Board of Health Annual Report 2007

              Serving Clinton, Gratiot & Montcalm Counties
www. mmdhd. org
Mid- Michigan District Health Department
P R E V E NT IV E HE ALT H S E R V IC E S
CLINTON* MONTCALM* GRATIOT
MID- MICHIGAN
DISTRICT
HEALTH DEPARTMENT
Your public health experts, connecting with the
community and exceeding expectations
2007 Board of Health Annual Report
We take action to assure the health and well- being of our community and the environment
by responding to public health needs and providing a broad spectrum of prevention and
educational services.
Your public health experts, connecting with the community and exceeding expectations.
GRAPHIC DESIGN and LAYOUT:
Leslie Kinnee, Mid- Michigan District Health Department
• Monitor health status to identify and solve community health problems.
• Diagnose and investigate health problems and health hazards in the community.
• Inform, educate and empower people about health issues.
• Mobilize community partnerships to identify and solve health problems.
• Develop policies and plans that support individual and community health efforts.
• Enforce laws and regulations that protect health and ensure safety.
• Connect people to needed personal health services.
• Assure a competent public and personal health care workforce.
• Evaluate effectiveness, accessibility and quality of personal and population- based
health services.
• Research for new insights and innovative solutions to health problems.
P R E VE NT IV E HE ALTH S ER V IC E S
CLINTON* MONTCALM* GRATIOT
MID- MICHIGAN
DISTRICT
HEALTH DEPARTMENT
Mid- Michigan
District Health Department
Serving the residents of Clinton, Gratiot and
Montcalm Counties for 41 years
Our Mission
Our Vision
Essential Public Health Services
HEALTH OFFICER’S
REPORT
Kimberly Singh, M. A., C. H. E. S.
Health Officer, Mid- Michigan
District Health Department
Sincerely,
Kimberly Singh, M. A., C. H. E. S.
Health Officer
3
The Mid- Michigan
District Health
Department will
continue its efforts to
enhance the health
and well- being of the
residents of the
district by providing
exceptional
customer service,
through strengthened
community partner-ships
and by actively
responding to
emerging issues.
The Mid- Michigan District Board of Health is pleased to provide you with our 2007 Annual
Report. This report provides an overview of several selected health indicators, as well as
highlights the Environmental Health ( EH) and Community Health & Education ( CHED),
Divisions’ programs and services. Health department staff work throughout the year to pro-tect
the public’s health and enhance the quality of life for all residents in Clinton,
Gratiot, and Montcalm Counties.
This report also summarizes department priorities and accomplishments throughout the year.
Strengthening our ability to respond to change and address emerging issues continued to be
a focus in 2007. Our emphasis was on maximizing existing resources and seeking creative
partnerships and funding opportunities to meet new challenges. The health department:
• Successfully completed the third on- site accreditation review, leading to fully- accredited
status.
• Chartered a new Vision Action Team to champion the agency’s strategic planning process,
resulting in a revitalized Strategic Plan.
• Enhanced our All- Hazards and Pandemic Influenza Response plans and sponsored the
second Pandemic Influenza Summit for community partners.
• Occupied a new health department facility in St. Johns, which includes a three operatory
community- based dental clinic.
• Implemented new Environmental Health programming in the areas of Food Certification
Training and a Thermometer Exchange Program.
• Expanded Breast Health Screening Clinics in conjunction with community partners for
uninsured and underinsured women.
In conclusion, the Mid- Michigan District Health Department will continue its efforts to en-hance
the health and well- being of the residents of the district by providing exceptional cus-tomer
service through strengthened community partnerships, and by actively responding to
emerging issues. On behalf of the Board of Health and the many dedicated professionals who
work at the health department, I encourage you to review this report. Please feel free to call
me ( 989- 831- 3610) with questions, or e- mail me at ksingh@ mmdhd. org. The Mid- Michigan
District Health Department looks forward to continuing our work in making our communities
healthier and appreciates your continued support.
2007
BOARD
OF HEALTH
The Mid- Michigan
District Health
Department Board of
Health governs the
Agency’s program-ming,
finances and
personnel. It is
composed of two
county commission-ers,
appointed by
each of the three
member counties
( Clinton, Gratiot and
Montcalm) served by
the health depart-ment.
It is the respon-sibility
of the Board
of Health to see that
a plan is designed
and implemented
which will provide
long- term, continuing
health protection for
the residents of the
district.
