2016 Health Indicators

MEMO
To:
Kitsap Public Health Board
From:
Siri Kushner and Kari Hunter, Epidemiologists
Date:
September 6, 2016
Re:
2016 Kitsap County Core Public Health Indicators Report
Every year, the Kitsap Public Health District releases an updated Kitsap County Core Public Health
Indicators Report (see attached). The Indicators are a synthesis of demographic and public health data
designed to provide an overview of the health of Kitsap County residents and surroundings.
Data are presented at the county level at two points in time, earliest year and most recent year.
Change over time is assessed with a graph and statistical trend. Washington State data for the Recent
Year and a statistical comparison to the Kitsap County recent year are also presented. The majority of
indicators are derived from standard public health data systems from national, state, county, and
program sources.
The Indicators have many implications for public health practice and policy and are presented in an effort
to provide sound, reliable data that can be used to help focus resources, encourage new and existing
partnerships, and support the work necessary to make Kitsap County a healthy and safe place to live,
learn, work, and play.
Based on discussion at last years presentation we have made several improvements -- the 2016 Report
includes over 20 new indicators to represent strategic Kitsap Public Health District work and other
important public health issues. The report has a new format that integrates data for Kitsap and a
Washington State comparison in one document (formerly two). Another notable change is default
reporting of single years of data rather than 3-years combined. This will showcase the most currently
available year of data rather than a 3-year average (multiple years of data will still be combined when
statistically necessary due to small numbers).
2016 Indicator Highlights
Key Findings
Indicators
Kitsap population is
growing, aging, and
becoming more
diverse.
The population has grown in all parts of our county; we have more adults
ages 50-69; and nearly one-quarter of our population is non-white and/or
Hispanic.
September 6, 2016
Memo re: Kitsap Core Public Health Indicators Report
Page 2
2016 Indicator Highlights - continued
Key Findings
Indicators
Kitsap education and

housing affordability
trends are promising
but long term trends
in poverty rates are
still on the rise.
Improving trends in the education levels of pregnant women and adults and
fewer households are spending more than 30% of monthly income on
housing. Continued worsening trends in poverty, employment, and youth
homelessness. All education, employment and most economic indicators are
better than the state. Of note, more Kitsap older adults live in poverty
compared to the state.
We need to ensure
children have healthy
starts.
Not enough pregnant women are starting prenatal care in the first trimester
of pregnancy; too many women are smoking during pregnancy, our rate is
higher than the state; more babies are being born into poverty; and half of
women served by Kitsap Public Health District home visiting programs had 3
or more Adverse Childhood Experiences. Kitsap has a positive trend and lower
rate compared to the state of children in out of home care (CPS removals).
Kitsap still has room

for improvement in
protecting the
population through
immunizations and
healthy eating and
active living.
Immunization status is mixed: only half of toddlers have complete

immunizations, a rate lower than the state, while 9 in 10 entering
kindergarteners have complete immunizations, a rate better than the state.
Fewer than half of adults report an annual flu shot.
No change in
emotional well-being
indicators.
Emotional well-being indicators (this includes suicide related hospitalizations

and deaths) are unchanged over time and the same as the state with one
exception as reported last year, a worsening trend in 8th graders considering
suicide that is also worse than the state.
Sexual and substance

use behaviors
continue to hurt
Kitsap residents.
Kitsap has an ongoing worsening trend in residents experiencing chlamydia

infections and what appears to be dramatic rise in residents experiencing
gonorrhea infections. The rate of persons living with HIV or AIDS is also worse
over time but lower compared to the state.
Most chronic disease, weight management, and physical activity and nutrition
indicators are unchanged over time and similar to the state. Two positive
exceptions: heart disease-related hospitalizations are decreasing and lower
than the state and youth meeting physical activity recommendations is
improving and higher than the state. One area of concern: more pregnant
women are being diagnosed with gestational diabetes.
Kitsap has more drug and opioid related hospitalizations and deaths over
time but, compared to the state, lower rates of opioid related deaths. Adults
in publicly funded substance abuse treatment is unchanged over time and
lower than the state.
As reported last year, Kitsap has worsening trends in youth electronic
cigarette and marijuana use and more 10th graders smoking and using
electronic cigarettes than the state.
Public health policies
and work
demonstrate clear
benefits.
Kitsap has improving trends in kindergarteners with complete immunizations,

smoking among pregnant women and youth, youth alcohol use, motor
vehicle hospitalizations and deaths, and shoreline water quality.
TABLE OF CONTENTS
September 2016
KITSAP COUNTY CORE PUBLIC HEALTH INDICATORS

