Community Health Assessment

Weber–Morgan Health Department Community Health Assessment

Section 1 Introduction Photo Credit: Laniece Roberts

Acknowledgements Photo Credit: Laniece RobertsT his community document has been developed by the Weber–Morgan Health Department and community partners. Many professionals dedicated their time and expertise in creatingthis Community Health Assessment. We wish to thank those involved for their valuableparticipation in developing this document:Abigal Weymouth, MPH, CHES Jarelyn Cox, RD, CD, IBCLCHealth Promotion Educator: Assistant WIC AdministratorTobacco Prevention and Control Program Kristy Jones, MPHBrian Bennion, MPA, LEHS Intermountain HealthCare Community BenefitExecutive Director/Health Officer Laura Santurri, PhD, MPH, CPHBrian Cowan, MPH, LEHS Weber State University Program DirectorAssistant Environmental Health Administrator & Assistant Professor of Health PromotionBryce Sherwood, BS, CHES Liese Zahabi, MGDHealth Promotion Supervisor Weber State University Assistant Professor of Graphic DesignCathy BodilyEmergency Services Program Manager Lori Buttars Public Information OfficerCathy FuentesOgden City Project Coordinator Michela Gladwell, LEHS Environmental Health Program ManagerColleen Jenson, BS, CLEDirector WIC Rob Hall Youth Impact DirectorDung Banh, MSNNursing AdministratorJacob Matthews, MPAPublic Health ContractorFor questions and suggestions about this Community Health Assessment, please contact theWMHD at (801) 399-7100 during the hours of 8am–5pm Monday–Friday. Community Health Assessment 3

Table of Contents Section 1: Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 2–27 About the Community Health Assessment . . . . . . . . . . . . . . . . . . . . . . . . Pages 6–7 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 6 Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 6 Process and Methods. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 6–7 Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 8–9 Description of Weber and Morgan Counties . . . . . . . . . . . . . . . . . . . . . . . Pages 10–12 Geography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 10 Cities and Unincorporated Communities. . . . . . . . . . . . . . . . . . . . . . Page 10 Government . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 11 Climate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 11 Transportation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 11–12 What Residents Are Saying About Transportation Options . . . . . . . . . Page 12 Demographic Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 13–19 Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 13–14 Projected Population Growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 15 Age of Residents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 15–16 Age Projections. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 17 Age Adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 18 Race and Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 18–19 Social and Economic Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 20–24 Workforce Composition and Wages . . . . . . . . . . . . . . . . . . . . . . . . . Page 20 Cost of Living . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 21 Education. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 22 Religion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 23 Politics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 23 Healthcare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 24 Special Populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 24–25 Under–Educated Populations . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 24 Populations in Poverty. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 24 Veterans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 25 Homeless . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 25 Incarcerated Residents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 25 Residents with Potential Language Barriers and Challenges . . . . . . Page 25 County Health Rankings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 26 Section 2: Mortality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 28–37 Premature Death, Health Indicator 1 . . . . . . . . . . . . . . . . . . . . . . . . . . Page 29 Death Rate and Life Expectancy, Health Indicator 2 . . . . . . . . . . . . . . . . Page 30 Leading Causes of Death, Health Indicator 3. . . . . . . . . . . . . . . . . . . . . Page 31 Chronic Disease Death Rates, Health Indicator 4 . . . . . . . . . . . . . . . . . . Page 32 Injury Death Rates, Health Indicator 5 . . . . . . . . . . . . . . . . . . . . . . . . . Pages 33-34 Suicide, Health Indicator 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 35–36 Infant Mortality, Health Indicator 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 374 Weber-Morgan Health Department

Section 3: Morbidity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 38–57 Health Related Quality of Life, Health Indicator 8 . . . . . . . . . . . . . . . . . Page 39 Birth Outcomes, Health Indicator 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 40–41 Hospitalizations, Health Indicator 10 . . . . . . . . . . . . . . . . . . . . . . . . . . Page 42 Chronic Disease Prevalence, Health Indicator 11 . . . . . . . . . . . . . . . . . . Page 43 Cancer Incidence, Health Indicator 12 . . . . . . . . . . . . . . . . . . . . . . . . . Page 44 Adult Obesity, Health Indicator 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 45–46 Childhood Obesity, Health Indicator 14. . . . . . . . . . . . . . . . . . . . . . . . . Page 47 Obesity Disparities, Health Indicator 15 . . . . . . . . . . . . . . . . . . . . . . . . Page 48 Communicable Disease Incidence, Health Indicator 16. . . . . . . . . . . . . . Page 49 Sexually Transmitted Infections, Health Indicator 17 . . . . . . . . . . . . . . . Pages 50–51 Vaccine Preventable Diseases, Health Indicator 18 . . . . . . . . . . . . . . . . Pages 52–54 Mental Health Conditions, Health Indicator 19. . . . . . . . . . . . . . . . . . . . Page 55 Oral Health Conditions, Health Indicator 20 . . . . . . . . . . . . . . . . . . . . . Pages 56–57Section 4: Health Behaviors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 58–76 Alcohol Abuse, Health Indicator 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 59 Tobacco Use, Health Indicator 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 60–62 Adolescent Substance Abuse, Health Indicator 23 . . . . . . . . . . . . . . . . . Pages 63–65 Healthy Eating, Health Indicator 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 66–69 Physical Activity, Health Indicator 25 . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 70–73 Safety, Health Indictor 26. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 74–75Section 5: Clinical Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 77–93 Insurance, Health Indicator 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 80 Cost of Healthcare, Health Indicator 28 . . . . . . . . . . . . . . . . . . . . . . . Page 81 Healthcare Provider Ratios, Health Indicator 29. . . . . . . . . . . . . . . . . . . Pages 82–83 Mental Health and Substance Abuse Services, Health Indicator 30 . . . . . Page 84 Diabetes Management, Health Indicator 31 . . . . . . . . . . . . . . . . . . . . . Page 85 Breast Cancer Screening/Mammograms, Health Indicator 32 . . . . . . . . . Page 86 Prostate & Colorectal Cancer Screenings, Health Indicator 33 . . . . . . . . . Page 87 Immunization & Vaccination, Health Indicator 34 . . . . . . . . . . . . . . . . . Pages 88–91 Preventable Hospital Stays, Health Indicator 35 . . . . . . . . . . . . . . . . . . Page 92Section 6: Social and Economic Factors . . . . . . . . . . . . . . . . . . . . . . . Pages 94–107 Education, Health Indicator 36 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 95–96 Employment, Health Indicator 37 . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 97 Income, Health Indicator 38 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 98 Economic Disparities, Health Indicator 39. . . . . . . . . . . . . . . . . . . . . . . Page 99 Housing, Health Indicator 40 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 100–101 Family & Social Support, Health Indicator 41 . . . . . . . . . . . . . . . . . . . . Pages 102–104 Community Safety & Crime, Health Indicator 42 . . . . . . . . . . . . . . . . . . Pages 105–106Section 7: Physical Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 108–120 Air Quality, Health Indicator 43 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 110–116 Water Quality, Health Indicator 44 . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 117–118 Physical Dwelling Safety, Health Indicator 45 . . . . . . . . . . . . . . . . . . . . Page 119Section 8: Conclusion and Future Planned Action . . . . . . . . . . . . . . . . Pages 121–123Section 9: PhotoVoice Exhibit and Interviewswith Key Stakeholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pages 124–144Community Health Assessment 5

About the Community Health Assessment Photo Credit: Laniece RobertsIntroductionA ssessing the health status of the community is a core public health function provided by the Weber–Morgan Health Department (WMHD). Conducting a Community Health Assessment(CHA) is a primary method of determining the health status and needs of the community.PurposeThe first purpose of this CHA is to better educate the WMHD staff, government officials, communityleaders, and residents of the current health status and needs of the community. The secondpurpose of this CHA is to provide the data needed to mobilize the WMHD and its communitypartners to develop public health priorities, allocate and streamline community resources, andplan actions to improve the public’s health.Ultimately, this CHA seeks to increase the >>>>>>>>>>M>on>itorASSESSeffectiveness and efficacy of the WMHD and >>>>>> ASSURANCE >>> Evaluate MENT >>>>>>> POLICYincrease the quality of life for residents of HealthWeber and Morgan Counties through SYSTE MENTenhanced health. Assure M MANAGE Diagnose & Competent Research InvestigateProcess and Methods WorkforceDuring 2014 and 2015 the WMHD worked Informwith several community partners to acquire Link to/ Educateand analyze the primary and secondary Provide Empowerdata used in the CHA. Data types included Careboth qualitative and quantitative data. Enforce Develop MobilizeTypically, WMHD or county level data was Laws Policies Communitycompared against the state and/or national Partnershipaverages, when it was available. Wherever DEVELOPMENT >>>>>>>>possible the small area data, the small regionsthat comprise the WMHD, was also comparedagainst state and national averages. Graphic 1: Core Functions of Public Health6 Weber-Morgan Health Department

The following graphic shows all of the geographic regions compared throughout the CHA.Graphic 2: Geographical Areas of Comparison in the CHANational Downtown Ogden Ben LomondUtah Weber–Morgan Health Roy/Hooper Eastern Department (WMHD) Riverdale Weber Davis County Health County Department (DCHD) South Ogden & Morgan County Salt Lake County Health Department (SLCoHD) Utah County Health Department (UCHD)Healthy People 2020 (HP2020) goals, a set of national health goals developed by numerousfederal agencies, were also compared against the WMHD’s actual health status. These goalsrepresent ideal health outcomes per 100,000 residents (age-adjusted) that every healthdepartment should strive to meet and exceed in order to help improve the community’s health. Community Health Assessment 7