JaCk enderle ( Clinton County)
Mr. Enderle is serving his 1st year on the Board of Health. He serves as a member of the Finance
and Mid- Central Coordinating Committees. As Chairperson of the Personnel Committee, he
presides at all negotiation meetings and presents recommended salary and benefit changes
to the Board.
Paul MCnaMara ( Clinton County)
Mr. McNamara is serving his 1st year on the Board of Health. As Chairperson of the Board, he
is responsible for preparing and/ or approving meeting agendas and presiding at Board meet-ings.
He also serves as a member of the Program and Public Health Emergency Committees.
He is also a representative of the Michigan Association for Local Public Health ( MALPH).
linton ChaPin ( gratiot County)
Mr. Chapin is serving his 3rd year on the Board of Health. As Chairperson of the Program
Committee, he is responsible for developing and presenting all proposed policies and program
changes.
roger Cook ( gratiot County)
Mr. Cook is serving his 1st year on the Board of Health. He also serves as a member of the
Finance, Mid- Central Coordinating and Public Health Emergency Committees.
Carl PaePke ( MontCalM County)
Mr. Paepke is serving his 13th year on the Board of Health and is Vice Chairperson. As Chair-person
of the Finance Committee, he is responsible for developing and presenting the proposed
annual budget for Board approval. He also serves as a member of the Program, Mid- Central
Coordinating and Public Health Emergency Committees.
MarCia Walker ( MontCalM County)
Ms. Walker is serving her 3rd year on the Board of Health. She serves as a member of the Per-sonnel
Committee.
kiMberly Singh, M. a., C. h. e. S. ( health offiCer)
Ms. Singh is serving her 11th year as the agency’s Health Officer. She is responsible for carry-ing
out the policies of the Board of Health and overseeing the internal operations of the Health
Department.
robert grahaM, d. o., M. P. h., f. a. a. f. P. ( MediCal direCtor)
Dr. Graham is serving his 16th year as the Medical Director for the Mid- Michigan District Health
Department and is also the Medical Director for the Central Michigan District Health Depart-ment.
He is responsible for determining and directing medical policies and procedures.
( front l- r) Carl Paepke, Marcia Walker, Health Officer Kimberly Singh, and Paul McNamara.
( back l- r) Linton Chapin, Jack Enderle, Roger Cook, and Medical Director Dr. Robert Graham.
4
2007
46% FINANCES
15%
11%
21%
7%
$ 6,916,212.93
REVENUES
State & Federal Funds ........................................................................
Medicaid & Medicare ........................................................................
Fees & Collections .............................................................................
Appropriations & County Funding .......................................................
Other Funding ....................................................................................
TOTAL REVENUES .............................
The accounting and
financial manage-ment
of the health
department’s re-sources
are overseen
by the Administrative
Services Division.
The financial man-agement
staff are
responsible for com-plying
with budget-ing
requirements and
financial reporting
for the various state
and federal agencies
that provide finan-cial
resources to the
agency.
PERSONNEL
SUPPLIES
CONTRACTUAL
COMMUNICATION
TRAVEL
EQUIPMENT
OTHER
67%
17%
7%
4%
3%
1%
1%
$ 6,916,212.93
EXPENDITURES
Personnel .........................................................................................
Supplies ..........................................................................................
Other ...............................................................................................
Contractual .....................................................................................
Travel ..............................................................................................
Equipment ......................................................................................
Communication ...............................................................................
TOTAL EXPENDITURES ......................
5
State & Federal Funds
Medicaid & Medicare
Fees & Collections
Appropriations & County Funding
Other Funding
ENVIRONMENTAL
HEALTH DIVISION
Through comm-unity
education
and enforcement
of environmental
rules designed to
protect the public,
the Environmental
Health Division
continually
oversees
the environment
in which we live
by responding
to emerging is-sues
such as food
safety, sanitation,
drinking water
supplies and
wastewater dis-posal.
Bruce Du Hamel, R. S., M. S. A.
Environmental Health
Division Director
2007 HIGHLIGHTS
While many facets of environmental health focus primarily on food service sanitation, wastewater
management and ground water quality control, the Environmental Health Division oversees many
other programs. Many of these programs are less visible, but are nonetheless just as important.
