Communities We Serve. 611 Saint Joseph Avenue, Marshfield, Wisconsin Ministry Health Care 2

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2 Communities We Serve 611 Saint Joseph Avenue, Marshfield, Wisconsin Ministry Health Care 2

3 TABLE OF CONTENTS Community 4 Community Involvement 5 Community Needs Assessment Process.. 6 Health Needs 7 Community Assets... 8 Health Priorities 8 Next Steps. 9 Appendices Appendix 1 _ Discharge Data by County 11 Appendix 2 _ Community Need Index By County Appendix 3 _ St. Vincent De Paul Free Clinic Summary.. 15 Appendix 4 _ Community Needs Assessment Team 17 Appendix 5 _ County Health Rankings by County Appendix 6 _ Marathon County LIFE Report.. 21 Appendix 7 _ Trauma and Service Line Data. 23 Ministry Health Care 3

4 Ministry Saint Joseph s Hospital Community Health Needs Assessment An assessment of Wood, Clark and Marathon Counties was conducted by Ministry Saint Joseph s Hospital in The mission of Ministry Saint Joseph s Hospital is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve. For more than 100 years, care has been provided to all individuals, regardless of ability to pay. The financial assistance policy, which is posted in the Emergency and Admissions Departments and on our website, provides support to those without income to pay for their medical services. Patient financial assistance staff works with all individuals to ensure their payment plans work within their financial situation. In 2011, Ministry Saint Joseph s Hospital provided $10.8 million in charitable care. The Sisters of the Sorrowful Mother opened the Hospital in 1890 with the water cure, which was one of the first community health improvement plans. By keeping individuals cleaner, they were able to reduce disease and infection that had previously impacted the population. For many years, Ministry Saint Joseph s Hospital has provided grants and involved in programs and activities that promote health and wellness as a response to identified community needs. This year, however, the primary focus was on health needs assessments and expanded beyond Wood County. Description of Community Served by the Hospital Ministry Saint Joseph s Hospital is a tertiary teaching hospital. Located in Wood County, Wisconsin, our primary and secondary service area represents 21 counties in central and northern Wisconsin. According to the Wisconsin Department of Administration, the majority of patients come from a three county area Wood, eastern Clark and western Marathon counties (see Appendix 1). Focusing on these three regions provide the greatest opportunity to impact the health of individuals who are closest in proximity to the hospital. Wood County is a rural area with two larger cities, Marshfield and Wisconsin Rapids, which are located at opposite ends of the county. The county s population has declined since 2000; however, there was a slight increase in 2012 to 73,942 in total population. Eighteen percent of the population is over the age of 65 and this percentage continues to grow. Wood County population is fairly homogeneous with 95.7% white and Hispanic as the next highest reported percentage of 2.3%. (Source: 2010 Census Data) From 2000 to 2011, there was a sharp increase in unemployment, which most of the country also encountered. Wood County s 2011 unemployment rate of 7.7% was higher than the state of Wisconsin average. In line with the unemployment increase, income also declined over the past three years in the county and the median income fell to $45,226. The population of Marathon County is 134,063 and growing slightly, with 92% of the population White and 5.5% Asian. The Asian population is mostly located in the city of Wausau. Residents in the Wausau area have access to two local hospitals: Aspirus Hospital and Ministry Saint Clare s Hospital. Clark County population is 97.9% white and 3.8% Hispanic. This emulates, as does Wood County data, Ministry Saint Joseph Hospital admission data. Ministry Health Care 4