WITH COMPARISONS TO WASHINGTON STATE
Introduction
Indicator changes since last release
Demographic Profile
Indicators
I.
Who Are We?
II. How Healthy Are We?
III. How Healthy Are Our Lifestyles and Behaviors?
IV. How Safe and Healthy Are Our Surroundings?
Sources
Background Information
Indicator Data Tables
INTRODUCTION
PAGE
1
2
4
6
8
11
13
15
16
23
The Kitsap County Core Public Health Indicators is a synthesis of demographic and public health data designed to provide an overview of the health of
Kitsap County residents and surroundings. Data are presented at the county level; sub-county area data are not presented here. Data are presented at
two points in time - earliest year and recent year - along with a trend graph, statistical trend over all years of available data, and a comparison to
Washington State for the "recent" year. The statistical trend is reported as an increase (), decrease (), or no change (). Green signifies an
improving trend and red signifies a worsening trend.
The majority of data come from standard public health data systems: vital records, public health program tracking, reportable illnesses, surveys, and the
U.S. Census. Data sources are footnoted throughout and described in the Sources and Background sections. Each of these data systems has limitations;
indicators should be interpreted as estimates.
The findings presented in this report have many implications for public health practice, policy, and services. These indicators are presented in an effort
to provide sound, reliable data that can be used to monitor change over time, help focus resources, encourage new and existing partnerships, and
support the work necessary to make Kitsap County a healthy and safe place to live, learn, work, and play.
Kitsap Public Health District * 345 6th Street, Suite 300 * Bremerton, WA 98337 * (360) 337-5235 * kitsappublichealth.org
September 2016
KITSAP COUNTY CORE PUBLIC HEALTH INDICATORS WITH COMPARISONS TO WASHINGTON STATE
INDICATOR CHANGES FROM THE LAST RELEASE
Babies (age 19-35 months) with complete immunizations
Youth (grades 8, 10, 12) report opportunities for positive participation in the family setting
Children in out-of-home care (CPS removals)
Low-income pregnant/parenting home visitation clients reporting 3 or more ACEs
Suicide hospitalization (nonfatal) rate per 100,000 residents
Older adult (age 65+) fall-related hospitalization rate per 100,000 residents
Alzheimer's Death rate per 100,000 residents
Pregnant women eligible for evidence-based home visiting programs
Homeless youth (age 5-17)
Residents experiencing food insecurity
Older adults (age 65 and older) living below 100% of poverty
FORMER
Households with firearms that are loaded and unlocked
Youth (grade 8) who walk or bike to school at least one day per week
Kitsap resident workers who walk or bike to work
Publicly funded substance abuse treatment rates per 1,000 residents
Opiod drug-associated death rate per 100,000 residents
Opiod drug-associated nonfatal hospitalization rate per 100,000 residents
Births to women diagnosed with gestational diabetes during pregnancy
Heart disease-related hospitalization (fatal & nonfatal) rate per 100,000
Adults ever told they have high blood pressure
Rate of persons living with HIV or AIDS per 100,000 residents
Adults with influenza vaccine in the past year
NEW INDICATORS
This 2016 Indicators Report includes several changes: now only one report that includes both Kitsap County data and the most recent year data for
Washington State as a comparison to Kitsap (the WA State Companion Report will no long be available); reordering of the indicator columns; reporting
of single years of data rather than 3-years combined unless a statistical test indicated instability in the single years due to small numbers; and many new
or replaced indicators (see lists below and in blue font in the report). Note: All indicators from the Healthy Youth Survey source are not updated this
year as the survey is conducted every-other-year.
NEW INDICATORS REPLACING FORMER INDICATORS
Homelessness rate per 100,000 residents