Executive Summary Photo Credit: Laniece Roberts T he Weber–Morgan Health Department (WMHD) is pleased to present its first Community Health Assessment (CHA) since the early 1990’s. This 2015 CHA was created through a collaborative effort between the WMHD and our community partners. This CHA documents the overall health of Weber and Morgan Counties. Understanding the health status, challenges, and needs of our residents will help the WMHD and its community partners prioritize and coordinate efforts, direct resource allocation, and provide more effective public health services to the community. The WMHD and its community partners collected both primary and secondary data from extensive sources to form the content of this CHA. Primary data collection included: resident surveys, resident and health leaders focus groups, interviews with key stakeholders, and resident input from the PhotoVoice Exhibit. Both English and Spanish speaking residents voiced their health concerns and provided invaluable feedback to the WMHD. Secondary data was principally collected from the Centers for Disease Control and Prevention (CDC), the Indicator Based Information System (IBIS), a database maintained by the Utah Department of Health (UDOH), the U.S. Census Bureau, and the County Health Rankings & Roadmaps Report by the Robert Wood Johnson Foundation. These various data sources were compiled and compared to national and state averages and where possible, to Davis, Salt Lake, and Utah Counties. Of the geographic comparisons, the most informative comparisons to Weber and Morgan Counties are in this order: nearby counties, local health departments, the state of Utah, and national averages. By providing geographic based comparisons, the WMHD is better able to understand areas of strength and improvement. These comparisons also serve as a basis for prioritizing public health activities in the WMHD. The community’s health status was also compared against Healthy People 2020 (HP2020) targets, which are 10-year health objectives developed by experts from 17 federal agencies, including the CDC, the Food and Drug Administration, the Health Resources and Services Administration, Indian Health Services, the National Institutes of Health, the U.S. Department of Education, and the U.S. Department of Agriculture. HP2020 provides health standards against which to measure the health progress of the residents served by the WMHD.8 Weber-Morgan Health Department

The 2015 CHA presents the most recent national, state, county, and local health department dataavailable. Because the health status of the community is continuously changing, this CHA will beupdated and released again no later than five years in the future.The 2015 CHA indicates the WMHD performs well in many areas when comparing health indicatorson a national and state basis, as well as on a local health department level. There are areas forimprovement ranging from minor to significant in the WMHD.1 Weber County is ranked as the 16thhealthiest county out of the 27 counties surveyed in Utah. For the past six years, Morgan Countyhas ranked as the healthiest county in the state of Utah. Morgan County is one of the healthiestcounties in the nation as it has ranked in the top 10% of U.S. counties for most health indicators.The WMHD is elated that Morgan County leads the way as the healthiest county in the state,however it is clear there are opportunities for improvement throughout the health district. Theinformation of this CHA will be used, to educate, engage, and empower the communities in Weberand Morgan Counties to improve their health. It will be used by the WMHD and its communitypartners to better serve the public by coordinating and prioritizing public health services andresources to meet the needs of residents. These coordinated and prioritized plans will be formallyoutlined in the 2016 Community Health Improvement Plan (CHIP).Together, public health workers and officials, local government, community leaders, and residentscan use the information in this 2015 CHA to make Weber and Morgan Counties cleaner and safercommunities where healthy individuals and families can thrive.Brian Bennion, MPA, LEHSExecutive Director/Health OfficerWeber–Morgan Health DepartmentFor questions and suggestions, please contact theWMHD at (801) 399-7100 during the hours of 8am–5pm Monday–Friday.Community Health Assessment 9

Description of Weber & Morgan Counties Photo Credit: Laniece Roberts Geography W eber County is the second smallest county Graphic 4: Weber County in Utah by land area (577 square miles) and is predominately an urban center with some rural communities.2,3 It is located in northern Utah and is directly above urban Davis County. It is also bordered by the Great Salt Lake to the west, to the north by the predominantly rural Counties of Box Elder, Cache, and Rich, to the southwest by rural Tooele County, and to the east by rural Morgan County. Weber County is divided by the Wasatch Mountains into the Upper Valley and Lower Valley regions. A majority of Weber County residents reside in the Lower ValleyWeber region. The Upper Valley region contains a few concentrated pockets of Weber County residents, but the overall population of the region is less than 10% of the Graphic 5: Morgan County entire Weber County population. Marsh land abounds near the Great Salt Lake on the western portion of the county. Elevation ranges from 4,200 feet in Ogden to approximately 10,000 feet in the mountains. Located in the valleys east of the Wasatch Front, Morgan County is the third smallest county in Utah by land area (609 square miles) and is a rural county.4,5 It is bordered by five counties — Weber County to the north, Rich County to the northeast, Summit County to the east, Salt Lake County to the southwest, and Davis County to the west. Morgan County is aptly described as having many high valleys and mountainous terrain. Elevation ranges from 4,915 feet in Mountain Green, Morgan County to 11,928 feet in the mountains.Morgan Cities and Unincorporated Communities Weber County consists of 14 cities, 1 town, and 7 unincorporated communities. Morgan County is comprised of 1 city and 7 unincorporated communities.10 Weber-Morgan Health Department

GovernmentThe county seat of Weber is located in Ogden City. Weber County is Webergoverned by a three member commission that acts as both the legislativeand administrative arms of the county.6 The county seat of Morgan County is located in Morgan City. Morgan Morgan County is governed by a county council comprised of Weber County Commissioners seven members.7 The council acts as the legislative and administrative arms of the county.6Morgan County CouncilClimateThe climate in Weber and Morgan Counties is classified as cold and semi-arid. Shrubs and bushesabound in this climate type. Cold semi-arid climates are typically found deep in the interior ofcontinental bodies and feature a hot and dry summer with winters being cold and wet. Bothcounties receive substantially less average rainfall than the U.S. average, but have significantlyelevated snowfall averages than the national average. Because of the high elevation,temperatures between day and night can vary greatly. Due to the proximity of the Great SaltLake, some portions of Weber County can experience “Lake Effect” or increased snowfall.Because of the elevated altitude, Morgan County experiences more snowfall in the winter andoverall cooler temperatures than Weber County.TransportationWeber County contains many transportation options available to most of its residents. Interstate15 (I-15) extends through the heavily populated Lower Valley region of Weber County, connectingthe county with Davis and Salt Lake Counties to the south and Box Elder County to the north.State Route 39 and North Ogden Canyon Road connect the Lower Valley with the less populatedUpper Valley region of Weber County. Interstate 84 (I-84) and State Route 167 are the onlyroutes in Weber County that connect to Morgan County. Morgan County is connected to Salt LakeCounty by State Route 65 and to Summit County by I-84.Many residents utilize these major interstate and stateroads to commute to employment locations within Weberand Morgan Counties. Many Weber residents also commuteto places of employment located within Davis and Salt LakeCounties. More than 50% of employed Morgan residentscommute to the greater Ogden area.8The FrontRunner commuter rail serves southern andeastern Weber County with stops in Roy and Ogden City. Weber County FrontRunner Stop. Photo courtesy PhotoVoice. Community Health Assessment 11

Regional airports include the Ogden-Hinckley Airport and the Morgan County Airport. Withouttraffic, the Salt Lake City International Airport is 44 minutes away from Morgan City and 37minutes away from Ogden City. With traffic, the travel time to the Salt Lake City InternationalAirport is increased by an additional 20–30 minutes.The Utah Transit Authority (UTA) provides extensive bus service within the core Lower Valleyregion of Weber County, however there are peripheral portions of the west and north sides of theLower Valley that are without service. There is limited UTA bus service in the Upper Valley area of Weber County. Morgan County is not served by a transit agency — transportation options for residents are primarily limited to privately owned vehicles. Ogden City has an extensive trail system that provides residents with alternative transportation routes designed for foot traffic and/or bicycles. These healthy modes of transportation are valued by city residents, however there are limited safe connection points between the east and west sides of Ogden City.29th St. Trail Head. Photo courtesy PhotoVoice.What Residents are Saying about Transportation OptionsWMHD residents spoke positively of the alternative transportation options available inOgden City. “The trails get better and better.”9 “Love the trails. Please keep them clean.”10 “I love the easy access to all the trails in Ogden.”11Public transit comments from WMHD residents were also positive. “It’s easy to get from one place to another, you don’t have to pay for parking.”12 “I love UTA! Gets us broke people out and back and forth to work!”13 “The FrontRunner is my way of connecting to events and to friends and it is a joy to ride and be safe, instead of wasting gas and fighting traffic — try it you’ll love the ride.”1412 Weber-Morgan Health Department

Demographic ProfilePopulationW eber and Morgan’s populations were respectively 231,236 and 9,469 in 2010. With a population increase of 17% from 2000 to 2010, Weber County experienced almost doublethe national population increase rate for the same time period. With a 32.8% population increasefrom 2000 to 2010, Morgan County experienced more than three times the national populationincrease rate for the same time period.Graphic 6: Population GrowthNational Weber County 231,236 (2010) 308,745,538 (2010) 196,533 (2000) 281,421,906 (2000) 17% 9.7% Population Increase Population Increase Utah 2,763,885 (2010) Morgan County 2,233,169 (2000)Source: U.S. Census Bureau 9,469 (2010) 23.7% 7,129 (2000) Population Increase 32.8% Population Increase Community Health Assessment 13

Chart 1: Weber County Population DistributionWeber Ogden 10,000 20,000 30,000 40,000 50,000 60,000 70,000 80,000 90,000 Roy North Ogden South Ogden West Haven Washington Terrace Pleasant View Hooper Farr West Harrisville Plain City Marriott-Slater Uintah Huntsville 0 Source: U.S. Census Bureau Ogden is the most populous city in Weber County with 35.8% of the total county population, Roy is the second most populated city with 15.9%, and North Ogden is the third with 7.5%. The Lower Valley holds 90.6% of Weber County’s total population. According to the U.S Census Bureau, approximately 11% of Weber County’s population resided in a rural area in 2010.15 The percentage of WMHD residents residing in rural areas is projected to fluctuate between 8.4% and 11% over the next 45 years. New Construction in Ogden. Photo courtesy PhotoVoice. Weber County has a population density of 401.4 per square mile.16 Nearby Counties have a population density of 485 (Davis) and 1,274 (Salt Lake) per square mile. Ogden City has a population density of 3,161 per square mile, Roy 4,866, and North Ogden 2,670. These population densities per square mile are higher than those found in the three largest cities in Utah. Salt Lake has a population density of 1,709 per square mile, West Valley’s population density per square mile is 3,651, and Provo has a population density of 2,555 per square mile. The most populated region in Morgan County is its Chart 2: Morgan County only city, Morgan. According to the U.S. Census Population Distribution Bureau, in 2010 61% of Morgan County’s populationMorgan resided in a rural area.17 This percentage is 8,000 estimated to decline to 51% by 2060.18 6,000 Morgan County has a population density of 15.5 3,000 Morgan City Unincorporated per square mile.19 Morgan City has a population 2,000 Morgan County density of 1,154 per square mile. Unincorporated Morgan County has a population density of 9.6 0 per square mile. Source: U.S. Census Bureau14 Weber-Morgan Health Department

