of preventive and curative strategies employed at the individual, state, and national levels. The section compares Houston County health outcomes and trends with state-level and national-level statistics. Parameters compared include program outcomes, health factors, and health outcomes. The health factors considered in this comparative section concern health behaviors, socioeconomic factors, and physical environment.

Discussion of Health Trends

The seven major health trends chosen were premature deaths, deaths related to driving due to impairments from alcohol, flu vaccinations, lack of insurance, breast cancer screening, sexually transmitted infections, and air pollution. Generally, health practice aims at preventing disease, restoring health, preventing deaths, and improving the quality of life of people. To assess the effectiveness of a health system in achieving these trends in health prevention, health promotion, health treatments, and mortalities can be effective. Health behaviors such as alcohol use and unsafe sexual practices can provide health care professionals and policymakers in targeting their interventions to manage these preventable deaths by reducing risk factors.

Screening and vaccinations in healthcare are essential health prevention strategies that identify at-risk populations with the disease of interest and initiate interventions early. Cancer is one of the leading causes of death nationally, while flu infections, especially the seasonal flu, are responsible for deaths in vulnerable populations. Using mammography data to screen breast cancers in figure 6 enables early identification and treatment. The trends in the number of flu vaccinations in figure 4 provide a visualization of the population readiness to avert adverse outcomes of influenza infections. Air pollution has implications for respiratory health and outcomes of lung conditions.

Health Trends (Visual Graphs)

Figure 2

Trends in years of potential life lost per 100,000 population in Houston County, Texas State, and the United States of America.

Note: This graph indicates a decrease in county rates of premature deaths from 1998 to 2019 of 2000 years of potential life lost per 100,000 population compared to a 700 decrease in the state of Texas and a 500 decrease nationally (County Health Rankings & Roadmaps, n.d.).

Figure 3

Trends in Alcohol-impaired driving deaths in Houston County, Texas state, and nationally between 2008 and 2020

Note: This graph indicates a decrease in county rates of alcohol-impaired driving deaths from 2008 to 2020 of 28% compared to a 7% decrease in the state of Texas and a 7% decrease nationally (County Health Rankings & Roadmaps, n.d.).

 

Figure 4

Graph showing trends on rates of Medicare enrollees receiving flu vaccinations between 2012 and 2019

Note: This graph indicates an increase in county rates of flu vaccinations from 2012 to 2019 of 5 % compared to a 4% increase in the state of Texas and a 4% increase nationally (County Health Rankings & Roadmaps, n.d.).

Figure 5

A graph showing trends in the percentage of uninsured persons between 2008 and 2019 in Houston, Texas, and Nationally

Note: This graph indicated a general increase in the percentage of uninsured after 2008 and before 2010 when the rates started to decrease. However, after 2016 the rates of uninsured have increased by 3% compared with a 2% increase in Texas and 1% nationally.

Figure 6

A graph showing trends in the percentage of Medicare enrollees screened for breast pathologies using mammography between 2012 and 2019 in Houston County, Texas state, and at the national level

Note: This graph indicates that the percentage has been steady or decreasing at the county, state, and national levels before 2016. However, from 2016 to 2019, Houston County has recorded a 3% decrease compared with a 2% increase in Texas state and 2 percent nationally between 2016 and 2019.

Figure 7

A graph showing chlamydia cases per 100000 population trends between 2007 and 2019 for Houston County, Texas State, and at the National level.  

Note: This graph indicates that since 2007, their trends in rates of chlamydia cases have been increasing at the county, state, and national levels until 2017. Thereafter, Houston County recorded a decrease of 24.8 per 100000 cases compared with a decrease at the state level of 89.6per 100,000 and a national increase of 26.4 per 100000.

Figure 8

A graph showing trends of levels of air pollution in particulate matter in micrograms per cubic meter between 2002 and 2018 in Houston County, Texas State, and at the national level  

Note: This graph indicates a general decrease in levels of air pollution at all levels up to 2016, when the rates started to increase with 1.2 micrograms per cubic mm in Houston County compared with 1.7 in Texas state and 0.2 nationally between 2016 and 2019.