5 While the majority of Wood County residents are living moderately well, there are still concerns of families living in poverty. Census data indicates 10% of individuals/families are living in poverty in Wood County, 13.9% in Clark County and 9.4% in Marathon County. All but Clark County are lower than the state of Wisconsin s average of 12%. A growing concern in our region was brought to light by the Marshfield School District, and that is the increase in the number of homeless youth (defined as students who lacked a fixed, regular and adequate night-time residence). In 2010, Marshfield School District reported 36 students as homeless, which represents an increase of 21 children since The Community Need Index (CNI) was reviewed, along with data from the free clinic at St. Vincent De Paul (SVDP), to locate any vulnerable populations that may not have been identified with other analysis. The CNI accounts for the underlying economic and structural barriers that affect overall health - income, culture and language, education, insurance and housing. The CNI Median Scores were 1.8 for Wood County, 2.6 for Clark County and 1.9 for Marathon County (see Appendix 2). Additional data from SVDP showed utilization from these same areas in Wood and Clark counties. However, individuals from Marathon County have other options for free care that are closer to their residence than Marshfield s Free Clinic (see Appendix 3). Who Was Involved in Assessment In 2012, a community health needs assessment (CHNA) was conducted by Wood County Health Department, Ministry Saint Joseph s Hospital and Riverview Hospital. The assessment team was comprised of health leaders and community stakeholders. This community team of Wood County representatives was formed to: 1. Review health problems with preventable causes that impact our residents. 2. Select top health priorities to be focused on in the next five years. 3. Develop goals, measurable outcomes and strategies that will address the top health priorities. Appendix 4 lists the Individuals participating on the assessment team. Public Health Experts The team was led by Public Health and Demographic Experts Sue Kunferman, RN, MSN, CPM - Director Wood County Health Department Angela Nimsgern, MPH, CPH - Regional Director Wisconsin Division of Public Health Northern Region Office More than 12 years of experience with community health assessments. Jim Lawrence, RS - Public Health Educator Wisconsin Division of Public Health Northern Region Office More than 20 years of experience in public health Peter Manley, BS, MS - Community Resource Development Educator Wood County University of Wisconsin Extension Ministry Health Care 5

6 How the Assessment Was Conducted? The team reviewed health data, epidemiologic trends, economic data, hospitalization incidence, birth and death data, high school surveys, environment impacts, and other local health related information. Additionally, information was also reviewed about factors that are present in the community that affect health, including the state health priorities of: Alcohol and Drug Use Chronic Disease Prevention and Management Communicable Diseases Environmental and Occupational Health Healthy Growth and Development Injury and Violence Prevention Mental Health Nutrition and Healthy Foods Oral Health Physical Activity Reproductive and Sexual Health Tobacco Use and Exposure The team s review included analysis of trends and comparisons within the state, northern region and national data. Secondary data was also compared with indicators established by Healthiest Wisconsin The general public was asked to provide input on ranking of the health issues via the Wood County Health Department website. Community leaders unable to attend the full data assessment session received a survey by mail. After reviewing the health data and the survey input, the assessment team finalized the top priorities for Wood County. The following three priorities were selected as the issues to be addressed by the Healthy People Wood County coalition: Chronic Disease Prevention and Management Mental Health and AODA Healthy Growth and Development of Adolescents Team members broke into three subcommittees of Healthy People Wood County to write goals and strategies for each of these identified issues. Each group was charged with identifying additional community members or agency leaders to join their work groups. They will continue to work on these initiatives over the next five years with annual updates provided to the community and Wood County Board of Directors. Hospital Assessment A group of hospital leaders further analyzed the Wood, Marathon and Clark County Health Rankings (Appendix 5), the Marathon County LIFE Report (Appendix 6) and hospitalization rates (Appendix 7) for the primary service area of the hospital. Several of the Wood County health issues were identified by the Clark County Health Rankings and in the Marathon County LIFE Report. The LIFE Report identified alcohol and drug misuse, development of children in poverty, obesity, dental care, and tobacco use among high school students as top concerns for Marathon County. The Clark County Health Rankings showed that Clark County had higher incidence of excessive and binge drinking, motor vehicle accidents, access to care, and obesity. The Wood County Health Rankings provided further evidence of the established Wood County CHNA health concerns. Ministry Health Care 6