Some programs may be specific to a particular county, such as the mercury thermometer exchanges
held in Gratiot County last year. Other programs, such as the identification of vulnerable popula-tions,
in conjunction with emergency preparedness encompass Clinton, Gratiot and Montcalm
counties. In keeping with the Health Department mission of assuring the health and well- being of
our community and the environment by responding to the public health needs and providing a broad
spectrum of prevention and educational services, the Environmental Health Division placed particu-lar
emphasis on several of these programs in the past year. They are:
Mercury Thermometer Exchange Program
The Environmental Health Division conducted a mercury exchange program in Gratiot County. Mer-cury
thermometers were replaced with digital thermometers that had been provided by the Saginaw
Bay Watershed Protection Council with grant funds from General Motors. Over the course of the year
a total of 535 thermometer exchanges were recorded in Gratiot County. Old mercury thermometers
were recycled versus being placed in a landfill.
Water Well Sampling
This past year the Environmental Health Division began sampling all new residential water wells
constructed in Clinton, Gratiot, and Montcalm counties. Previous to this, water sampling was volun-tary
on the part of the homeowner and was conducted on approximately 25% of new well
installations. By ensuring that all wells are sampled, the Division is not only able to identify and
correct problem installations, but can also provide added assurance to homeowners that their water
supply is free of contamination and safe to drink.
Emergency Preparedness
During the year, the Division began to identify vulnerable populations. By definition, a vulnerable
population is a special- needs group whose needs are not fully addressed by traditional providers or
who cannot comfortably or safely access and use standard resources during an emergency, relief, or
recovery event. Examples include long- term care/ nursing homes, schools, day care facilities, pris-ons,
and independent/ assisted living facilities. During the year, the Division completed the first
phase of a mapping and inventory project where approximately 700 facilities within the district were
mapped and coded electronically for future reference. The ultimate goal is to have a complete
database that will allow these groups to be notified and assisted as applicable in the event of emer-gency
or disaster events.
Food Certification Training
In January of 2007, the Division began offering a food certification training program targeting
managers and owners of area food service restaurants and operations. The training is advanced
in nature and is endorsed by the Michigan Department of Agriculture. Participants must complete
an in- depth 16- hour training course. Upon successful completion of the training program, candi-dates
receive a certificate of completion. The certificate is valid for a period of five years. As of
September 30, 2007, 111 food service professionals have successfully completed the training and
received certification.
6
In 2007, the Environmental Health Division provided service to 4,793 unduplicated clients or
facilities throughout the district.
The focus of the food program is to assure
a safe, clean food product for the public
through regular inspections and educa-tion.
Efforts in this program are key ele-ments
in assuring the meals we consume
outside of home are safe.
food PrograM Number of Inspections Completed ( unduplicated)
Clinton Gratiot Montcalm District
Food Service Sanitation ( Fixed)
Food Service ( Temporary permits)
TOTALS
398
92
490
262
45
307
393
86
479
1,053
223
1,276
One of the most important methods of
preventing the spread of disease and viral
infection is the proper treatment of hu-man
wastewater. These programs provide
guidance and oversight for on- site sewage
disposal.
WaSteWater
ManageMent
Number of Inspections and Permits Issued ( unduplicated)
Clinton Gratiot Montcalm District
On- Site Sewage Disposal Permits
Site Evaluations
Sewage Disposal Evaluation
TOTALS
118
140
5
263
81
87
6
174
281
287
135
703
480
514
146
1,140
Assuring a good quality of life where we
live and play is a key component of these
programs.
environMental
Quality
Number of Clients Served ( unduplicated)
Campground Program
Dept. Human Services Inspections
Nuisance Complaints
Radon Test Kits 222 174
Mercury Thermometer Exchange
Public Swimming Pool Program
TOTALS
2
57
29
N/ A
35
345
6
19
37
535
9
780
25
56
94
176
N/ A
14
365
33
132
160
572
535
58
1,490
A fundamental component of public health
met by these programs is the protection
of our lakes, streams and the water we
drink.
SurfaCe and
groundWater
Control
Number of Clients Served ( unduplicated)
Clinton Gratiot Montcalm District
Drinking Water Well Program
Well Contaminate Monitoring 11
Septage Waste Haulers
Trucks Inspected
Sites Inspected
Water System Evaluation
TOTALS
197
8
9
3
5
222
119
7
4
7
148
346
17
14
10
130
517
662
36
30
17
142
887
7
Clinton Gratiot Montcalm District
COMMUNITY HEALTH &
EDUCATION DIVISION
The Community
Health & Education
Division provides a
variety of preven-tive
health services
to individuals and
families in many
settings, including
health department
clinics, homes,
community centers,
churches, schools
and throughout the
entire community.