Civilian women start prenatal care in the first trimester
Individuals currently or imminently experiencing homelessness and seeking housing

Non-low-income civilian women start prenatal care in the first trimester
Adults report always or usually getting needed social/emotional support
Low-income civilian women start prenatal care in the first trimester

Adults report that they and people in their community do favors for each
other often or very often
Youth (grades 8,10,12) report risk factor of poor family management
Adults ever told they have cardiovascular disease or diabetes
Youth (grades 8,10,12) report parent(s) do not set clear rules or are not
engaged in details of daily life (SAME INDICATOR DIFFERENT TITLE)
Adults ever told by a health care provider that they have cardiovascular disease
Adults ever told by a health care provider that they have diabetes
DISCONTINUED INDICATORS
Illness commonly related to unsafe food, water, or poor hygiene rate per 100,000 residents
2
Chlamydia rate per 100,000 adolescents and adults (aged 15-44).

Gonorrhea rate per 100,000 adolescents and adults (aged 15-44).
Diabetes-related hospitalizations rate per 100,000 residents.
Drug-associated nonfatal hospitalization rate per 100,000 residents.
Motor vehicle injury-related hospitalization rate per 100,000 residents.
Fast food and convenience store density per 100,000 residents.
Firearm death rate per 100,000 residents.
September 2016
INDICATORS CALCULATED WITH 1-YEAR PREVIOUSLY 3-YEARS OF DATA

Birth rate per 1,000 women (ages 15-44).
Infant mortality rate per 1,000 live births.
Death rate per 100,000 residents.
Premature death rate per 100,000 residents (<75 years old).
Babies born at low birth weight (less than 2500 grams).
Suicide death rate per 100,000 residents.
Kindergarten children with complete immunizations.
INDICATORS CALCULATED WITH 2-YEARS PREVIOUSLY 3-YEARS OF DATA

Drug-associated death rate per 100,000 residents.
The following changes in statistical trend over time for Kitsap County and for the most recent year comparison of Kitsap to Washington State only
reflect those indicators that were exactly the same as in the 2015 Indicators Report. The list below does not include any indicators described in the
previous sections: new in 2016 or modified compared to previous reports either by content or number of years.
INDICATOR STATISTICAL TREND CHANGES FROM LAST RELEASE

Premature death rate per 100,000 residents (<75 years old) was decreasing, now unchanged.
Households spend more than 30% of monthly income on housing costs was worsening, now unchanged.
Drug-associated death rate per 100,000 residents was unchanged, now worsening.
CHANGES IN COMPARISON OF KITSAP TO WASHINGTON FROM LAST RELEASE

Civilian adults currently employed was same, now better.
Households paying more than 30% of monthly income on housing costs was better, now same.
3
Earliest Year (2000)
# (%)
Recent Year (2015)
11%
8%
20%
15%
6%
76%
46%
Percent
Change
September 2016
# (%)
258,200
171,940 (67%)
86,260 (33%)
23,390 (27%)
39,410 (46%)
13,510 (16%)
9,950 (12%)
# (%)
Earliest Year (2000)
78%
3%
1%
5%
1%
5%
7%
# (%)
Recent Year (2015)
4%
4%
3%
29%
39%
67%
87%
Percent
Change
70%
4%
1%
8%
1%
4%
12%
# (%)
2015
Washington State
83%
3%
2%
4%
1%
4%
4%
Kitsap County
231,969
159,896 (69%)
72,073 (31%)
20,308 (28%)
37,259 (52%)
7,693 (11%)
6,813 (9%)
Kitsap County
DEMOGRAPHIC PROFILE
Kitsap County Total Population 1