7 Key data elements reviewed by the hospital team included: Readmission rates/diagnosis Top service line discharges Trauma data and emergency department data Relevant quality reporting data Public Health Data and relevant Hospital data showed that the number one reason for trauma incidence was falls. The data also indicated that the top service line discharges of heart, orthopedic and pulmonary have remained constant for the past three years. Further data will need to be gathered regarding root causes to the identified needs in order to further define strategies and tactics to meet community health needs. In addition, there may be other gaps in information that we discover as we continue to further refine our implementation strategies. Health Needs Identified 1. Chronic Disease and Prevention Management/Obesity Chronic diseases, such as heart disease, stroke, cancer and diabetes, are the leading and most costly health problems. Rates for each disease continue to rise due to the age of our population and the current epidemic of obesity. The LIFE Report of Marathon County and the Clark County health rankings showed obesity as a top health concern. Adult obesity in Wood and Clark counties are above the national benchmark at 27% and 31% respectively and both are one of the highest in the state. Since obesity is linked to nearly every chronic health condition, we have combined this health issue with chronic disease prevention and management. The prevalence of obesity is increasing at an alarming rate both within our service area, but also the entire nation. This trend is even occurring in school age children. Heart admissions lead the data for Ministry Saint Joseph s Hospital and pulmonary issues are showing increases. The group felt that healthier eating and increased physical activity would be addressed via this team as these are the best ways to prevent and manage each of these chronic diseases as well as Obesity. There are currently two teams working on this initiative Healthy Lifestyles and the Wood County coalition for Healthy Living. 2. Healthy Growth and Development of Youth and Adolescents Tobacco use and exposure represent the leading overall cause of death in the U.S. and Wisconsin. Data from all three counties showed high incidence of tobacco use among pregnant women and teens. Pregnant women who reported smoking during their pregnancy was at 19.8% in the northern region of Wisconsin and 19.6% in Wood County. These percentages have actually increased slightly throughout the five prior years. Numbers showed 159 Wood County new moms reported smoking during their pregnancy in While the data for youth who smoked a whole cigarette before age 13 has declined, as has the number of students who smoked cigarettes on 20 or more days, the percentage is still high at 9%. Additionally, students in grades 9-12 in Wood County who had used snuff or dip is at 11% for Wood County higher than the state or national average. By reducing the incidence of tobacco use among pregnant women and adolescents, we can reduce health risks and possibly reduce the leading cause of death for the next generation. Ministry Health Care 7

8 Identified strategies from the Wood County Healthy People coalition are to expand the breadth of the First Breath program, which will help insure compliance of this tobacco free incentive program. Additionally, the team will explore evidence-based strategies to reduce tobacco use among adolescents. The coalition is also committed to continuing the dental sealant program and dental awareness campaign to ensure infants and adolescents have healthy teeth and gums. The county has gained tremendous strides with this program and if discontinued, oral health would again become an issue. According to the county health rankings report, Wood and Clark counties had higher teen birth rates than the national average, as well as sexually transmitted infections. The final objective of the group is to reduce teen pregnancy and communicable diseases. 3. Falls Prevention Data collected from both Riverview Hospital and Ministry Saint Joseph s Hospital showed falls as the number one reason for trauma-related admissions and emergency department visits. Nearly 45% of all trauma injuries were due to some type of fall (see Appendix 7). The number of fall-related injuries that need emergency medical attention has been increasing over the past three years. This is a preventable issue for which we need more in depth data on types of falls, ages of patients and other factors in order to determine the best way to reduce them. 4. Improved Access to Healthcare Access to health care continues to be an issue for Clark County residents, in part due to the increase in unemployment. Additionally, access to programs that pay for medications and other medical supplies is a concern for each of the counties surveyed. Even with health care access, if individuals are unable to pay for the medication and supplies they need, we cannot improve the health of our residents. Ministry has been partnering with St. Vincent de Paul Free Medical Clinic as well as Indianhead Community Action Program to provide access to health care, as well as prescription assistance and hearing aids and eyewear. Community Assets Identified Today, Ministry Saint Joseph s Hospital is a 504-bed tertiary care teaching institution serving individuals from more than 20 counties with a primary service area of Wood, northern Clark and western Marathon counties. Last year, there were more than 19,000 inpatients and 75,000 outpatient visits to the facility. It provides all medical and surgical specialties and subspecialties, with the exception of solid organ transplants and burn care, to the people of central and northern Wisconsin and Michigan s Upper Peninsula. Within the identified primary service area, there are six hospitals, all of which provide emergency room care and offer charity care programs. Three of the hospitals are part of the Ministry Health Care system Ministry Our Lady of Victory in Clark County, Ministry Saint Clare s Hospital in Marathon County and Ministry Saint Joseph s Hospital in Wood County. In addition, Riverview Hospital provides care to individuals in the eastern region of Wood County in Wisconsin Rapids and Nekoosa. Marshfield Clinic, Ministry Medical Group and Aspirus Network provide non-acute medical care as well as provide urgent care. They also have charity care programs. St. Vincent De Paul operates a free Medical Clinic in Marshfield twice per month providing care to low income or uninsured individuals. In addition, St. Vincent De Paul recently opened a Diabetes Clinic one time per month for low-income residents. Ministry Health Care 8