Health Trends Discussion

Figure 2 shows that the years of potential life lost per 100,000 population in Houston County is still higher than at state and national levels showing that there is still a need for improvement in health access, prevention, promotion, and maintenance to improve life expectancy and prevent premature deaths. Recent trends in years of potential life lost per 100,000 populations have been improving with a steady increase. The trends in the deaths related to driving with alcohol involvement have been rising and falling with recent reductions at the county, state, and national levels, thus suggesting the improvement in road safety and alcohol use policies in Houston, Texas, and nationally. Figure 7 shows that the rates of chlamydia among residents of Houston have been lower than state and national levels. However, the rates have risen in the past 15 years, showing an increased risk of complications such as pelvic inflammatory disease and infertility among women.

Figure 4 shows that the proportion of people in Houston County getting flu vaccinations has been persistently lower than the state and national data for the past ten years, thus putting the residents at risk of adverse outcomes of seasonal flu and associated respiratory complications. Figure 6 shows that the proportions of mammography screening in Houston have been increasingly lower in Houston than in state and national estimates for the past 10 years, thus putting residents of Houston at increased risk of late breast cancer diagnosis and poorer treatment outcomes.

Figure 5 demonstrates how the rates of uninsurance have increased in Houston County for the past half-decade more than it has at the state and national levels, thus limiting affordability and access to care by Houston residents. Figure 8 shows a persistently high rate of air pollution in Houston, more than the state and national levels for the past 20 years, that put Houston residents at increased risk of respiratory diseases such as Chronic Obstructive Pulmonary Disease (COPD), asthma and generally poorer respiratory health.

The overall health ranking of Houston County is lower than that of the state and the country. The rankings in preventive health (flu vaccination and mammography screening), environmental health (health risks such as air pollution), and premature deaths were lower than the state and national rankings. This suggests the need for promotive and preventive health at the county level. Most of these rankings are based on the trends in the last six years. These rankings could be related to higher poverty rates, lower health insurance coverage, and a lower percentage in the civilian labor force than the national estimated rates.

ORDER A PLAGIARISM-FREE PAPER HERE

Health Factors

Health Factors Table

Table 2

Factors Influencing Health Profiles for Houston County, Texas, and the Top U.S. Performer

Factors Influencing Health	County Data	State Data	Top U.S. Performer
Percent Smoking (adults)	24%	15%	15%
Percent with Access to Exercise Opportunities	54%	86%	80%
Percent Excessive Drinking	18%	15%	20%
Primary Care Physicians (Ratio of Population to 1 Physician)	5,740:1	1010:1	1630:1
Percent of High School Graduation	81%	94%	84%
Percent with Some College	47%	74%	63%
Percent with Unemployment	5.3%	4.0%	7.6%
Percent of Children in Single-Parent Households	35%	14%	26%
Social Associations (Number of Associations Per 10,000)	12.2	18.1	7.5
Violent Crime (Number of Violent Crimes Per 100,000)	214	63	420
Injury Deaths (Number of Injury Deaths Per 100,000)	83	61	60
Percent of Children Eligible for Free or Reduced-Price Lunch	70%	32%	60%
Air Pollution (Average Daily Density of Air Pollutants)	9.8	5.9	9.0
Percent with Severe Housing Problems	18%	9%	17%

Note: N/A means not applicable and indicates the data were not available for that population characteristic.

Comparison of Data

The tabulated data on health factors in figure 2 above has shown that Houston County still compares poorly with the top national performers and Texas in adult smoking, access to physical exercise services, primary care physician-to-resident ratio, high school education, college education, single-parent households with children, number of social associations, rates of injury deaths, percent of children eligible for free or reduced-price lunch, air pollution, and severe housing problems. At the state level, the county has met the targets in reducing excessive dirking and violent crimes. These comparisons show that the county still has poor state socioeconomic and environmental factors that are critical determinants of health. The children’s health has been at risk compared to the state and national estimates. The county is significantly different from the overall state data in environmental and social determinants of health, such as smoking, pollution, and access to exercise opportunities. On the positive side, the county has lower unemployment rates, lower violent crimes, and a high number of social associations than the overall state data.