Projected Population GrowthWeber and Morgan Counties are projected to have much growth in the next 45 years. DowntownOgden’s population is projected to grow an average of 12% per decade until 2060. The averagepopulation rate increase per decade is forecasted for the remaining regions of the WMHD asfollows: Ben Lomond 24%, Eastern Weber County & Morgan County 22%, Roy/Hooper 13.5%,South Ogden 5%, and Riverdale less than 1%. Chart 3: Projected Population Growth in the WMHD160,000 Eastern Weber County140,000 and Morgan County120,000 Downtown Ogden100,000 Roy/Hooper Riverdale 80,000 South Ogden 60,000 Ben Lomond 40,000 20,000 2020 2030 2040 2050 2060 0Source: http://gomb.utah.gov/budget-policy/demographic-economic-analysis/Based on these forecasts the WMHD should anticipate shifting resources to meet the public healthneeds of the rapidly growing areas of Ben Lomond and Eastern Weber County and Morgan County.Age of ResidentsUtah has the youngest Chart 4: 2010 Weber County Age Distribution in Thousandspopulation in the nation.Weber County nearly under 5mirrors the age distributionof the state of Utah. It is 5–9substantially differentthan the national age 10–14distribution because WeberCounty’s population is 15–19considerably younger. 20–24In 2010 the median agefor males and females in 25–29Weber County was 30.2and 31.4 years. In 2010 30–34the median age for malesand females in Utah was 35–39 Weber 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 Males 80–84 Females 85+ 12 10 8 6 4 2 0 2 4 6 8 10 12 Source: U.S. Census Bureau Community Health Assessment 15

Chart 5: 2010 Morgan County Age Distribution in Hundreds 28.7 and 29.7 years. In 2010 the U.S. median age under 5 for males and females was 35.8 and 38.5 years. 5–9 Although, Weber County’s population is slightly older 10–14 than the population found in other sections of Utah, it 15–19 is still substantially younger than the national 20–24 average. 25–29 Morgan County also has a young population. The age 30–34 distribution in Morgan County varies greatly from the age 35–39 distribution of the U.S. and state of Utah. Even with theMorgan 40–44 large population surge of 45–49 50–54 55–59 60–64 65–69 70–74 75–79 Males 80–84 Females 85+ 6543210123456 Source: U.S. Census Bureau persons aged 5 to 19, Morgan County has a slightly higher median age than that of Utah’s with males and females average age Chart 6: 2010 U.S. Age Distribution in Millions calculated at 31.2 and 32.7 years. under 5 Males 5–9 Females 10–14 Chart 7: 2010 Utah Age Distribution in Thousands 15–19 20–24 under 5 25–29 30–34 5–9 35–39 40–44 10–14 45–49 50–54 15–19 55–59 60–64 20–24 65–69 70–74 25–29 75–79 80–84 30–34 85+ 35–39 15 10 5 0 5 10 15 40–44 Source: U.S. Census Bureau 45–49 50–54 55–59 60–64 65–69 70–74 75–79 Males 80–84 Females 85+ 150 125 100 75 50 25 0 25 50 75 100 125 150 Source: U.S. Census Bureau16 Weber-Morgan Health Department

Age ProjectionsIn 2010 in Weber County the three age groups of 0–17, 18–64, and 65 years and older comprisedthe following percentages of the total population:• 0–17 year group, 30%• 18–64 year group, 59.9%• 65 year and older group, 10.1%Chart 8: Weber County Age Projections By 2060 the percentage composition of the age groups will have shifted as 300,000 follows:250,000 • 0–17 year group, 25% Weber200,000 • 18–64 year group, 57.4%150,000 • 65 year and older group, 17.6%100,000 The average age of Weber County 50,000 residents is projected to steadily 0 increase as its elderly population increases by 7.5% from 2010 to 2060. 2020 2030 2040 2050 2060 With this shift in average age, the 18–64 65+ 0–17Source: http://gomb.utah.gov/budget-policy/demographic-economic-analysis/ WMHD should expect to see a gradual shift in the type of health challengesfaced by Weber County residents per capita. With the aging of the Weber County population therewill likely be an increase in cases of old-age diseases, such as Alzheimer’s, and a decrease insexually transmitted infections that predominantly occur in younger population groups.In 2010 in Morgan County the three age groups of 0–17, 18–64, and 65 years and older comprisedthe following percentages of the total population:• 0–17 year group, 35.4% Chart 9: Morgan County Age Projections• 18–64 year group, 54.1%• 65 year and older group, 10.5% 14,000By 2060 the percentage composition of 12,000the age groups will have shifted as follows: 10,000• 0–17 year group, 31.1% 8,000 Morgan• 18–64 year group, 53.1% 6,000• 65 year and older group, 15.8% 4,000 2,000The average age of Morgan County 0 2030 2040 2050 2060residents is projected to steadily increase 2020as its elderly population increases by 0–17 18–64 65+5.3% from 2010 to 2060. With thistransition in average age, the WMHD Source: http://gomb.utah.gov/budget-policy/demographic-economic-analysis/should anticipate to see a mild shift inthe type of health challenges faced by Morgan County residents. Community Health Assessment 17

Weber County yoga class. Photo courtesy PhotoVoice. Age Adjustment Certain conditions and diseases, such as heart attack, cancer, obesity, and diabetes are less normal in the younger populations like those found in Weber and Morgan Counties. In order to make fair comparisons between the health status of Weber and Morgan Counties and populations on a national, state, and county level, this CHA uses age-adjusted data whenever possible.Race and EthnicityWeber and Morgan Counties are predominantly White. 92.9% of Weber and 97.8% of Morganresidents self-reported as White in the 2010 U.S. Census. The state of Utah reported itspopulation as 91.6% White. This differs from U.S. data with 77.7% of residents that self-reportedas White. Those reporting two or more races were the next highest measurement in this categorywith 2.4% for Weber and 2.3% for Morgan.Weber County data indicates that racial and ethnic diversity is limited in many areas. Ogden hasthe most diversity with a White population of 75.2% and Plain City has the least with 96.9% ofthe population reporting as White. Ethnic diversity is also centered in Ogden with 30.1% ofresidents identifying as Hispanic or Latino. Most Weber County Minorities reside in Ogden, Roy,North Ogden, and South Ogden.Chart 10: 2013 Race Data100% White 90% Black or African 80% American 70% American Indian 60% & Alaska Native 50% Asian 40% Native Hawaiian 30% & Pacific Islander 20% Two or More Races 10% 0 Weber Morgan State of Utah NationalSource: U.S. Census BureauBecause the sample size of non-white race groups in Weber and Morgan Counties are not largeenough, comparisons across racial lines are unfeasible for this CHA. It is important to becognizant of the racial composition of Weber County and acknowledge the health disparities thatexist among the different races.Differences in race and ethnicity status have consequential impact on health policy and programs.20The National Research Council explains the difference between race and ethnicity as follows:18 Weber-Morgan Health Department

“Races…[are] distinguished on the basis of physical characteristics, especially skin color,[whereas] ethnic distinctions generally focus on such cultural characteristics as [shared]language, history, religion, and customs.”21The following table shows the racial and ethnic composition of Weber County.Table 1: Weber County Ethnicity and Race By CityCities in Order of Ethnicity RacePopulation Size Black American Native Hawaiian Two or and other More Hispanic White African Indian & Asian Races Pacific Islander American Alaska Native Ogden 30.1% 75.2% 2.2% 1.4% 1.2% 0.3% 3.7%Roy 13.5% 87% 1.1% 0.6% 1.9% 0.2% 3.4%North Ogden 5.4% 94.3% 0.5% 0.4% 0.9% 0.2% 1.9%South Ogden 12.8% 87.5% 1.4% 0.6% 1.3% 0.3% 3.2%West Haven 8.9% 91% 1.0% 0.6% 1.3% 0.1% 3.1%Washington Terrace 12.9% 86.9% 2.1% 0.7% 1.3% 0.3% 2.7%Pleasant View 7.3% 93.1% 0.4% 0.2% 0.9% 0.4% 1.9%Hooper 5.3% 94.6% 0.4% 0.6% 0.9% 0.1% 1.8%Farr West 5.2% 95.5% 0.3% 0.3% 0.6% 0.2% 1.5%Harrisville 8.4% 92.4% 0.6% 0.4% 1.3% 0.2% 2.0% Plain City 2.7% 96.9% 0.2% 0.3% 0.5% 0.3% 1.1%Source: U.S. Census Bureau Community Health Assessment 19

Social and Economic Characteristics Workforce Composition and Wages I n 2014, Weber County’s total workforce of 96,818 was comprised of 76,664 private sector jobs and 20,154 public sector jobs.22 When combining all local, state, and federal employees, the government sector provides 20.8% of all Weber County jobs. The largest industry was manufacturing (transportation equipment, chemical, machinery, and fabricated metal products) with 12,900 employees or 13.2% of the total Weber County workforce; this industry generates an average monthly wage of $4,352. Healthcare and social assistance (ambulatory healthcare services, hospitals, nursing facilities, and social assistance) was a close second with 12,402 jobs or 12.8% of the total workforce; this industry generates anWeber average monthly wage of $3,485. Retail trade (general merchandise, food and beverage stores, and motor vehicle parts and distributors) was the third largest industry with 11,700 employees or 12% of the total workforce; this industry generates an average monthly wage of $2,162. Local government was the 4th largest employer with 8,963 The Average Employee employees or 9.2% of the total workforce; this industry in Weber County Makes generates an average monthly wage of $2,730. 12.4% Less than the The average monthly wage in 2014 in Weber County was Average Utah Wage and $3,127 or $37,524 per year.23 The average annual national 19.6% Less than the wage in 2013 was $44,888 or 19.6% higher than Weber Average National Wage. County’s average annual wage.24 The Utah average annual wage in 2014 was $42,180 or 12.4% higher than Weber Source: Utah Department of Workforce Services County’s average.25Morgan In 2014, Morgan County’s total workforce of 1,948 was comprised of 1,487 private sector jobs and 461 public sector jobs.26 When combining all local, state, and federal employees, the government sector provides 23.6% of all Morgan County jobs. Local government was the largest employer in Morgan County with 427 employees or 21.9% of the total workforce; this industry generates an average monthly wage of $4,830. The second largest industry was construction (specialty trade contractors, heavy and civil engineering construction, and construction of buildings) with 322 employees or 16.5% of the total Morgan20 Weber-Morgan Health Department