Andrea Tabor, R. N., B. S. N., M. P. H.
Community Health and
Education Division Director
Breast Health Screening Clinics
The Mid- Michigan District Health Department ( MMDHD) was awarded two grants through the Komen
Foundation ( Grand Rapids Affiliate and Capitol Area Affiliate), which resulted in more than $ 61,000
of funding for Clinton and Montcalm Counties. In Montcalm County, MMDHD partnered with the
Montcalm Community College Division of Nursing and United Lifestyles. In Clinton County, MMDHD
partnered with Clinton Memorial Hospital. MMDHD hosted six clinics in Clinton and ten in Montcalm
County, offering education and free breast screenings for uninsured or underinsured women. Free
mammograms were offered to eligible women in need of the service. Over 200 women were served
through the clinics. In September, the Michigan Cancer Consortium ( MCC) awarded MMDHD the Spirit
of Collaboration Award for its contribution to cancer control in Montcalm County.
Women, Infant and Children ( WIC)
The demand for WIC services continued to increase in 2007, with staff providing 875 more visits com-pared
to the previous year. One of the goals of WIC is to promote healthy weight by providing nutrition
education and coupons for healthy foods. In 2007, MMDHD experienced a decrease in the percentage
of children in the program that are overweight ( 10.9% compared to 13% in 2006; State percentage
16.2%), which ranks the program best in the state. The positive results are due to staff training on
Ellyn Satter principles, increased breast- feeding rates and using value- enhanced nutrition assessment
principles when working with families on feeding issues.
Stanton Dental Care Center
The Dental Center continues to provide quality service to over 1,800 Medicaid patients annually. The
Center’s current patient caseload is approximately 81% children, with Medicaid adults served for urgent
dental needs when appointments are available. The Dental Center’s continued successful operation,
with its primary focus on children and low- income families, is dependent upon strong community sup-port
from the United Way and other community partners.
The following satisfaction survey comments reveal the level of appreciation for the public dental center:
St. Johns Community Based Dental Clinic
In April, the Dental Clinic opened to serve Medicaid- eligible adults from Clinton and Gratiot Counties.
Prior to the clinic opening, there were very few dentists accepting new adult patients on Medicaid.
There were 260 adults served in the clinic in 2007. The clinic’s continued successful operation is
dependent upon strong support from community partners and professional dental volunteers.
Clients included the following comments on the satisfaction surveys:
8
In 2007, the Community Health and Education Division provided service to 42,267
unduplicated individuals and families.
2007 HIGHLIGHTS
• “ Staff is friendly and easy to speak with. My dental experience was awesome!”
• “ Everyone here is very positive and compassionate. Great service, thank you.”
• “ Staff are professional and care about my well- being. Thanks for being available for services.”
• “ My family is grateful to the Stanton Dental Center and staff. We have never been treated
so well.”
• “ The dental center has been extremely helpful with the homeless students on my caseload.
The staff is professional and goes above and beyond to support the patients.”
• “ I had to go to Bay City before I came here. It’s clean here and easy to access with my wheel-chair;
much better than any other dentist I’ve been to. The staff is great and always very nice”
• “ The clinic is close to me and accepts my foster kids without having to wait six months or
more to get an appointment. We love this place!”
These programs offer testing, education,
prevention and treatment services to con-trol
communicable diseases within our
communities. Many of these services may
be available at low or no cost.
CoMMuniCable diSeaSe
Control PrograMS Number of Clients Served ( unduplicated)
Clinton Gratiot Montcalm District
Communicable Disease Control
HIV Counseling/ Testing
Immunizations
Sexually Transmitted Disease Control
TOTALS
250
14
1,042
261
1,567
212
36
1,969
413
2,630
331
62
1,348
455
2,196
793
112
4,331
1,123
6,359
These activities target specific chronic
diseases. Efforts focus on early detection
and referral.
ChroniC diSeaSe
Control PrograMS
Number of Clients Served ( unduplicated)
Clinton Gratiot Montcalm District
Breast & Cervical Cancer Control
Lead Poisoning Screening
TOTALS
58
107
165
93
287
380
N/ A
513
513
151
907
1,058
Maternal and child health programs give
financial, social, nutritional and medical
support to qualified families. These pro-grams
benefit the community by reducing
infant mortality, ensuring healthy births
and maintaining infant and child health.