Unincorporated
Incorporated
Bainbridge Island*
Bremerton*
Port Orchard*
Poulsbo*
* Proportion is of the incorporated population; not the total population.
Race/Ethnicity
White, Non-Hispanic
Black or African American, Non-Hispanic
American Indian and Alaska Native, Non-Hispanic
Asian, Non-Hispanic
Native Hawaiian and Other Pacific Islander, Non-Hispanic
Two or more races, Non-Hispanic
Hispanic or Latino
4
September 2016
85 +
75-79
80-84
85 +
Recent Year, 2015
85 +
80-84
Recent Year, 2015
80-84
males
WA Rate
800
62
99
646
72
84
692
64
females
4%
same
5%
statistically lower
same
statistically higher
Kitsap Compared to
WA
1%
0%
1%
2%
3%
Percent of Total Population
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
70-74
65-69
females
70-74
60-64
75-79
70-74
65-69
55-59
75-79
65-69
60-64
2%
60-64
3%
50-54
4%
55-59
5%
55-59
4%
50-54
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
0-4
1%
0%
1%
2%
3%
50-54
4%
45-49
5%
Earliest Year, 2000
2%
Washington State
males
3%
Kitsap County
females
5%
Kitsap Rates
71
Earliest Year Recent Year Recent Year
Kitsap Trends
Statistical
Change
Graph
Age Group
Kitsap County
Population by Age Group and Gender1
males
5%
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
0-4
4%
Timeframe
3%
BIRTH AND DEATH RATES 2
1998-2015
1%
0%
1%
2%
Birth rate per 1,000 women (ages 15-44)
1998-2015
2%
Infant mortality rate per 1,000 live births
1998-2015
3%
Death rate per 100,000 residents
1998-2015
4%
Age Group
5
Premature death rate per 100,000 residents

(<75 years old)
5%
Age Group
2005-2014
2011-2015
2005-2014
96%
47%
68%
85%
35%
11%
95%
69%
73%
84%
47%
Earliest Year Recent Year
Kitsap Rates
17%
13%
94%
65%
69%
81%
41%
Recent Year
WA Rate
worse
better
better
better
better
better
better
better
Kitsap Compared to
WA
September 2016
1998-2015
9%
11%
8%
Kitsap Trends
Statistical
Change
1998-2015
6%
10%
Graph
2005-2014
5%
Timeframe
I. WHO ARE WE?
EDUCATION
*4
Children ages 3-4 enrolled in early education

programs 3
High school graduation rate
** 3
Adults aged 25-64 with more than high school

education 3
Civilian pregnant women with more than high
5
school education
EMPLOYMENT
Civilian adults currently employed 6
ECONOMIC WELL-BEING
Residents living below 100% of poverty
2005-2014
better
Youth (age 5-17) living below 100% of

poverty** 3
2005-2014
14%
Older adults (age 65 and older) living below

** 3
100% of poverty
13%
N/A
13%
2012-2014
Residents experiencing food insecurity 7
*New calculation beginning in 2010-11 school year, adjusted actual 5-year cohort graduation rate.
**A family of four earning $16,450 or less in 1998 or $24,230 or less in 2014 was living in poverty.
6
Individuals currently or imminently

experiencing homelessness and seeking
8
housing
Households spend more than 30% of monthly

income on housing costs 3
Civilian births paid by Medicaid^ 5
Public school students (grades K-12)

enrolled in free or reduced lunch program^4
2006-072014-15
2011-2015
2005-2014
1998-2015
1998-992015-16
74%
64%
84%
0.8%
1.5%
33%
38%
26%
70%
85%
70%
91%
2.9%
1.8%
34%
41%
36%
Kitsap Rates
86%
72%
85%
67%
87%
3.3%
N/A
34%
42%
44%
Recent Year
WA Rate
worse
same
same
same
better
better
N/A
same
same
better
Kitsap Compared to
WA
September 2016
Homeless youth (age 5-17) 4
2008-2014
68%
84%
Kitsap Trends
Statistical
Change
Adults report having visited a dentist or dental 2011, 2012,

9
2014, 2015
clinic in the past 12 months
Civilian adults aged 18-64 report having health

3
insurance
2006-2014
86%
Graph
Youth (grade 8) report having had a dental

checkup, exam or cleaning in the past 12
10
months
1998-2015
Timeframe
Low-income civilian women start prenatal care

in the first trimester 5
1998-2015
HEALTH CARE ACCESS
Non-low-income civilian women start prenatal