County workforce; this industry generates an average monthly The Average Worker in Morganwage of $3,114. Retail trade (nonstore retailers and motor Morgan County Makesvehicle parts and distributors) was the third largest industry 15.9% Less than thewith 205 employees or 10.5% of the total workforce; this Average Utah Wage andindustry generates an average monthly wage of $1,267. 23.4% Less than theHealthcare and social assistance (ambulatory healthcare Average National Wage.services, hospitals, nursing facilities, and social assistance)was the fourth largest industry with 201 jobs or 10.3% of the Source: Utah Department of Workforce Servicestotal workforce; this industry generates an average monthlywage of $3,485.The average monthly wage in 2014 in Morgan County was $3,033 or $36,369 per year.27Cost of LivingCost of living is a measurement to determine how expensive it is to live in one area relative toanother. It is most useful when used for evaluating the nearest metropolitan area and the U.S.average, which is set at 100. Any cost of living category over 100 indicates the area it is moreexpensive than the U.S. average and data below 100 indicates the area is more affordable. Thereis no cost of living data specific for Weber or Morgan Counties. Cost of living data for Weber andMorgan Counties is calculated from an area that combines these counties with Davis County intothe Ogden-Clearfield Metropolitan area. The Ogden-Clearfield Metropolitan area is generally moreaffordable than both the U.S. average and the values of Salt Lake City. Only in utilities andgroceries does the Ogden-Clearfield Metropolitan area slightly exceed either the Salt Lake City orU.S. measurements. Given the average wages in Weber and Morgan Counties, which are lowerthan both the U.S. and state of Utah averages, the benefits of a lower cost of living are muted.Table 2: Cost of Living AssessmentCost of Living Ogden-Clearfield Salt Lake City United StatesCategory Metro. Area Utah AverageOverall 90.5 94.8 100Groceries 94.9 92 100Health 86.3 91 100Housing 80.1 90.4 100Utilities 102.8 80.8 100Transportation 93.5 95.5 100Miscellaneous 93.7 93.4 100Source: http://mura.daviscountyutah.gov/economic_development/business-development/demographicspopulationcost-of-living/Education Community Health Assessment 21

EducationThere are three school districts in the WMHD — Weber, Ogden, and Morgan School Districts.When comparing the 2014 student size of the school districts, Weber is the 6th largest, followedby Ogden at the 12th largest, and Morgan as the 26th largest school district out of the total of 40school districts in the state of Utah.28 The following table shows how many public high schools,junior high schools, and elementary schools are in each of the school districts in the WMHD.Table 3: School Type by District Junior High Schools Elementary Schools High Schools 10 29Weber School District 7Ogden School District 3 3 14Morgan School District 1 1 2Sources: http://wsd.net/index.php?option=com_content&view=category&id=81&Itemid=472, https://ogdensd.org/school_sites.php, http://www.morgansd.org/district/District.htmThere are seven charter schools in Weber County and none in Morgan County. Because thesecharter schools serve student populations ranging anywhere between kindergarten and 12thgrade they cannot be classified as a high school, junior high school or elementary school.The 2013 high school graduation rates for the three school district are as follows:29 Table 4: High School Graduation Morgan School District (MSD): 93% Weber School District (WSD): 81% Ogden School District (OSD): 68% Overall State of Utah: 81%Higher Education in the WMHD is primarily served by Weber State University (WSU) which hasmore than 26,000 students enrolled.30 WSU offers more than 250 undergraduate degrees, 11graduate programs, and a variety of professional certificate programs.31 Some residents commuteto nearby counties to attend the University of Utah, Utah State University, Salt Lake CommunityCollege, Westminster College, and LDS Business College. There are vocational schools availablewithin the WMHD. There are many accredited remote institutions of higher education, such asUniversity of Phoenix and Walden University, available to residents as well.Weber County has an opportunity of improvement with 22.7% of its adults 25 years or older thathave a bachelor’s degree or higher. Morgan County does well in this measurement and exceedsthe state and national average by several percentage points. The table below shows how Weberand Morgan compare to the U.S., state of Utah, and nearby counties.22 Weber-Morgan Health Department

Table 5: Adults with a Bachelor Degree or Higher United State of Weber Morgan Davis Salt Lake Utah States Utah County County County County County Adults 25 Years+ 28.8% 30.3% 22.7% 33.4% 34.1% 31% 36.5% with a Bachelor’s Degree or HigherSource: U.S. Census BureauReligionIn 2010, 75.3% of residents in Weber and 89.63% of Morgan Counties identified as religious,which is significantly higher than the U.S. average of 48.8%.32There are 398 congregations in Weber County of which 314 are LDS, 22 are Pentecostal, 14 areBaptist, 10 are non-denominational, and 6 are Catholic.33In Morgan County there are 23 congregations of which 22 are LDS and 1 is Baptist.34PoliticsMany residents in Weber and Morgan Counties participate in voting. Table 6 compares the partyaffiliation on a county, state, and national level. As noted in Table 6, both Weber and Morganresidents are predominantly registered Republican or are unaffiliated with any party.Table 6: Voter Party Affiliation Weber Morgan Davis Salt Lake Utah County County County County CountyTotal Number of 5,246 140,431 434,135 263,150Registered Voters: 114,946 37.6% Percentage of Registered Voters by Party Registration 55.6% 4.8%Unaffiliated 47.9% 41.4% 38.9% 47.8% 0.6% 0.7%Republican 40.1% 54.0% 52.9% 37% 0.7%Democratic 10.3% 3.3% 6.7% 13.5%Independent 0.7% 0.4% 0.5% 0.7%AmericanLibertarian 0.5% 0.2% 0.5% 0.6%Constitution 0.3% 0.7% 0.2% 0.2%Sources: http://www3.co.weber.ut.us/new/clerk_auditor/elections/voter_stats.php Community Health Assessment 23

Healthcare There are two main hospitals that serve Morgan and Weber Counties — Ogden Regional Medical Center and Intermountain Healthcare’s McKay- Dee Hospital. Both hospitals are located in south Weber County near the border of Davis County. Special Population McKay-Dee Hospital Under-Educated Populations Map 1: Areas in Weber County Where Education imparts a significant impact on health 20–39% of Residents Did Not Graduate outcomes. Weber County has a concentrated from High School (2013) pocket of residents that have not graduatedWeber from high school. The map to the right shows regions where at least 20% of residents have not received their high school diploma. Some of these areas have up to 39% of the population — more than 1 in 3 adults — that do not have a high school education. Except for a small sliver in West Haven, almost all of these areas exist in Ogden City.Morgan Morgan County has a high school graduation rate of 93%. A map is not available for this measurement because there are no census Source: http://assessment.communitycommons.org/Footprint/ tracts in Morgan County with a concentration of least 20% of residents that did not complete a high school degree. Populations in Poverty Map 2: Areas in Weber County Where Poverty and poor health are intricately linked. 20–45% of Residents Live at or Below Weber County has a concentrated pocket of 100% of the Federal Poverty Level (2013) residents that live at or below 100% of the FederalWeber Poverty Level (FPL). The poverty threshold varies by family size and age.35 In 2014 a family of two, under the age of 65, can earn $15,853 to be considered at 100% of the FPL. A family of two, at or above the age of 65, can earn $14,309 to be considered at 100% of the FPL. Each additional person increases the maximum amount the family can earn.Morgan 4% of Morgan County residents live at or below the FPL. Because the number is so low it does not warrant the use of a map. Source: http://assessment.communitycommons.org/Footprint/24 Weber-Morgan Health Department

Residents with DisabilitiesWeber County has more residents 5 years and older with disabilities than any of the nearbycompared counties. With 2.5% of residents 5 years and older with disabilities, Morgan County isthe lowest of the compared counties. The following table evaluates both physical and learningdisabilities.36Weber County Chart 11: 2005–2007 Residents 5 Years & Older With Disabilitiesresidents with Utah Countydisabilities are fairly Salt Lake Countystationary with Davis County87.2% reporting Morgan Countyliving in the samelocation one year Weber Countyago. For Morgan 0% 2% 4% 6% 8% 10% 12% 14% 16%County the number Source: http://disabilityplanningdata.com/site/county_population_table.php?cntyname=Davis&state=utah&submit=submitwas 86.2%.37VeteransAccording to the 2010 Census, 16,813 or 7.3% of Weber Countyresidents are veterans.38 For Morgan County, 725 or 7.6% of allresidents are veterans.39HomelessIn 2012, 1,290 residents or 0.5% of the total population in WeberCounty were homeless. In 2012, there were no reported homelessresidents in Morgan County. For Davis County this measurementwas 0.1% of the total population, in Salt Lake County it was 1%, and for Utah County it was0.1%. In 2012 the state of Utah average for this measurement was 0.11% and the national was0.2%. As of 2012 Weber County has 4.5 times the state average and 2.5 times the nationalaverage of residents which are homeless.40Incarcerated ResidentsWeber County’s incarcerated residents are held in either the Weber Correctional Facility or theKiesel Jail Facility. Morgan County does not have a jail and its incarcerated residents are held inone of the two facilities operated by Weber County. As of September 2015, approximately 0.1%of Weber County’s and 0.01% of Morgan County’s total population is currently incarcerated.41Residents with Potential Language Barriers and Challenges13.2% of Weber County residents 5 years or older speak a language other than English athome.42 Only 3.3% of Morgan County residents 5 years or older speak a language other thanEnglish at home.43 This measurement for the state of Utah is 14.3%. Community Health Assessment 25