Maternal & Child
health PrograMS 2,797
4,811
191
529
1,001
N/ A
N/ A
9,329
2,188
2,857
180
888
1,468
189
138
303
8,211
3,863
6,063
260
1,109
1,986
N/ A
N/ A
13,281
8,848
13,731
631
2,495
4,455
189
138
30,487
9
These programs promote oral health edu-cation
and prevention, increase community
awareness of the needs in the district and
improve access to oral dental services.
oral health Number of Clients Served ( unduplicated)
Clinton Gratiot Montcalm District
Stanton Dental Care Center
St. Johns Community- Based
Dental Clinic ( opened 4/ 07)
In- School Education ( Kindergarten N/ A
through third grade)
Sealants
TOTALS
N/ A
143
143
N/ A
117
N/ A
117
1,836
N/ A
1,968
299
4,103
1,836
260
1,968
299
4,363
Number of Clients Served ( unduplicated)
Clinton Gratiot Montcalm District
Hearing Screenings (# conducted)
Vision Screenings (# conducted)
Children’s Special Health Care Services
Family Planning Services
Women, Infants & Children Program
Maternal Support Services
Infant Support Services
Early On N/ A N/ A N/ A
TOTALS
MEDICAL DIRECTOR’S
REPORT
The Medical Direc-tor
provides general
oversight of all health
department programs
and also provides
consultation to health
care providers re-garding
diseases
that affect the
community.
Robert Graham, D. O., M. P. H., F. A. A. F. P.
Medical Director
At MMDHD we are committed to improving the health of our citizens and minimizing po-tential
health risks. One of the ways we accomplish this is through disease surveillance
by collecting information on the state of the public’s health. Knowing what illnesses
are affecting the public helps health care providers allocate resources, assess the
effectiveness of health care programs, and assure that health needs are being met.
Data is collected from a variety of sources for both acute and chronic illnesses. Acute
illnesses are conditions such as influenza, whooping cough, diarrheal illnesses, and
meningitis. Examples of chronic illnesses are diabetes, cancer and heart disease.
The Michigan Disease Surveillance System is a program in which data on diseases
that are required to be reported are sent to the Michigan Department of Community
Health in Lansing for monitoring. This internet- based and paperless system was vital
in the detection of the outbreak of salmonella associated with contaminated peanut
butter in 2007.
The Sentinel Physician Influenza Network is another program that collects information
about the number of people being seen by doctors with influenza and influenza- like
illnesses. This program is linked with the Centers for Disease Control ( CDC) and Pre-vention
in Atlanta, Georgia. Information from this national network helps doctors by
providing timely information about influenza activity locally as well as on a national
level. The Sentinel Physician Influenza Network is also being counted on to help detect
new strains of influenza such as Avian ( bird) flu.
Additional sources of information on the state of the public’s health is from hospital
discharge diagnoses as well as birth and death certificate data. From this information
we can estimate the birth rate, the number of people with heart disease, and a multi-tude
of other health conditions. This data helps schools plan for future needs, shows
health care policymakers what types of services are needed, and aids public health
agencies in the development of educational and prevention programs.
When I started my tenure as Medical Director for MMDHD 16 years ago, the majority
of these surveillance programs did not exist. With these programs in place, we have
greatly improved our capability to meet the challenges of an emerging illness head on
rather than after a disease has caused second and third generations of illness. With
the fast pace at which new disease challenges are emerging it is reassuring to know
we have these early warning systems to help protect the public’s health.
10
Dr. Robert Graham is the Medical Director for the Mid- Michigan District Health Depart-ment
( MMDHD). A 1977 graduate of the Kirksville ( MO.) College of Osteopathic Medi-cine,
Dr. Graham received his Master’s Degree from the University of Michigan in 1994,
and was made a fellow of the American Academy of Family Physicians in 2004. He be-gan
his tenure with MMDHD in 1992. Prior to his affiliation with the health department,
Dr. Graham was in private family practice for 14 years in Ithaca, Michigan. Some of the
activities Dr. Graham oversees include immunizations, family planning clinics, disease
outbreak investigations, and advising the MMDHD Board of Health in medical matters.
11
Making a difference in our communities
MMDHD...
Disease Outbreak Response
In November 2007 MMDHD was notified that a Grand Rapids dermatologist, who also practiced in Greenville, was found to have exposed thou-sands
of people to several different blood borne pathogens through the re- use of single- use surgical instruments and unsafe sanitation meth-ods.