5
care in the first trimester
Êligibility 185% of poverty; a family of four earning $30,433 in 1998 or $44,826 in 2014 was living at 185% of poverty.
7
4.7%
89%
5.0%
Kitsap Rates
56%
85%
5.0%
Recent Year
WA Rate
same
same
same
same
Kitsap Compared to
WA
September 2016
84%
53%
45
better
II. HOW HEALTHY ARE WE?
1998-2015
43%
41
1691
Adults report their general health is excellent,

very good, or good during the past 30 days 9
Adults report activities not limited by poor
physical or mental health during the past
9
30 days
Alzheimer's Death rate per 100,000 residents
Kitsap Trends
Statistical
Change
2011-2015
18
1307
Graph
2011-2015
1421
Timeframe
1998-2015
GENERAL HEALTH
1998-2014
Babies born at low birth weight (less than

2500 grams) 5
Older adult (age 65 and older) fall-related

hospitalization (fatal and nonfatal) rate per
100,000 residents 2
2012, 2014
2006-2014
2006-2014
65%
27%
58%
54%
65%
29%
63%
48%
67%
31%
62%
same
same
same
same
N/A
53%
2012-2014
N/A
Adults report never having a permanent tooth

9
extracted because of decay or gum disease
EMOTIONAL WELL-BEING
Youth (grade 6) report being bullied in the last
month 10
Youth (grade 8) report having adults they can
turn to for help when feeling sad or
hopeless 10
Adults report that they and people in their
community do favors for each other often or
very often 9
8
September 2016
15%
20%
11%
48
16%
11%
same
same
worse
same
Kitsap Compared to
WA
12%
44
16
same
WA Rate
55
20
36%
same
Kitsap Rates
2011-2015
13
34%
28%
Recent Year
2006-2014
N/A
29%
1998-2014
N/A
N/A
Kitsap Trends
Statistical
Change
1998-2015
N/A
N/A
Graph
2011
N/A
better
2011
4%
same
N/A
3%
24%
N/A
6%
25%
same
51%
N/A
32%
N/A
N/A
33%
N/A
N/A
40%
N/A
2000-2014
2014
2006-2014
2014
Timeframe
Adults report mental distress (14 or more days

of poor mental health during the past
30 days) 9
Youth (grade 8) report seriously considering
attempting suicide during the past
10
12 months
Suicide hospitalization (nonfatal) rate per
100,000 residents 2
Suicide death rate per 100,000 residents 2
ADVERSE CHILDHOOD EXPERIENCES (ACEs)

Adults report NO Adverse Childhood
Experiences (ACEs) 9
Adults report 3 or more Adverse Childhood
Experiences (ACEs) 9
Low-income pregnant or parenting home
visitation clients reporting 3 or more ACEs 11
Children in out-of-home care (CPS
removals) 12
Youth (grades 8, 10, 12) report ever being
physically hurt on purpose by an adult 10
Youth (grades 8, 10, 12) report parent(s) do
not set clear rules or are not engaged in
10
details of daily life
Adverse Childhood Experiences (ACEs) are experiences children may have during their first 18 years of life: physical, emotional, or sexual abuse; exposure to traumatic stressors in the
home (substance abuse, mental illness, domestic violence, incarceration of a household member, parental separation/divorce). ACEs are linked to higher risk of poor physical, mental, and
behavioral health outcomes throughout life.
Parents dont ask if homework got done; parents would not know if you did not come home on time; at home, parent does not know where I am or who Im with; rules in my family are
not clear; family does not have clear rules about alcohol/drug use; would not be caught by parents if drank alcohol without their permission; would not be caught by parents if carried a
handgun without their permission; would not be caught by parents if skipped school.
9
59%
Kitsap Rates
58%
62%
Recent Year
WA Rate
better
worse
worse
Kitsap Compared to
WA
September 2016
61%
51%
85%
same
2015
Kitsap Trends
Statistical
Change
N/A
89%
43%
same
Graph
N/A
90%
46%
902
same
Timeframe
42%
944
199
better
2006-2014
1998-992015-16
519
173
186
Youth (grades 8, 10, 12) report opportunities