2014 County Health Rankings Photo Credit: Laniece Roberts Photo Credit: Laniece RobertsT he Robert Wood Johnson Foundation developed a ranking system to evaluate and compare the health status of nearly all counties in the United States of America. The graph belowshows how Weber and Morgan Counties compared against the 27 evaluated counties in Utah. Thisranking system provides an ideal starting point for evaluating the health of the community. WeberCounty scored as the 16th healthiest county in Utah. Morgan County scored as the 1st healthiestcounty in Utah. Chart 12: 10 3th Length of Life (50%) rd Health Outcomes (100%)Health Rankings of 19 1th Quality of Life (50%) st 16th 1st Weber & Morgan Counties Health Factors (100%) Tobacco Use 18th 2nd Diet & Exercise Health Behaviors (30%) Policies & ProgramsAlcohol & Drug Use 17th 8th Sexual ActivityAccess to Care Clinical Care (20%)Quality of Care 8th 3rd EducationEmployment Income Social & EconomicFamily & Social 21st Factors (40%) 1st SupportCommunity SafetyAir & Water Quality PhysicalHousing & Transit 19 22th Environment (10% ndWeber County The above ranking system is scored from 1st to 27th. The healthiestMorgan County county is scored 1st and the least healthy is scored 27th. Although there are 29 counties in Utah, only 27 were evaluated.26 Weber-Morgan Health Department

Section 1 Endnotes1. http://www.countyhealthrankings.org/app/utah/2015/rankings/morgan/county/outcomes/overall/snapshot2. http://ilovehistory.utah.gov/place/counties/weber.html3. http://quickfacts.census.gov/qfd/states/49/49057.html4. http://ilovehistory.utah.gov/place/counties/morgan.html5. http://quickfacts.census.gov/qfd/states/49/49029.html6. http://www.co.weber.ut.us/commission/7. http://www.morgan-county.net/Departments/Council.aspx8. http://ilovehistory.utah.gov/place/counties/morgan.html#land9. 2014 WMHD Focus Groups10. 2015 WMHD PhotoVoice11. 2015 WMHD PhotoVoice12. 2014 WMHD Focus Groups13. 2015 WMHD PhotoVoice14. 2015 WMHD PhotoVoice15. https://www.census.gov/geo/reference/urban-rural.html16. http://quickfacts.census.gov/qfd/states/49/49057.html17. https://www.census.gov/geo/reference/urban-rural.html18. http://gomb.utah.gov/budget-policy/demographic-economic-analysis/19. http://quickfacts.census.gov/qfd/states/49/49029.html20. http://www.nap.edu/catalog/11036/understanding-racial-and-ethnic-differences-in-health-in-late-life21. http://www.nap.edu/openbook.php?record_id=11036&page=922. https://jobs.utah.gov/jsp/wi/utalmis/industrydetail.do23. https://jobs.utah.gov/jsp/wi/utalmis/industrydetail.do24. http://www.ssa.gov/oact/cola/AWI.html25. https://jobs.utah.gov/jsp/wi/utalmis/industrydetail.do26. https://jobs.utah.gov/jsp/wi/utalmis/industrydetail.do27. https://jobs.utah.gov/jsp/wi/utalmis/industrydetail.do28. http://www.schools.utah.gov/data/Superintendents-Annual-Report/2014/GraduationReport.aspx29. http://www.schools.utah.gov/data/Superintendents-Annual-Report/2014/GraduationReport.aspx30. http://www.weber.edu/AboutWSU/FastFacts.html31. http://www.weber.edu/AboutWSU/FastFacts.html32. http://www.bestplaces.net/religion/county/utah/weber33. http://www.thearda.com/rcms2010/ar/c/49/rcms2010_49057_county_name_2010.asp34. http://www.thearda.com/rcms2010/r/c/49/rcms2010_49029_county_name_2010.asp35. https://www.census.gov/hhes/www/poverty/data/threshld/36. http://disabilityplanningdata.com/site/faq.php#defined37. http://disabilityplanningdata.com/site/county_population_table.php?cntyname=Morgan&state=utah&submit=submit38. http://quickfacts.census.gov/qfd/states/49/49057.html39. http://quickfacts.census.gov/qfd/states/49/49029.html40. https://jobs.utah.gov/housing/documents/Utah2012ComprehensiveReportonHomelessness.pdf41. Information provided by the Weber County Sherriff’s Department42. http://quickfacts.census.gov/qfd/states/49/49057.html43. http://quickfacts.census.gov/qfd/states/49/49029.html44. http://www.cdc.gov/nchs/data/nhsr/nhsr077.pdfCommunity Health Assessment 27

Section 2 MortalityMortality data tellshow many peopledied and what wasthe cause of death.

Health Indicator 1 Premature DeathP remature death or years of potential life lost (YPLL) is a measurement emphasizing earlydeaths before the age of 75. Knowing the YPLL helps enhance focus on preventable deaths.Chart 13 compares Weber and Morgan Counties with nearby counties, Utah, and national averagesfrom 2005-2013. Weber County has been fairly consistent for the past few years, but due tonational improvements it is now slightly above the U.S. average; there is room for improvementin Weber. At present, the WMHD cannot conclusively account for the anomalous jump in YPLL inMorgan, which had stayed reasonably consistent from 2005-2011. One potential explanation isthat adult obesity rates increased inMorgan by 2% since 2007 and there ✓ Even with Morgan’s recent jump in YPLL,were increased obesity related bringing it in parity with Davis County,deaths as a result. Recent Morgan it is still in the top 10% of performingYPLL data warrants careful monitoring counties in the U.S. for YPLL.by the WMHD and additionalresearch to pinpoint the exactcause(s) for this increase.Chart 13: Years of Potential Life Lost7500 Weber County7000 Morgan County6500 Davis County6000 Salt Lake County5500 Utah County5000 State of Utah4500 United States40003500 2007–09 2009–11 2001–133000 2005–07Source: http://www.healthindicators.gov/Indicators/Years-of-potential-life-lost-before-age-75-per-100000_3/Profile/Download Community Health Assessment 29

Health Indicator 2 Death Rate & Life ExpectancyL ife expectancy is an estimate of how Table 7: How Long You Live by Area many years the average person willlive and it is an important measure of health. Eastern Weber County & Morgan County 81.5Life expectancy and death rates have aninverse relationship; low death rates mean Downtown Ogden 76.1longer life expectancy and vice versa. South Ogden 80.7As outlined in Table 7, some parts of theWMHD are surpassing both the average Riverdale 78.2national life expectancy. Overall, the WMHDlife expectancy lags compared to Utah and Roy/Hooper 79.3nearby LHDs. Much of the positive lifeexpectancy in Utah and the WMHD can be Ben Lomond 77.5attributed to the healthy diet and behaviorspromoted by the community. Davis County 81.1 Salt Lake County 79.7 Utah County 81.0 Source: http://ibis.health.utah.gov/indicator/complete_profile/LifeExpect.html Graphic 7: Utah WMHD U.S.Life Expectancy 80.2 79.1 78.8Source: http://ibis.health.utah.gov/indicator/complete_profile/LifeExpect.html30 Weber-Morgan Health Department

Health Indicator 3 Leading Causes of DeathTable 8: Top 10 Causes of Deaths Per 100,000 Age-AdjustedRounded Average of 2011–2013 Data Weber Morgan Davis Salt Lake Utah U.S. Utah County County County County CountyHeart Disease 171 145 158 162 145 142 157 ✓ Weber andCancer Morgan haveStroke 166 127 133 115 123 130 120 achievedChronic Lung HP2020’s goalDisease 37 38 42 30 35 35 47 of ≤ 161.4 Accidents cancer deathsDiabetes 42 31 42 21 25 33 20 per 100,000.Alzheimer’sInfluenza & 39 43 44 29 39 43 37 Source: https://www.healthypeople.gov/2020/Pneumonia topics-objectives/topic/cancer/objectivesNephritis 21 25 30 22 24 28 25Suicide 24 20 17 — 18 17 21 15 17 21 — 17 16 16 13 13 15 — 11 10 18 13 21 23 — 15 21 17 Equal to or better than both Utah and U.S. Morgan County uses a rounded Worse than U.S. or Utah, but not both average of 1999–2013 data for Worse than both U.S. and Utah categories other than cancer and heart disease.Sources: http://wonder.cdc.gov/controller/datarequest/D76,http://ibis.health.utah.gov/indicator/complete_profile/LifeExpect.html ✓ Morgan has achieved HP2020’s goal of ≤ 30.4 Although data is insufficient, due to stroke deaths per 100,000. confidentiality concerns, to illustrate all categories, Morgan is excelling with low Source: https://www.healthypeople.gov/2020/topics-objectives/topic/ death rates. In Weber there are several heart-disease-and-stroke/objectives opportunities for improvement. It should be noted in Utah that insulin-dependent diabetics died 3.4 times the rate of non-insulin-dependent diabetics; nationally this rate was 5.1 times for insulin-dependent diabetics (150% greater than Utah’s 3.4 rate results). Community Health Assessment 31

Health Indicator 4 Chronic Disease Death RatesC hronic disease can be Table 9: Chronic Disease Death Per 100,000 Age-Adjusted treated, but not cured.Treating chronic disease accounts 2011–2013 Data Unless * then 2009–2013for 86% of all healthcare costs inthe U.S.1 Heart disease and all Breast Cancer Utah WMHD DCHD SLCoHD UCHDforms of cancer are the leading Prostate Cancer* 20.4 20.8 21.2 20 20.8causes of chronic disease deaths Lung Cancer 22.2 19.2 19.6 22.4 20.2in the WMHD. Melanoma of 19.6 23.7 17.6 20.9 12.9 the SkinAlthough, the WMHD shows a need Colorectal Cancer* — 3.8 3.1 3.4 4.2for improvement when compared Diabetesto Utah and nearby LHDs, it has Alzheimers* 11.5 12.9 10.6 11.6 11.9achieved the HP2020 goal for all Stroke 25.2 28.4 23.4 27.5 25of these chronic disease deaths; Coronary Heart 19.5 16.3 18.8 14.2 18.6**Alzheimer’s excepted, as there Disease 37.6 41 34.5 35.2 46.1is no death rate goal associatedwith it. 69 84.6 75.4 61.7 66 Equal to or better than Utah Worse than Utah Source: http://ibis.health.utah.gov/✓ The WMHD has achieved the HP2020’s goals for these chronic disease deaths** Source: www.healthypeople.gov32 Weber-Morgan Health Department