MMDHD immediately notified area physicians and alerted the media. MMDHD also held 17 clinics and tested over 109 Montcalm County
residents for Hepatitis B, Hepatitis C and HIV. ” Our response to the situation was something to be proud of,” said Dr. Robert Graham, MMDHD
Medical Director. “ We had clinics up and running within days of receiving notice of the problem.”
Pandemic Influenza Summit
On October 23, 2007, MMDHD sponsored a day- long conference on pandemic influenza. The conference included participants from over 100
community partners in Clinton, Gratiot and Montcalm Counties. Dr. Arnold Monto, a well- known and respected influenza expert from the Univer-sity
of Michigan, was the keynote speaker. A panel of state officials presented information about the pandemic influenza preparedness activities
their agencies are involved in. It is through efforts like this that, when an influenza pandemic strikes, our communities will be better prepared.
Montcalm Healthy Smiles Endowment Fund/ Night at the Theatre
The 3rd annual Night at the Theatre fundraiser, held in August 2007 raised $ 2,223 to benefit the Montcalm Healthy Smiles Endowment Fund.
The fund was created in 2004 to help provide operating support for the Stanton Dental Care Center, which serves 1,800 Medicaid- eligible and
uninsured patients annually, 80% of which are children. As of 2007, the average Medicaid reimbursement rate was only $ 72.00 for a client visit
that costs $ 130.00. The remaining $ 58.00 to serve each client must come from grants and donations. While the community has been generous
in giving, the Stanton Dental Care Center will not be able to continue long- term operations without the Healthy Smiles Endowment Fund. Guests
were treated to hors d’oeuvres, able to bid on numerous silent auction items and viewed the 1940 classic film “ Philadelphia Story.” The fund’s
current balance is $ 18,770.42.
Area Restaurants Go Smoke Free
A number of area restaurants in Clinton, Gratiot and Montcalm Counties were presented with a certificate of appreciation from MMDHDs Board
of Health for choosing to be smoke- free, protecting patrons and employees from the potential health hazards of secondhand smoke. Smoke- free
policies decrease absenteeism, reduce housekeeping and maintenance costs, lower insurance rates and result in fewer smoking- related fires.
Visit www. mmdhd. org for a complete list of the 34 Clinton County, 19 Gratiot County and 38 Montcalm County
smoke- free restaurants.
Many indicators are used to measure the health of the population. The following pages summarize select
indicators which help create a snapshot of the health status of the residents living in Clinton, Gratiot and
Montcalm counties. In some cases, Michigan data has also been provided to allow for comparison between
the counties and the State. Because the population of mid- Michigan is primarily White, Non- Hispanic ( 98%),
“ Michigan, White” statistics are included on selected indicators to better reflect our district’s population.
Infant mortality
The infant mortality rate is a measure of the number of infant deaths under the
age of one year per 1,000 live births. Infants at greatest risk of death are those
born prematurely, having low birth weight or born with major congenital anomalies.
Other factors influencing infant mortality include socioeconomic status, age and
health of the mother, risk of infant injury, extent of prenatal care, and the infant’s
medical care during the first year of life. Infant mortality is often used as an index
of the general health of the community, since many of the risk factors reflect on
community issues such as health- care access, education, poverty, and lifestyle
choices. After seeing a steady improvement in infant mortality since the early
1970s to early 1990s, the rate in Michigan changed little in the ten years lead-ing
up to 2004, hovering around eight deaths per 1,000 infants. The state- wide
infant mortality rate for the first time has fallen below eight deaths/ 1,000 births
for the years 2004- 06 ( 7.5 deaths/ 1,000 births). Each of the three counties
in our district present a unique trend in the infant mortality rate over the past
10 years; however, all three counties have experienced a rate change that now
closely approximates that of the state- wide Caucasian infant death rate. MMDHD
continues to advocate for a community- wide collaborative effort to examine and
reduce factors that lead to infant mortality.
COMMUNITY HEALTH STATUS
CommunITy IndICaTorS
Teen pregnancy
The teen pregnancy rate typically represents the number of women
15 to 19 years old who have given birth, experienced an abortion or
miscarried per 1,000 teens of the same age. For this report, however,
the data represents a more specific group of teens, age 15- 17 only. The
counties of the Mid- Michigan District Health Department have shown
steady declines in the teen pregnancy rate over the past decade, mir-roring
the trend for Michigan as a whole. Gratiot and Clinton County
rates have remained below that of Michigan, while the Montcalm
County rate consistently remains above that of the State, but falling
at a similar pace. Efforts to encourage responsible sexual decision
making and increased use of contraceptives have contributed to the
decrease in teen pregnancy. MMDHD offers Family Planning services
in all three counties.