for positive participation in the family
setting 10
2011-2015
131
118
COMMUNICABLE DISEASES
Babies (age 19-35 months) with complete
13
immunizations
Kindergarten children with complete
immunizations* 13
2000-2014
57
N/A
Adults with influenza vaccine in the past year 9
2000-2014
same
2000-2015
30%
same
N/A
33%
8%
better
N/A
34%
7%
657
35%
5%
572
48%
N/A
849
2011, 2013,
2015
2011-2015
1998-2014
2008-2015
Chlamydia rate per 100,000 adolescents and

adults (aged 15-44) 1, 2
Gonorrhea rate per 100,000 adolescents and
1, 2
adults (aged 15-44)
Rate of persons living with HIV or AIDS per
100,000 residents 14
Routine food establishment inspections
resulting in one or more red violations ^ 15
CHRONIC DISEASES
Adults ever told by a health care provider that
they have high blood pressure 9
9
they have cardiovascular disease
Heart disease-related hospitalization (fatal
and nonfatal) rate per 100,000 residents 2
Student can discuss problems with parents; student has chances for fun with parents; student is involved in family decisions.
*Kindergarten children exempt from immunizations: 1998-99: 2%; 2015-16: 4%; statistically more children were exempt in 2015-16 compared to 1998-99.
Â red violation indicates high risk for food contamination threats to human health.
10
3%
9%
1027
8%
10%
Kitsap Rates
1115
8%
8%
Recent Year
WA Rate
better
same
same
Kitsap Compared to
WA
September 2016
2011-2015
892
Kitsap Trends
Statistical
Change
1998-2015
Graph
1998-2014
Timeframe

they have diabetes 9
Births to women diagnosed with gestational
diabetes during pregnancy 5
Diabetes-related hospitalization (fatal and
nonfatal) rate per 100,000 residents 2
Kitsap Rates
Recent Year
WA Rate
same
Kitsap Compared to
WA
III. HOW HEALTHY ARE OUR LIFESTYLES AND BEHAVIORS?

39%
Kitsap Trends
Statistical
Change
37%
Graph
40%
Timeframe
WEIGHT MANAGEMENT
2011-2015
same
Adults at a healthy weight (BMI= 18.5-24.9) 9
36%
better
same
41%
58%
same
77%
40%
64%
77%
same
76%
42%
77%
25%
74%
79%
24%
same
N/A
30%
60%
58%
2006-2014
2011, 2013,
2015
2006-2014
2006-2014
2006-2014
2006-2014
29%
Youth (grade 8) at a healthy weight (BMI

th
10
below 85 percentile)
PHYSICAL ACTIVITY AND NUTRITION

Adults report engaging in 1 or more hours of
physical activity on average each day per
9
week
Youth (grade 8) report 1 or more hours of
physical activity five or more days per week 10
Youth (grade 8) report 2 hours or less of
screen time* for fun on school days 10
Youth (grade 8) report eating 5 or more
fruits/vegetables daily 10
Youth (grade 8) report drinking no sugary
beverages in past 7 days at school 10
*Watching TV, videos or DVDs, playing video games, or using a computer.
11
Youth (grade 10) report using alcohol in the

past 30 days 10
Youth (grade 10) report using electronic

cigarettes in past 30 days 10
Youth (grade 10) report smoking in the past 30

days 10
Civilian women report smoking during

5
pregnancy
Adults report currently smoking 9
2006-2014
2006-2014
2012, 2014
2006-2014
1998-2015
2011-2015
48
195
17%
30%
6%
15%
20%
18%
15
149
329
20%
21%
23%
11%
10%
17%
Kitsap Rates
16
224
511
18%
21%
19%
8%
7%
15%
Recent Year
WA Rate
better
better
same
better
better
same
same
worse
worse
worse
same
Kitsap Compared to
WA
September 2016
Youth (grade 10) report using marijuana in the

past 30 days 10
1998-2014
12
Kitsap Trends
Statistical
Change
Drug-associated nonfatal hospitalization rate