Health Indicator 5 Injury Death RatesI njury death rates include both unintentional and intentional causes of death. It is a valuable measurement because it shifts attention to evaluating safety protocols, education,and access to potentially harmful materials. Per Table 10, there is room for improvement in WeberCounty when compared to the U.S., Utah, and nearby LHDs’ results — especially in firearm safetyand poisoning.Table 10: Top 4 Causes of Injury Death Rates Per 100,000Rounded Average of 2008–2013 Data Age-Adjusted Weber Morgan Davis Salt Lake Utah U.S. Utah County County County County CountyFirearm 18 21 25 15 20 18Poisoning 18 27 29 23 18 29 18Falling 11 12 11 12 13 11Motor Vehicle 16 12 13 <10 10 18 ! Weber County mayTraffic meet the HP2020 goal of ≤12.4 Equal to or better than both Utah and U.S. Due to confidentiality concerns, Morgan motor vehicleWorse than U.S. or Utah, but not both County’s death rates for all 4 categories traffic deaths.Worse than both U.S. and Utah were merged together. Morgan is under the national and state average for each and every category on this list.Source: http://wonder.cdc.gov/controller/datarequest/D76;jsessionid=852BD4B7034191B43AA9BF3C9CCA4AFF X Weber County will likely not meet three HP2020 goals: ≤13.2 poisoning deaths, ≤9.3 firearm deaths, and ≤7.2 fall related deaths per 100,000 residents. ✓ Morgan County has achieved the HP2020’s goals for all of these categories. Source: https://www.healthypeople.gov/2020/topics-objectives/topic/injury-and-violence-prevention/objectives Community Health Assessment 33

Graphic 8: Poisoning Deaths By DrugsDrugs* are Responsible 62–86%for 90.1% of PoisoningDeaths in Utah of poisoning deaths are unintentionalThe WMHD ranks as the3rd highest LHD out of 14–38%12 for deaths by drugpoisoning of poisoning deaths are intentional*Drugs include prescription drugs, over-the-counter drugs, dietary supplements, and street drugs such as heroin, cocaine, and hallucinogens.Source: http://ibis.health.utah.gov/indicator/complete_profile/PoiDth.htmlWith approximately 90% of poisoning Table 11: Drug Poisoning Deaths by Areadeaths occuring from drugs use, of and Percentage (2011–2013)which 62% were unintentional deaths,there is a great need for improved Downtown Ogden 31.2%education on appropriate drug usage,storage, and disposal. As shown in Table South Ogden 17.6%11, the areas with the greatest need forpoison prevention are Downtown Ogden Riverdale 15.4%and South Ogden.2 Roy/Hooper 13.8% Ben Lomond 13.4% Eastern Weber County & Morgan County 8.7% Source: http://ibis.health.utah.gov/indicator/view/PoiDth.LHD.htmlWhat are Residents Saying?“[Drugs are] very accessible. It’s kid-friendly.”“They’re making drugs that look like candy, taste like candy, and are easy to get.”“People turn towards prescriptions than counseling because they want a quick fix.”3Community ResourcesThe Annual Safe Kids Fair hosted by the WMHD educates children and adults on safety regardingmotor vehicle, falls, and poisoning.4 Weber Human Services, McKay-Dee Hospital, and OgdenRegional Medical Center are also community resources for these community health issues.34 Weber-Morgan Health Department

Health Indicator 6 SuicideS uicide is a significant indicator of poor Table 12: Suicide by Area Per 100,000 mental health in the community. As of Residents2014, Utah is the 5th highest state for suicide.5In Utah and Weber County suicide is the 7th Downtown Ogden 31.3%leading cause of death for all age groupscombined; it is the leading cause of death for Eastern Weber County and 23.5%Utahns aged 10-17, the second-leading cause Morgan Countyof death for ages 18-24 and 24-44, the fourth-leading cause of death for ages 45-64.6 Riverdale 22.7%In Utah, the primary method of suicide is Ben Lomond 21.3%firearms for males and poison for females.Both methods are trending upwards: 14.7 Roy/Hooper 20.0%males (2007) compared to 19.4 males (2013)per 100,000; 2.8 females (2007) compared to South Ogden 13.6%3.3 females (2013) per 100,000).7 Davis County Health Department 15.2% Salt Lake County Health Department 20.8% Utah County Health Department 15.2% Source: http://ibis.health.utah.gov/indicator/view/SuicDth.SA.htmlGraphic 9: Suicide Per 100,000 Residents Suicide is a community health problem that is moderately trending upwards. Males are moreAge-Adjusted 2013 Data likely to complete suicide because they use more lethal methods, however females make U.S. more attempts.8 On a per 100,000 population: 12.6 in 2012, 20.3 U.S. / 33.0 Utah males completed suicide compared to 5.4 U.S. / 9.0 Utah Utah females.9 21.4 WMHD HP2020 has set a goal of no more than 10.2 26.0 suicides per 100,000 residents.10 Table 12 shows that all areas served by the WMHD areSource: http://ibis.health.utah.gov/indicator/view/SuicDth.html falling short of this HP2020 goal and that we do not compare well to some of the nearby LHDs. Community Health Assessment 35

What are Residents Saying? A contributing factor to suicide is depression and social isolation. Weber residents shared the following: “Depression stems from people here not being very social, people…stick with their family.” “…feel like an outsider…have felt that way my whole time spent here.” “Neighborhood mentality has gone by the wayside.”11 Community Resources Local and national suicide education/prevention resources available include: • Counseling services made available by the numerous religious denominations • Mental health services by Midtown Clinic and its partner Weber Human Services (WHS) • Education and programs offered at WHS for those suffering mental illness provided by the Utah branch of the National Alliance of Mental Illness (NAMI) • Nuhope.Net • WMHD health educators Local and national suicide crisis resources available include: • The 24 hour/7 days Weber Human Services Crisis Prevention Hotline (801) 625-3700 • The 24 hour/7 days National Suicide Prevention Lifeline 1-800-273-TALK • The Trevor Lifeline for LGBTQ 1-866-488-7386 • The University of Utah Neuropsychiatric Institute’s Crisis Hotline: 801-587-3000 • The Weber-Morgan Health Department: 801-399-7187 or 801-399-7186 • Online suicide prevention chat available at: http://www.suicidepreventionlifeline.org/36 Weber-Morgan Health Department

Health Indicator 7 Infant MortalityI nfant mortality is a snapshot Table 13: Infant Death Rate Per 1,000 (2009–13) indicator of the general health of Weber Morgan Davis Salt Lake Utahthe community and of the wide range of U.S. Utah County County County County Countyfactors impacting the health of children.Death rates for infants are the highest of 6.1 5.1 5.8 No Data 5.4 5.3 4.6any group under the age of 65 years,hence the importance of focusing on it.12 Equal to or better than both Utah and U.S.Overall Weber and Morgan Counties are Worse than U.S. or Utah, but not bothdoing well in this measurement and have Worse than both U.S. and Utah *Because of the small population in Morgan County, its data is low in this measurement and it cannot be shown due to confidentiality concerns. Source: http://ibis.health.utah.gov/indicator/view/InfMort.htmlachieved the HP2020 goal of no more than 6.0 infant deaths per 1,000.13 Although, most ofWeber County is doing well, there are pockets in need of improvement. Hooper/Roy has a rate of8.3, Ben Lomond 6.3, and Downtown Ogden a rate of 6.3 infant deaths per 1,000 respectively;of the areas in the WMHD these need additional attention to bring the rates down.14✓ Weber and Morgan Counties have met HP2020’s goal of no more than 6.0 infant deaths per 1,000.Source: http://wonder.cdc.gov/controller/datarequest/D76;jsessionid=79FD01A34476D3544D6E39C9EB313BA1?stage=results&action=toggle&p=O_show_suppressed&v=trueSection 2 Endnotes 9. http://www.webermorganhealth.org/prevent_%20suicide.php1. http://www.cdc.gov/chronicdisease/index.htm 10. http://ibis.health.utah.gov/indicator/view_numbers/SuicDth. Ut_US.html2. http://ibis.health.utah.gov/indicator/complete_profile/PoiDth.html 11. Weber-Morgan Health Department Community Health Assessment:3. Weber-Morgan Health Department Community Health Assessment: Focus Group Report. Page 10. Focus Group Report. Page 13. 12. http://pediatrics.aappublications.org/content/78/6/1155.abstract4. http://www.co.weber.ut.us/health/safe_kids.php?d=5 13. http://www.healthypeople.gov/2020/topics-objectives/topic/5. http://www.co.weber.ut.us/health/safe_kids.php?d=5 maternal-infant-and-child-health/objectives6. http://www.rwjf.org/en/library/articles-and-news/2013/06/ 14. http://ibis.health.utah.gov/indicator/view_numbers/InfMort.SA.html solving-the-riddle-of-the-u-s--suicide-belt.html7. http://ibis.health.utah.gov/indicator/view/SuicDth.Ut_US.html8. http://ibis.health.utah.gov/indicator/view_numbers/SuicDth. MethSex.html Community Health Assessment 37

Section 3 MorbidityMorbidity data tellshow many peopleare diseased orunhealthy.