12
SeLeCTed BIrTH IndICaTorS
Selected Birth characteriSticS •
Findings from the Centers for Disease
Control ( CDC) and Prevention indicate
that many women report high- risk be-haviors
or experience high- risk condi-tions
before, during, and shortly after
pregnancy. These characteristics of
the mother may influence the delivery
outcome and the future health status
of her newborn infant. Some of these
characteristics are monitored at the
county and state levels so that trends
can be observed and evaluated.
These findings are useful in assisting
the design of public health programs
and policies that address these be-haviors
and experiences so that the
health of mothers and their infants can be improved. The table and figures ( above) compare selected birth characteristics between
Clinton, Gratiot and Montcalm counties and the state of Michigan.
Total Live Births
– Live births to women under age 20 years
– Live births to women over age 40 years
% birth mothers under 20 years of age
% birth mothers w/ less than 12 yrs education
% birth mothers unmarried
% birth mothers enrolled in Medicaid ( 2003)
% birth mothers who smoked while pregnant
% received prenatal care during 1st trimester
% low birth weight ( under 5 lbs. 8 oz.)
% very low birth weight ( under 3 lbs. 5 oz.)
% pre- term birth ( born before 37 complete weeks)
844
49 ( 5.8%)
28 ( 3.3%)
5.8
7.2
24.4
23.1
9.2
86.7
7.0
1.2
11.1
468
58 ( 12.4%)
7 ( 1.5%)
12.4
15.4
41.5
43.8
22.6
83.3
6.0
1.5
7.7
838
112 ( 13.4%)
8 ( 1.0%)
13.4
16.2
43.9
40.1
21.2
84.1
6.7
1.6
7.9
127,537
12,493 ( 9.8%)
2,904 ( 2.3%)
9.8
16.9
38.1
33.3
13.8
83.3
8.4
1.6
9.6
SeLeCTed BIrTH CHaraCTerISTICS - 2006
Clinton Gratiot Montcalm Michigan
NOTE: Values in red indicate specific county results that are less favorable than state results. SOURCE: Birth
Characteristics data from Michigan 2005 Resident Birth Files, Michigan Department of Community Health, 2007.
Selected Maternal Birth trendS • The four graphs below represent trends of selected maternal birth outcomes. At the state level,
both “ Repeat Teen Births” ( women giving birth to a second child while a teen) and “ Births to Mothers who Smoked During
Pregnancy” appear to be moving in the right direction ( rates decreasing) over the past decade; whereas “ Births to Unwed
Mothers” and “ Births with Medicaid as Source of Payment” appear to be moving in the wrong direction ( rates increasing).
County- level results generally mirror the state trend for each indicator, with one minor exception: Gratiot County appears to
be experiencing an upswing in the percentage of mothers who smoked during pregnancy. Most noticeable in the county- level
results is the relatively better results for Clinton County in relation to the state and the other two counties. Both Gratiot and
Montcalm counties continue to experience greater rates than the state for “ Births to Mothers who Smoked During Pregnancy”
and “ Births with Medicaid as Source of Payment.”
13
CL I n T o n Co u n T y
LEADING CAUSES OF DEATH
THE 10 DISEASE CATEGORIES IN THE TABLE BELOW REPRESENT THE MOST FREQUENT CAUSES OF DEATH
AND ACCOUNT FOR ABOUT 75% OF ALL DEATHS. The values represent the average number of deaths per 100,000 people
for the years 2004- 2006. Mortality data helps provide a snapshot of the general health status of a community, which aids in the
identification of health concerns and the development of intervention programs. This mortality data can also be used to compare
the health status of one population to another ( i. e., counties) or to evaluate the status of one population over time ( i. e., county
trends). The table shown provides a comparison between the three counties of the Mid- Michigan District Health Department and
Michigan. The bar charts represent the proportion of all deaths during 2006 that each underlying cause is responsible for. The
numbers 1- 10 for each county correspond to the same numbers 1- 10 in the Michigan bar chart ( e. g., 1= heart disease).