Summary

Significant Findings

The summarized trends in health outcomes showed decreasing trends in mammography screening among residents of Houston County. Since 2016, the percentage of residents getting mammography screening for breast cancer has been diminishing as the state and nationally reported rates rose. The deviation from state and national trends could be due to disparities in resource access, cultures, policies, and programs, such as the lack of post-Affordable Care Act cost-sharing programs for mammography screening (Carlos et al., 2019). Using the trends graph as a predictive tool shows that future trends could worsen for Houston County. Therefore, this is an actionable trend that can benefit from public health interventions to improve uptake and frequent use of preventive interventions.

According to Duffy et al. (2020), mammography screening reduces the rates of advanced breast cancers in women. Current recommendations require that women above 50 should attend at least one mammography screening every year to reduce the risk of late breast cancer diagnosis. Breast cancer is among the top causes of cancer mortalities in the United States. Therefore, the diminishing trends in Houston County warrant community health preventive measures.

Action Plan(s)

Addressing mammography screening trends can involve improvement in policies, programs, and awareness. The county health rankings model describes a framework where health policies and programs modify health factors that, in turn, improve health outcomes (County Health Rankings, 2022). Programs can influence resource utilization and access that can improve mammography screening and breast cancer prevention and achievement of best outcomes of treatment. Initial steps to implement this plan will require stakeholder involvement and financial planning. Key stakeholders will include the state department of health policymakers, the state board of nursing, community health nurses, and informaticists. Involving these stakeholders is important in promoting the success of the programs.

Services or Programs

Employee programs are evidence-based stratus that can be used to improve mammography screening in Houston County. Employee programs involve offering classes and seminars on mammography screening to enhance the active involvement of employees on-site at the workplace. Community health programs that involve offering mammography screening at the workplace can also increase mammography screening by overcoming structural barriers such as distance and access to these services (Farrell et al., 2020). Therefore, combining Mobile mammography vans and onsite workplace seminars and classes can be a more effective strategy.

Raise Public Awareness and Promote Public Engagement

Raising public awareness can be achieved through various means. One-on-one patient education in the primary care setting is the cheapest strategy to engage the public in mammography screening by targeting messages for breast cancer screening. The use of technology is also a viable option that can involve social media and mass media such as television. Workplace education, as aforementioned, can also raise public awareness about mammography screening (CDC, 2021; Farrell et al., 2020). To supplement patient teaching technologies such as telephone and other telehealth strategies can be used to reinforce patient education and follow up the patients identified to be at risk to enhance their uptake of these services (CDC, n.d.).

Monitoring and Evaluating Action Plan

The effectiveness of the above programs and public awareness strategies can be evaluated through regular surveys and point-of-screening reports about the number of women assessing these services. Biennial reports on the numbers of eligible women and at-risk women accessing mammography screening is a possible way to monitor and evaluate the effectiveness of this plan. Sources of reports can include all public and private centers offering mammography screening. Baseline data for comparison is important to assess a statistical change. Development of trends using this reporting data would provide a sense of direction in the minoring and evaluation. Analysis of the value of change from bassline stats will be used to determine the success of the plan.

Data Sources and Methods

The data sources for this population data brief of Houston County and plan for change were the census.gov website and the County Health Rankings and Roadmap website. These websites provided the most current data on required parameters and graphs for trends on specific outcomes and factors. These sources contained tables for easy comparison and already summarized rates, ratios, and percentages on the outcomes of interest. Therefore, the required data was obtained through manual entry and snipping graphs and charts.