Health Indicator 8 Health Related Quality of LifeH ealth related quality of life is a multi-faceted measurement, which includes self-reported evaluations on overall health, as well as information on perceived physical and mental health. Health related quality of life is an important measurement that provides perspective tothe overall burden of chronic disease, disabilities, and mental health in the general community.The three ways health related quality of life will be measured are as follows:• The percentage of adults that self-report having poor or fair health• The average number of days of poor mental health self-reported by adults• The average number of days of poor physical health self-reported by adultsWeber County is positively outperforming national results for the percentage of adults self-reportingpoor or fair health. Weber County also is essentially equivalent to national and state outcomes onboth the average number of poor mental health days and on the average number of poor physicalhealth days. Weber’s Women, Infant, and Children (WIC) population is comparable with the rest ofthe county with 14.3% percentage of WIC adults reporting poor or fair health. For Weber CountyWIC clients there is a strong need for improvement in the average number of poor mental healthand physical days experienced with scores of 10.4 and 11.7 respectively. When compared to othercounties, Utah, and national results it is clear Morgan is the healthiest in all three measurements.Morgan’s WIC population is doing better in the first two measurements with scores of 0% and 2.8days. The Morgan WIC population is only slightly behind the national, state, and other counties’average number of poor physical days with a score of 3.7.Table 14 contains 2006–2012 data unless otherwise noted.Table 14: Health Related Quality of Life Indicators U.S. State of Weber Morgan Davis Salt Lake Utah (2008) Utah County County County County CountyPercentage of Adults 17.4% 13.8% 14% 5% 10% 12% 11%Self-Reporting Pooror Fair HealthAverage Number of Poor 3.6 3.3 3.6 1.7 3.1 3.3 3.5Mental Health DaysAverage Number of Poor 3.4 3.2 3.5 2.3 3.0 3.3 3.1Physical DaysSources: http://www.countyhealthrankings.org/app/utah/2015/rankings/utah/county/outcomes/overall/snapshot, http://www.countyhealthrankings.org/app/utah/2015/rankings/salt-lake/county/outcomes/overall/snapshot , 2015 2015 WMHD WIC Survey Results , http://www.countyhealthrankings.org/app/utah/2015/rankings/morgan/county/outcomes/overall/snapshot, http://ibis.health.utah.gov/indicator/view_numbers/FPHlth.Ut_USYear.html, http://www.countyhealthrankings.org/app/utah/2015/rankings/weber/county/outcomes/overall/snapshot, http://www.healthypeople.gov/2020/about/foundation-health-measures/General-Health-Status Community Health Assessment 39

Health Indicator 9 Birth OutcomesB irth outcomes are an important measurement because they influence current and future morbidity of children. Birth outcomes, with health consequences at birth and throughout achild’s life, include the following:• Children born with a low birth weight, anything less than 5 pounds 8 ounces, have an increased chance for infant mortality, developing chronic diseases, and frequently require expensive and intensive care.1✓ Birth outcomes are • Children born to women with poorly managed considered a critical gestational diabetes have an increased risk for health indicator for Utah developing obesity and type two diabetes.2 because it has the highest • Preterm births (births before 37 weeks) birth rate of the states. increase the chance for infant mortality, health complications, and costly care.3Source: http://kff.org/other/state-indicator/birth-rate-per-1000/ • Females with unintended pregnancies —pregnancies that were not planned or currently wanted — that progress to a live birth are lesslikely to seek early prenatal care or maintain prenatal care throughout the pregnancy, aremore likely to smoke or drink during the pregnancy, and are more likely to formula feed; thesebehaviors have critical consequences on the current and future health of children.4 Childrenborn to teenage mothers are likely the result of an unintended pregnancy.5 In Utah, 68% of18-19 year old females and 79.3% of 17 year old or younger females indicated theirpregnancies were unintended.6• Children born to teenage mothers are at increased risk for long-term physical or mental illness and are also at elevated risk for low birth weight and infant mortality.7, 8Table 15 shows the percentage of births from 2011–2013 with low birth weights, the percentageof birth certificates from 2009–2010 indicating gestational diabetes, the rate of preterm births in2013, unintentional birth — births that were unplanned or currently unwanted — rates from 2009–2011, and the 2013 birth rate per 1,000 teenage mothers that are 15–19 years old. The WMHD isdoing well in some categories, but has a few areas of moderate improvement and one area ofsignificant improvement — teen pregnancy in Weber County. Downtown Ogden and Ben Lomondeach have 5 times the rate of infants born to teenage mothers than east Weber County andMorgan County combined.940 Weber-Morgan Health Department

Table 15: Birth OutcomesPercentage of Births U.S. Utah WMHD DCHD SLCoHD UCHDwith Low Birth Weights 8% 6.9% 7.5% 6.8% 7.4% 5.8%(2011–2013) (2013) 4.6% 3.4% 3% 2.8% 3.7% 3.5%Birth CertificatesIndicating Gestational 11.4% 9.2% 9.1% 9.5% 9.5% 8.6%Diabetes (2009–2010) 31.8% 35.5% 28.2% 32.6% 33.7% 30.3%Percentage of Preterm 36.6 35.9 17.9Births (2013) 29.7 43.6 (Weber) 23.1 26.6 10.1 (Morgan) 25.4 12.7Unintentional Birth Rate(2009–2011) 20.6 31 14.6Teen (15–19 Years Old)Pregnancy Rate Per1,000 (2006–2012)Teen (15–19 Years Old)Live Births Per 1,000(2013)Sources: http://ibis.health.utah.gov/indicator/complete_profile/UniPreg.html, http://www.healthypeople.gov/2020/topics-objectives/topic/family-planning/objectives, https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives,http://ibis.health.utah.gov/indicator/view/PreBir.LHD.html, http://epi.health.utah.gov/indicator/complete_profile/DiabGestDiab.html, http://ibis.health.utah.gov/indicator/complete_profile/LBW.html,https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives, http://ibis.health.utah.gov/indicator/view_numbers/AdoBrth.LHD.html, http://assessment.communitycommons.org/CHNA/report?page=2&id=2112010 U.S. estimate only for births from mothers with gestational diabetes. The CDC reports that the true prevalence of gestational diabetes is unknown becausemany states birth certificates do not differentiate between pre-pregnancy diabetes and gestational diabetes. Because the true prevalence is unknown there is noHP2020 goal for this measurement. http://www.cdc.gov/pcd/issues/2014/13_0415.htm2002 data for U.S. unintentional births https://www.healthypeople.gov/2020/topics-objectives/topic/family-planning/objectives2013 data only for percentage of U.S. low weight birthsPregnancy data is 2006–2012.✓ The WMHD has met HP2020’s goals for low birth weights, infants born to mothers with gestational diabetes, preterm births, and unintentional births.Source: https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives Community Health Assessment 41

Health Indicator 10 HospitalizationsH ospitalization and emergency department usage rates provide another aspect of community morbidity and highlight health issues related to age, health behaviors, chronic diseasemanagement, and preventable accidents.Table 16 reviews hospitalization rates per 10,000 residents for heart attack, unintentional falls,diabetes, asthma and motor vehicle crashes and asthma that result in emergency departmentvisits. The WMHD is in need of improvement in every category except unintentional falls.Table 16: Hospitalization and Emergency Department Discharge Rates per 10,000 ResidentsHeart Attack (2012) Utah WMHD DCHD SLCoHD UCHD 21.4 19.4 (Weber) 21.7 23.9 23.3Unintentional Falls (2012) 14.5 (Morgan)Diabetes (2010) 22 21.3 25.9 22Asthma (2009-2010) 8.9 20.1 6.7 10.1 8.0Motor Vehicle Crashes: 5.7 10.2 4.5 7.9 3.6Emergency Dept. Visits 5.8(2004–2006)Asthma Emergency 91.5 96.2 75.1 92 81.1Dept. Visits (2011–2012) 22.5 25 16.3 27.1 13.1Sources: http://ibis.health.utah.gov/indicator/complete_profile/FallInjHosp.html,http://ibis.health.utah.gov/indicator/complete_profile/HeaAttHosp.html,http://ibis.health.utah.gov/indicator/complete_profile/DiabRelHosp.html,http://ibis.health.utah.gov/indicator/complete_profile/AsthHosp.html,http://ibis.health.utah.gov/indicator/view_numbers/MVC_ED.LHD.html,http://ibis.health.utah.gov/indicator/complete_profile/AsthED.html42 Weber-Morgan Health Department

Health Indicator 11 Chronic Disease PrevalenceC hronic diseases are a primary cause of death, disability, and morbidity nationally and locally. Because they are a source of long-term illness and poor health to many adults they are animportant measurement of morbidity.For adults with diabetes, high cholesterol, heart disease, and high blood pressure Weber County is inneed of improvement when compared to nearby counties and the Utah average. In the measurementof adults with asthma, Weber is slightly better than nearby counties and both the national andstate averages. Morgan County is excelling in all of these measurements except for adults withhigh blood pressure. Most Morgan County data was suppressed out of confidentiality concerns; it islikely that Morgan County is doing well in these measurements.Table 17: Adult Chronic Disease PrevalenceAdults With: U.S. State of Weber Morgan Davis Salt Lake Utah 9.1% Utah County County County County CountyDiabetes (2012) 38.5% 7.6% 8.4% 7.1% 4.4% 7.7% 7.7% 7.3%High Cholesterol 28.2% 34.6% 36.7% –(2011–2012) 13.4% 34.7% 35.2% 31.2% 2.8% 3.5% –Heart Disease 24% 25% 31.2% 2.1% 2.69% 2.3%(2011–2012) 23.6% 23.8% 22.4% 13.2% 13% –High Blood Pressure 13.9% 13.4% 13.2%(2006–2012)AsthmaSources: http://assessment.communitycommons.org/CHNA/report?page=6&id=607http://assessment.communitycommons.org/CHNA/report?page=6&id=637http://assessment.communitycommons.org/CHNA/report?page=6&id=609http://assessment.communitycommons.org/CHNA/report?page=6&id=608http://assessment.communitycommons.org/CHNA/report?page=6&id=651✓Source: http://www.healthypeople.gov/2020/topics-objectives/topic/heart-disease-Xand-stroke/objectivesWeber County has met HP2020’s goal of no more than 26.9% of alladults with high blood pressure. Morgan County is in need of improvement in order to meet this same goal. Community Health Assessment 43