1. Heart Disease
2. Cancer
3. Diabetes related
4. Stroke
5. Chronic Respiratory
6. Unintentional Injury
7. Alzheimer’s Disease
8. Pneumonia/ Influenza
9. Kidney Disease
10. Suicide
Subtotal
Age 65+
174.0
165.5
72.0
71.7
33.3
28.1
24.2
14.8
11.2
12.3
607.1
11.2%
248.0
201.6
103.3
67.4
49.3
30.0
19.1
23.4
22.5
*
764.6
13.5%
224.8
180.9
72.0
60.2
54.9
45.4
19.6
24.8
23.4
14.4
720.4
12.4%
230.6
190.3
81.7
47.0
42.0
33.2
21.2
17.3
14.9
10.8
689.0
12.3%
aGe- adjuSTed morTaLITy Per 100,000
PoPuLaTIon ( 2004- 2006 averaGe)
Clinton Gratiot Montcalm Michigan
NOTE: Values in red represent county rates greater than State of Michigan rate.
Asterisk (*) indicates too few cases to determine a reliable mortality rate.
mo n T C a L m Co u n T y Gr a T I o T Co u n T y
14
mI C H I G a n
•
www. mmdhd. org
BOARD OF HEALTH/
ADMINISTRATIVE
OFFICES
615 N. State St., Ste. 2
Stanton, MI 48888
989.831.5237
fax 989.831.5522
CLINTON BRANCH
OFFICE & DENTAL
CENTER
1307 E. Townsend
St. Johns, MI 48879
989.224.2195
fax 989.224.4300
Off- site clinic:
DeWitt
GRATIOT
BRANCH OFFICE
151 Commerce Dr.
Ithaca, MI 48847
989.875.3681
fax 989.875.3747
Off- site clinic:
Alma
MONTCALM
BRANCH OFFICE
615 N. State St., Ste. 2
Stanton, MI 48888
989.831.5237
fax 989.831.3666
Off- site clinics:
Greenville
Howard City
STANTON DENTAL
CARE CENTER
620 W. Main/ P. O. Box 161
Stanton, MI 48888
989.831.7071
866- 831- 7071
fax 989- 831- 5860
Mid- Michigan District
Health Department Services
PR E VE NT IVE HE AL T H SE R V IC E S
CLINTON* MONTCALM* GRATIOT
MID- MICHIGAN
DISTRICT
HEALTH DEPARTMENT
Environmental Health Programs
Community Health Programs
Mid- Michigan Health Plan
• WIC ( Women, Infants and Children)
• Family Planning Program
• Immunization Program
• Communicable Disease Control
• Sexually Transmitted Disease testing, treatment, counseling and follow- up.
• Tuberculosis Control
• HIV Counseling and Testing
• Children’s Special Health Care Services
• Maternity Outpatient Medical Services ( M. O. M. S.), MIChild Healthy Kids Enrollment
• Maternal and Infant Support Services
• Breast and Cervical Cancer Control Program ( BCCCP)
• Early On
Maternal & Child Health Services
• Oversee operational status of septic systems and drinking water wells
• Food Service Sanitation Program
• Issue permits for installing or repairing sewage disposal and water supply systems
• DHS- Licensed Facility Inspections
• Inspect public swimming pools, spas and hot tubs
• Rabies control through investigation of animal bite complaints
• Annual inspections of campgrounds
• Regulate the service of septic tanks, portable toilets and septage waste haulers
• Provide test kits for radon
• Review new pool location plans and monitor pool sample reports for quality
• Lead testing in homes
• Health Education
• Hearing & Vision Screening
• Locally- organized system of care for uninsured adults
Stanton Dental Care Center
• Provides access to dental health and hygiene services for Medicaid, low- income
and uninsured patients in Montcalm County.
St. Johns Community Based Dental Clinic
• Provides access to dental health and hygiene services for Medicaid- eligible
adults in Clinton and Gratiot Counties.
PRSRT STD
U. S Postage
PAID
EDMORE, MI 48829
Permit No. 29
MID- MICHIGAN DISTRICT
HEALTH DEPARTMENT
Your public health experts,
connecting with the community and exceeding expectations.
www. mmdhd. org
Gratiot Branch Office
( Ithaca)
Clinton Branch Office
( St. Johns)
Montcalm Branch Office
( Stanton)
MID- MICHIGAN DISTRICT HEALTH DEPARTMENT
ADMINISTRATIVE OFFICES
615 N. STATE ST., SUITE 2
STANTON, MI 48888
PR EV ENTIVE HEALTH S E RV IC ES
CLINTON* MONTCALM* GRATIOT
MID- MICHIGAN
DISTRICT
HEALTH DEPARTMENT