9 Health Priorities The data from each of these assessments was reviewed and prioritized. Priority was given to those categories that affected all three counties within the primary service area. In addition, the team assessed assets of the region if the hospital did not have expertise in one of the categories. In reviewing the identified priorities in each county, neither motor vehicle accidents nor unemployment/wage concerns were selected as priorities as the hospital does not have expertise in these areas. While these issues certainly impact health and life, the decision was made to focus on areas that the hospital could make an impact. Wood County has an active mental health coalition working on ways to improve gaps in services so this was not identified as a priority for the hospital at this time. The hospital will continue to support the work of this coalition whenever possible but will not be leading this initiative. It was determined that for the primary service area of Wood, northern Clark and western Marathon counties, the primary health concerns for Ministry Saint Joseph s Hospital to focus are: 1. Chronic Disease and Obesity Prevention/Management 2. Healthy Growth and Development of Adolescents 3. Falls Prevention 4. Improved Access to Health Care Next Steps Teams for each Wood County priority have been meeting for several weeks and already identified their goals and objectives for the identified needs. Staff members of Ministry Saint Joseph s Hospital are on each of the three Wood County teams to address health risks chronic disease and obesity, healthy growth and development of adolescents, and mental health. In addition, a group of hospital leaders will meet each quarter to plan and monitor activities to react to the identified hospital priorities. Internally, we have developed a new program to continually track and monitor hospital programs and services related to the identified needs. Funding has been secured for grants to help external and internal programs that meet one of the Hospital s Health Priorities. Ministry Saint Joseph s Hospital has been involved since the inception of the St. Vincent De Paul Free Medical Clinic, which addresses chronic disease and access to health care. Ministry provides equipment, staff and funding to allow St Vincent de Paul Free Medical Clinic to provide care to those without insurance and additionally, pays for any medications prescribed during the visit. Our goal is to strengthen this partnership to further assist low-income access to health care services and medications. In addition to St Vincent De Paul Free Medical Clinic, Ministry Saint Joseph s Hospital has been providing grants to programs that serve the poor and help them become independent. One of the first ways to impact these newly identified health issues was to change the granting process to instead target the identified health needs. Only those programs that had projects that would directly impact one of the identified health concerns were eligible for funding consideration. Ministry Health Care 9

10 This was the first step in our implementation plan. More than $230,000 was awarded to the following programs: Clark County Independence provides assistance with eye and dental expenses for individuals in poverty; improves access to care. Alzheimer s Assistance provides funding for those needing in home or center care for individuals with Alzheimer s; improves mental health of stressed out caregivers. Healthy Smiles provides dental sealant and assistance with dental care for all second graders in Wood County; reduces adult dental issues & emergency department visits. Kiddie Kaboose Daycare teen parenting and child care program; reduce teen pregnancy and improve outcomes for infants of teen parents. St Vincent De Paul provides a free clinic twice a month to low income individuals; improves chronic disease management. St Vincent De Paul provides short-term, post-hospitalization home health services to lowincome individuals; prevents re-admission to the hospital. YMCA improves health of low-income clients; reduces chronic disease issues. Youth Net program to help at risk children learn healthy lifestyles; provides education/support on healthy adolescent development. Ministry Health Care 10