Health Indicator 12 Cancer IncidenceC ancer incidence is an important measurement of morbidity that tells how many new cases of cancer occurred during a given time period; this measurement is not to be confused withcancer prevalence, which is a ratio determined by dividing the number of cancer patients with thetotal population.10Weber County is doing better in breast cancer for both national and state rates, however there isan opportunity for advancement in the other categories. Compared to local and state averagesMorgan County is doing better in prostate cancer, however it is still significantly above the nationalaverage. Much Morgan County data is suppressed due to confidentiality concerns. We are currentlyunsure why the entire state has considerably elevated prostate cancer rates.Table 18: Cancer Incidence RatesBreast U.S. State of Weber Morgan Davis Salt Lake UtahProstate Utah County County County County CountyColorectal 122.7 112 103.8 120.3 114.9 117.1Lung 142.3 170.6 163.3 – 240.9 165.1 170.6Cervical 43.3 34 153 33 64.9 28.2 35.8 36.7 30.8 35.5 5.3 33.1 – 20.8 5.2 19 7.8 – 4.5 3.6 7 –Sources: http://assessment.communitycommons.org/CHNA/report?page=6&id=610, http://assessment.communitycommons.org/CHNA/report?page=6&id=611,http://assessment.communitycommons.org/CHNA/report?page=6&id=612, http://assessment.communitycommons.org/CHNA/report?page=6&id=613, http://assessment.communitycommons.org/CHNA/report?page=6&id=614Of all the areas served by the WMHD, Downtown Ogden has the lowest incidence rate forprostate cancer with 127.9 per 100,000 and Riverdale has the highest with 187.8.✓ Weber County has met two HP2020’s goals: 39.9 or fewer colorectal cancers per and 7.1 or fewer cervical cancers per 100,000 residents.Source: http://www.healthypeople.gov/2020/topics-objectives/topic/cancer/objectives44 Weber-Morgan Health Department

Health Indicator 13 Adult ObesityO besity is an ever-expanding national public health issue. Obesity is defined as having a body mass index (BMI) of 30 or higher. Obesity is a preventable condition usually caused by acombination of a sedentary lifestyle and excessive caloric intake. Obesity is concerning because theobese are significantly at increased risk for high blood pressure, high cholesterol, type 2 diabetes,heart disease, stroke, and arthritis. Obesity is a paramount public health crisis because it is thesecond leading cause of preventable death in the U.S.11Adult obesity rates have grown to pandemic rates both nationally and locally. From 1997 to 2013,Utah obesity rates skyrocketed from 15.8% to 24.9%; in just 14 years Utah obesity rates haveincreased by a staggering 63%.12Weber County is consistent with national averages and is moderately above the averages of nearbycounties and the state of Utah. The areas in Weber with the greatest concentrations of obeseadults are in Roy/Hooper and Downtown Ogden. Even with 22% of its adult population obese,Morgan County is in the top 10% of performing counties for adult obesity.13Table 19: Overweight and Obese Adults U.S. State of Weber Morgan Davis Salt Lake Utah Utah County County County County CountyObese (BMI 30 or higher) 27.1% 25% 27.2% 35.8% 22% 24.6% 25.1% 24.1%2012 data 33.9% 31.7% No Data 36.2% 34.2% 32.4%Overweight(BMI between 25–30)2011–2012 dataSources: http://assessment.communitycommons.org/CHNA/report?page=6&id=604 , http://assessment.communitycommons.org/CHNA/report?page=6&id=603As Chart 14 shows, since 2004 Weber County has consistently been above its peers for adultobesity rates and Morgan has constantly performed in the top 10% of counties in America. Community Health Assessment 45

Chart 14: Adult Obesity Rates28% 2005 2006 2007 2008 2009 2010 2011 2012 Weber County26% Morgan County24% Davis County22% Salt Lake County20% Utah County18% State of Utah United States 2004Source: http://assessment.communitycommons.org/CHNA/report?page=6&id=603What are Residents Saying?Weber residents shared the following about obesity and its causes: “…Not enough time to exercise or walk because I have to work all the time…” “We don’t pay attention to what we are eating.” “You just can’t throw healthy food at people, some people don’t even know how to cook vegetables. We need more education.”14A WMHD resident shared the following on the PhotoVoice comment board: “We are not so likely to have people note nutrition matters in what we are putting into our diets. This large number of [fast food] outlets is promoting we may eat quickly, but at what cost to our health overall and disease costs more than prevention of disease!”1546 Weber-Morgan Health Department

Health Indicator 14 Childhood ObesityC hildhood obesity is a serious immediate Chart 15: Levels of Obesity in Local and long-term public health concern. A School Districtschild is considered obese if their BMI is at or Ogdenabove the 95th percentile for children of the Schoolsame age and gender.16 Generally, insufficient Districtactivity and a high caloric diet are the primary Webercauses of childhood obesity.17 Childhood School Districtobesity matters because, for example, obese Ogden & Maleschildren 10–13 years old have an 80% chance Weber Femalesof becoming obese adults.18 Districts 5% 10% 15% 20% 25%In 2014, the WMHD acquired childhood obesitydata by measuring the weight and height of a State of Utah Average 0%large sample size of approximately 2,700 Source: UDOH & WMHDschool children enrolled in 1st, 3rd, and 5thgrades in the Ogden School District (OSD).19 2012 data was available for Weber School District(WSD). Chart 15 reveals OSD has twice the obesity rates for both female and male students thanthe state average and WSD. WSD is consistent with Utah’s average obesity. Even when the school districts are combined,Chart 16: Obesity in Utah’s 3rd Graders their obese male and female results are several percentage15% points above the state average.13%11% 1994 2006 2008 2010 2012 2014 Using data from Utah 3rd 9% graders captured at 6 different 7% points over the span of 20 5% years, it is clear the percentage of obese Utah children is progressively increasing. 3rd Grade Girls 3rd Grade BoysSource: http://ibis.health.utah.gov/indicator/view/OvrwtChild.html Community Health Assessment 47

Health Indicator 15 Obesity DisparitiesO besity disparities distinctly shed light on where unequal Chart 17: Obese Adults by Race levels of obesity burden fall. Obesity rates are not uniformEvery race in among the different races. In Utah in Pacific AfricanUtah has 2.7–4.7 2013, 42.5% of Pacific Islanders were Islander Americantimes more obese, whereas 31.5% of American 42.5%obese adults Indians, 27% of Hispanic/Latino adults, 31.5%than there are 24.5% of Caucasians and only 9.1% ofobese Asians. Asians were obese.20 Hispanic/ Native Latino American In Utah, males are generally more likely 27.0% to be obese than females. The bulk of 32.4% obesity cases rests in the 35–49 and 50–64 Asian age groups. Lastly, there is an association Caucasian 9.1% 24.5%Chart 18: Obesity in Utah by Gender & Age between education Source: http://ibis.health.utah.gov/indicator/ and obesity where complete_profile/Obe.html18–34 years old (2013) rates significantly drop off after obtaining a college35–49 years old degree or higher; other education groups have50–64 years old Male significantly higher obesity rates. Female 65+ years old Chart 19: Adult Obesity by Education Level (2013)35% 25% 15% 5% 5% 15% 25% 35% 35% 30%Source: http://ibis.health.utah.gov/indicator/view_numbers/Obe.AgeSex.htmlIt is important to note, that although Body 25%Mass Index is the current standard fordetermining obesity, it does have it 20%shortfalls.21 These shortfalls include: 15%• Older adults tend to have more fat than younger adults with the same BMI score 10%• Women typically have more body fat than 5% men with an equivalent BMI 0 Some College Less than H.S. Grad College Graduate High School or G.E.D. Source: http://ibis.health.utah.gov/indicator/complete_profile/Obe.html• Physically fit individuals have a high BMI because of increased muscle mass48 Weber-Morgan Health Department

Health Indicator 16 Communicable DiseasesI n 2014 the WMHD reported a total of 1,412 communicable diseases. This was a modest 2.5% increase from 2013, however it was a 14% increase from 2009. Additional chlamydia, pertussis,and gonorrhea cases account for the moderate increases the WMHD has seen every year since 2009.The top four communicable diseases for 2014 were chlamydia, pertussis, hepatitis C, andgonorrhea. 58.7% of the 2014 communicable diseases are attributable to the sexuallytransmitted infections (STI) of chlamydia and gonorrhea. Since 2009 the percentage of totalcommunicable diseases attributed to STIs ranged anywhere from 56% to 68% in the WMHD.Table 20: Top 10 Communicable Diseases per 100,000 (2014)Chlamydia trachomatis infection WMHD UtahPertussis 278.8 279.4Hepatitis C virus infection, past or presentGonorrhea 61.7 31.9Influenza-associated hospitalization 54.6 51.0Campylobacteriosis 49.0 49.0Streptococcal disease, invasive, other 47.5 48.0Salmonellosis 30.8 19.0Hepatitis B virus infection, chronic 10.3Streptococcal disease, invasive, Group B 9.8 9.5 12.6 9.1 10.2 7.1 Not in the Top 10Sources: http://health.utah.gov/epi/data/topdiseases/2014_Top_10.pdf, IBISAll communicable diseases impact the health of the community, accrue medical expense, andreduce productive hours, however pertussis and influenza are the most likely to result inhospitalization or death.Overall, the WMHD is consistent with the state averages, however there is an opportunity forimprovement in pertussis and camplylobacteriosis rates. Community Health Assessment 49

Health Indicator 17 Sexually Transmitted InfectionsS exually transmitted infections are an indicator of poor health status and unsafe sex practices. This indicator will focus on the top two sexually transmitted infections: chlamydiaand gonorrhea.Chlamydia is moderately trending upwards, both locally and nationally, however all parts of Utahare well below the national average. It is likely that Utah values encouraging abstinence beforemarriage may be responsible for this.Chlamydia is not only the top reported sexually transmitted infection in the two counties servedby the WMHD, but it is also the top reported disease.22 Historically, Weber County has moderatelytrended upward and exceeded its peers, except for Salt Lake County and national trends, for newchlamydia cases each year. In 2014 the WMHD dipped below the state average. Overall, MorganCounty performs well in this measurement, but periodically trends upwards.Chart 20: Annual Chlamydia Incidence Rate per 100,000 Residents460 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014410 UCHD360310260210160110 60 10 2004U.S. Utah WMHD Morgan County DCHD SLCoHDSource: http://assessment.communitycommons.org/CHNA/report?page=6&id=615, http://www.healthindicators.gov/Indicators/Chlamydia-per-100000_20/Profile/ClassicData, http://ibis.health.utah.gov/indicator/view/ChlamCas.LHD.html50 Weber-Morgan Health Department