ORDER A PLAGIARISM-FREE PAPER HERE

References

Carlos, R. C., Fendrick, A. M., Kolenic, G., Kamdar, N., Kobernik, E., Bell, S., & Dalton, V. K. (2019). Breast screening utilization and cost-sharing among employed, insured women after the Affordable Care Act. Journal of the American College of Radiology: JACR, 16(6), 788–796. https://doi.org/10.1016/j.jacr.2019.01.028

CDC. (n.d.). Breast Cancer Screening Guidelines for Women. Cdc.gov. https://www.cdc.gov/cancer/breast/pdf/breast-cancer-screening-guidelines-508.pdf

CDC. (2021, May 12). Programs. Cdc.gov. https://www.cdc.gov/workplacehealthpromotion/health-strategies/breast-cancer/interventions/programs.html

County Health Rankings. (2022). County Health Rankings 2022: 2022 State Report Texas. Countyhealthrankings.org. https://www.countyhealthrankings.org/sites/default/files/media/document/CHR2022_TX_0.pdf

County Health Rankings & Roadmaps. (n.d.). Houston (HOU) County, Texas. County Health Rankings & Roadmaps. Retrieved October 26, 2022, from https://www.countyhealthrankings.org/app/texas/2022/rankings/houston/county/outcomes/overall/snapshot

Duffy, S. W., Tabár, L., Yen, A. M.-F., Dean, P. B., Smith, R. A., Jonsson, H., Törnberg, S., Chen, S. L.-S., Chiu, S. Y.-H., Fann, J. C.-Y., Ku, M. M.-S., Wu, W. Y.-Y., Hsu, C.-Y., Chen, Y.-C., Svane, G., Azavedo, E., Grundström, H., Sundén, P., Leifland, K., … Chen, T. H.-H. (2020). Mammography screening reduces rates of advanced and fatal breast cancers: Results in 549,091 women. Cancer, 126(13), 2971–2979. https://doi.org/10.1002/cncr.32859

Farrell, K., Bennett, D. L., & Schwartz, T. L. (2020). Screening for breast cancer: What you need to know. Missouri Medicine, 117(2), 133–135.

Maps of the World. (2022, March 8). Houston County Map. USA States. https://www.mapsofworld.com/usa/states/texas/counties/houston-county-map.html

B2.  Discussion of Health Trends

Approaching Competence.  The information provided in the “Discussion of Health Trends” subsection of the attached “Population Health Data Brief Template” does not include a discussion of the use of trend graphs for the 7 major health trends selected in part B3. Or the discussion does not detail the health of the county or whether each health trend is improving or getting worse. Or the discussion does not include the county’s overall health outcomes or length of life ranking.

EVALUATOR COMMENTS

The data brief thoughtfully expresses that health outcomes reflect the current health of a population while trends reflect the outcome of preventive and curative strategies. Whether each trend is improving or getting worse is addressed in aspects B3 Health Trends (Visual Graphs) and B4 Health Trends Discussion. The discussion does not address the county’s overall health outcomes and length of life ranking.

D2. Action Plan(s)

Approaching Competence. The information provided in the “Action Plan(s)” subsection of the attached “Population Health Data Brief Template” does not include the initial steps needed for implementing an action plan to address the main health trend in part D1.

EVALUATOR COMMENTS:

The action plan on page 14 notes that improving policies, programs, and awareness can address mammography screening trends. The plan is missing details about the initial steps that are needed to implement an action plan to address this main health trend.

 

D2c. Monitoring and Evaluating an Action Plan

Approaching Competence. The information provided in the “Monitoring and Evaluating Action Plan” subsection of the attached “Population Health Data Brief Template” does not plausibly summarize how the elements of the proposed action plan from parts D2a and D2b will be monitored. Or the summary does not include the data collection tools used to gather, evaluate, or visually represent data for analysis and reporting on progress.

EVALUATOR COMMENTS:

Surveys, point-of-screening reports, and specific biennial reports are identified as ways to monitor and evaluate program effectiveness. How the collected data will be visually represented for analysis and reporting on progress is not included.