11 Appendix 1 - Ministry Saint Joseph s Hospital 2010 Discharge Data by County Primary (70.6%) and Secondary (23.4%) Service Area Ministry Health Care 11

12 Appendix 2 - Community Need Index for Wood County, Wisconsin Source: Ministry Health Care 12

13 Appendix 2 - Community Need Index for Marathon County, Wisconsin Source: Ministry Health Care 13

14 Appendix 2 - Community Need Index for Clark County, Wisconsin Source: Ministry Health Care 14

15 Appendix 3 - St. Vincent De Paul Free Medical Clinic Summary The purpose of St. Vincent De Paul Free Medical Clinic is to provide free medical care and assistance to the uninsured, the underinsured and those in need regardless of race, ethnicity or religious affiliation. The free medical clinic in Marshfield was established in 1988 and operates under auspices of the St. Vincent De Paul Society, which is a national Catholic organization designed to offer a broad range of services to meet the needs of the poor and underserved. The free medical clinic in Marshfield has continued to operate with the support of volunteer physicians, nurses and others on the first and third Wednesday of each month with hours from 5:00 p.m. until the last patient is served. Services provided by the Free Medical Clinic Medical screening and management by physicians, PA, Nurse practitioner Mental health counseling Medication prescriptions Basic lab test Diabetic education Referrals to Marshfield Clinic for service beyond scope of clinic Referrals for dental and optical care Funding source $20,000 from Ministry Health Care $20,000 from Ministry Health Care $32,000 from Ministry Health Care intent to support expansion of services Statistics and expenditures [6 months] Lab $ $ $ Medications $13, $15, $ Optical $ $ $ Miscellaneous $ $ Total $16, $21, $13, Patients served in 6 months Ministry Health Care 15

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17 Appendix 4 - Community Needs Assessment Team Tina Bart *Ann Boson Anne Egge Nancy Eggleston Jodi Friday Lori Galetka Jim Hoese Jamie Jestadt Tari Johns Jennifer Knecht *Lisa Leinwander Julie Marie Mary Moss Andrew Netz John Nystrom Jan Pelot Kristie Rauter, RN Terry Reynolds *Terri Richards, RN, MSN Bret Salscheider Ciara Schultz Jay Shrader Deb Steltenpohl Joe Welter, MD Mary Wolosek *Ministry Health Care leaders. Riverview Hospital Ministry Saint Joseph s Hospital Aspirus Medical Clinic Wood County Health Department University of Wisconsin/Wood County Extension University of Wisconsin/Marshfield Campus Marshfield School District Auburndale School District United Way of Inner Wisconsin Marshfield Clinic Ministry Saint Joseph s Hospital Wisconsin Rapids School District Mid-State Technical College Wood County Sheriff s Department Marshfield Area YMCA Wood County Head Start Wood County Health Department Pittsville School District Ministry Saint Joseph s Hospital South Wood County YMCA Aging and Disability Resource Center Security Health Plan St. Vincent De Paul Marshfield Clinic City of Wisconsin Rapids Ministry Health Care 17

18 Appendix 5 - County Health Ranking for Wood County, Wisconsin 2012 Wood County Error Margin National Benchmark* Wisconsin Rank (of 72) Health Outcomes 22 Mortality 23 Premature death 5,614 4,985-6,242 5,466 6,124 Morbidity 56 Poor or fair 12% 9-15% 10% 12% Poor physical health days Poor mental health days Low birth weight 6.0% % 6.0% 6.9% Health Factors 8 Health Behaviors 12 Adult smoking 20% 16-25% 14% 20% Adult obesity 27% 22-32% 25% 29% Physical inactivity 20% 16-24% 21% 23% Excessive drinking 21% 17-27% 8% 24% Motor vehicle crash death rate Sexually-transmitted infections Teen birth rate Clinical Care 3 Uninsured 9% 8-10% 11% 11% Primary care physicians 448:1 631:1 744:1 Preventable hospital stays Diabetic screening 92% 85-99% 89% 89% Mammography screening 77% 69-84% 74% 73% Social & Economic Factors 20 High school graduation 92% 86% Some college 61% 57-64% 68% 63% Unemployment 8.6% 5.4% 8.3% Children in poverty 18% 14-22% 13% 19% Inadequate social support 14% 10-18% 14% 17% Children in single-parent 25% 21-29% 20% 29% households Violent crime rates Physical Environment 22 Air pollution-particulate matter days Air pollution-ozone days Access to recreational facilities Limited access to healthy 2% 0% 6% foods Fast food restaurants 38% 25% 41% * 90 th percentile, i.e. only 10% are better Note: Blank values reflect unreliable or missing data; Source: Ministry Health Care 18

19 Appendix 5 - County Health Ranking for Marathon County, Wisconsin 2012 Marathon County Error Margin National Benchmark* Wisconsin Rank (of 72) Health Outcomes 57 Mortality 55 Premature death 7,090 5,946-8,234 5,466 6,124 Morbidity 56 Poor or fair 14% 10-18% 10% 12% Poor physical health days Poor mental health days Low birth weight 6.3% % 6.0% 6.9% Health Factors 57 Health Behaviors 57 Adult smoking 27% 21-33% 14% 20% Adult obesity 29% 24-34% 25% 29% Physical inactivity 24% 19-30% 21% 23% Excessive drinking 25% 20-32% 8% 24% Motor vehicle crash death rate Sexually-transmitted infections Teen birth rate Clinical Care 40 Uninsured 11% 9-12% 11% 11% Primary care physicians 720:1 631:1 744:1 Preventable hospital stays Diabetic screening 89% 79-98% 89% 89% Mammography screening 73% 62-83% 74% 73% Social & Economic Factors 49 High school graduation 92% 86% Some college 52% 47-57% 68% 63% Unemployment 11.5% 5.4% 8.3% Children in poverty 17% 12-21% 13% 19% Inadequate social support 18% 13-24% 14% 17% Children in single-parent 23% 18-28% 20% 29% households Violent crime rates Physical Environment 18 Air pollution-particulate matter days Air pollution-ozone days Access to recreational facilities Limited access to healthy 2% 0% 6% foods Fast food restaurants 31% 25% 41% * 90 th percentile, i.e. only 10% are better; Note: Blank values reflect unreliable or missing data; Source: Ministry Health Care 19

20 Appendix 5 - County Health Ranking for Clark County, Wisconsin 2012 Clark County Error Margin National Benchmark* Wisconsin Rank (of 72) Health Outcomes 32 Mortality 38 Premature death 6,425 5,443-7,407 5,466 6,124 Morbidity 23 Poor or fair 15% 10-21% 10% 12% Poor physical health days Poor mental health days Low birth weight 5.5% % 6.9% Health Factors 63 Health Behaviors 54 Adult smoking 21% 15-30% 14% 20% Adult obesity 31% 26-37% 25% 29% Physical inactivity 25% 20-31% 21% 23% Excessive drinking 26% 19-35% 8% 24% Motor vehicle crash death rate Sexually-transmitted infections Teen birth rate Clinical Care 71 Uninsured 15% 14-17% 11% 11% Primary care physicians 3,722:1 631:1 744:1 Preventable hospital stays Diabetic screening 90% % 89% 89% Mammography screening 71% 60-82% 74% 73% Social & Economic Factors 51 High school graduation 91% 86% Some college 44% 41-46% 68% 63% Unemployment 9.8% 5.4% 8.3% Children in poverty 24% 18-30% 13% 19% Inadequate social support 18% 12-25% 14% 17% Children in single-parent 17% 14-19% 20% 29% households Violent crime rates Physical Environment 30 Air pollution-particulate matter days Air pollution-ozone days Access to recreational facilities Limited access to healthy 2% 0% 6% foods Fast food restaurants 25% 25% 41% * 90 th percentile, i.e. only 10% are better; Note: Blank values reflect unreliable or missing data; Source: Ministry Health Care 20

21 Appendix 6 - LIFE Report of Marathon County: The LIFE Steering Committee Focus LIFE in Marathon County: Local Indicators for Excellence. Wausau, WI, EXECUTIVE SUMMARY. This is the eighth edition of LIFE in Marathon County, a report representing Marathon County information and data. The LIFE report builds on previous reports and focuses on identifying key issues in our community while at the same time monitoring trends that affect the quality of life in Marathon County. The report provides insight into the complexities of our community. The objective is to inform and engage the leaders and residents of Marathon County to work together around our challenges and calls to action. Together, we can overcome the obstacles and become a stronger community, thus enhancing the quality of life for the people who live, learn, work, and play in Marathon County. Unemployment/Jobs Providing a Living Wage: Why is this important in Marathon County? Unemployment rates in Marathon County are higher than the state in the last 2 years. Unemployment or a job that does not provide adequate income leads to family s lack of financial recourses for the necessities of life (food, shelter, clothing, and access to health care), which leads to a diminished sense of control and social isolation/issues. Families in poverty or near poverty have poorer health outcomes and children are at greater risk of not succeeding in school. Alcohol and Drug Misuse: Why is this important in Marathon County? Alcohol and drug misuse affects families and communities both socially and economically, with increased criminal offenses, family violence and arrests, for example. Alcohol and drug abuse and their related problems are among society s most pervasive health, safety and social concerns. Age at onset of drinking and drug use strongly predicts development of alcohol and drug dependence over the course of a person s life. Development of Young Children - Ages 0-6: Why is this important in Marathon County? Early care and education both inside and outside of the home are foundational to a child s later life success. Ninety percent of brain development occurs in the first five years of life, so informational and experiential input during these first years of life play a significant role in how a child learns and develops including their social/emotional development. Vocabulary development by age three has been found to predict reading achievement by third grade, and a child who is not at least a modestly skilled reader by the end of third grade is unlikely to graduate from high school. An early educational experience for young children, such as being read to daily, encourages the development of essential skills and prepares children for success in school. Investing community resources in early age support has a strong return on investment due to lower crime, as well as less delinquency, teen pregnancy, and welfare dependence. These investments also lay the foundation for a more prepared work force. Ministry Health Care 21

22 Overweight/Obesity: Why is this important to Marathon County? Obesity and related chronic diseases affect the economy in two major ways. The first is direct costs associated with the medical care to treat these diseases - estimated at $1.5 billion in just Medicaid costs annually in Wisconsin. The second is indirect costs, including lost productivity and wages. Obesity is the leading preventable cause of death worldwide, with increasing prevalence in adults and children. Authorities view it as one of the most serious public health problems. Overweight and obesity acquired during childhood or adolescence may persist into adulthood and increase the risk for some chronic diseases later in life. In addition, the Health and Wellness section of the LIFE Report indicated dental care for those unable to afford it, and tobacco use among high school students and pregnant women is of concern. Ministry Health Care 22

23 Appendix 7 - Ministry Saint Joseph s Hospital Data Ministry Saint Joseph s Hospital Total Trauma Population Injuries % 40.0% 35.0% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% Ministry Saint Joseph s Hospital Service Line Market Share Heart 14% Orthopedic 10.4% Pulmonary 9.0% * Newborn/NICU 8.4% Gastroenterology 7.0% * Obstetrics and GYN 7.0% General Surgery 6.0% Neurology 5.0% General Medicine 3.5% Renal Disease 3.3% Mental Health 3.0%** Oncology 3.0% All other 20% Ministry Health Care 23