per 100,000 residents 2
1998-2014
11
Graph
Opiod drug-associated nonfatal hospitalization

rate per 100,000 residents 2
1998-992014-15
10
Timeframe
Drug-associated death rate per 100,000

residents 2
1998-992014-15
SUBSTANCE USE
Opiod drug-associated death rate per 100,000

residents 2
2002-2013
N/A
Publicly funded substance abuse treatment

16
rates per 1,000 residents
12
September 2016
2004-2015
2000-2015
2001-2015
64
69%
33%
91%
83%
70
39
85%
42%
93%
98%
Kitsap Rates
4%
77
44
N/A
N/A
N/A
85%
Recent Year
WA Rate
worse
better
same
same
N/A
N/A
N/A
better
Kitsap Compared to
WA
IV. HOW SAFE AND HEALTHY ARE OUR SURROUNDINGS?
2000-2015
65
6%
34%
Group A/B water systems meet standards for

acceptable levels of total coliform bacteria ^ 18
Fresh water streams meet standards for
acceptable levels of fecal coliform
bacteria ^^ 19
Shoreline miles classified as open for
shellfish harvesting 15
BUILT ENVIRONMENT
Motor vehicle injury-related hospitalization
(fatal and nonfatal) rate per 100,000
2
residents
Fast food restaurant and convenience store
1, 20
density per 100,000 residents
Kitsap Trends
Statistical
Change
1998-2014
3%
29%
Graph
1998-2014
33%
Timeframe
2006-2014
NATURAL ENVIRONMENT
Kitsap resident workers who walk or bike to

work 3
2008-2014
Healthy air days

(Air Quality Index = Good*) ** 17
Youth (grade 8) who walk or bike to school at

10
least one day per week
*Good is an Air Quality Index (AQI) of 0-15, meaning the air quality is considered satisfactory and air pollution poses little or no risk.
**Air quality monitoring data from Meadowdale station 2001-April 2012; Spruce station from May 2012-present.
În 2000, 65% of all group A and B systems were tested and in 2015, 83% of all group A and B systems were tested.
^În 2004, 15% of all streams passed part 1 but failed part 2 and in 2015, 35% of all streams passed part 1 but failed part 2.
13
CRIME AND SAFETY

6272
11
5569
Kitsap Rates
10
5754
Recent Year
WA Rate
same
better
Kitsap Compared to
WA
September 2016
Kitsap Trends
Statistical
Change
2012-2015
Graph
1998-2015
same
Timeframe
Group A offense crime rate per 100,000

residents 1, 21
2
20%
Firearm death rate per 100,000 residents
15%
N/A
21%
2013, 2015
Households with firearms that are loaded and

unlocked 9
In 1998 and in 2015, 83% of all Kitsap County firearm deaths were self-inflicted. Combining all years from 1998 to 2015, 87% of all Kitsap firearm deaths were self-inflicted.
In 2015, 35% of Kitsap and 33% of WA households report having a firearm in or around the home.
14
September 2016
Housing Solutions Center of Kitsap County, Homeless Management Information System
Map the Meal Gap, Feeding America
US Department of Labor, Bureau of Labor Statistics, Local Area Unemployment Statistics
Washington State Department of Health, Center for Health Statistics, Vital Statistics Databases (births and deaths): analyzed by Kitsap Public Health District
Washington State Office of the Superintendent of Public Instruction
US Census and American Community Survey
Washington State Department of Health, Community Health Assessment Tool (CHAT)
Washington State Office of Financial Management, Population Estimates
SOURCES
1
2
3
4
5
6
7
8
Washington State Association of Sheriff and Police Chiefs
US Census County Business Patterns
Kitsap Public Health District Water Quality Program
Kitsap Public Health District Drinking Water Program
Puget Sound Clean Air Agency
Washington State Department of Social and Health Services, Risk and Protection Profiles for Substance Abuse Prevention Planning
Kitsap Public Health District Food and Living Environment Program
Washington State Department of Health, Infectious Disease Assessment Unit
Washington State Department of Health, Immunization Program
Partners for Our Children Child WellBeing Data Portal, 2015. Web 8/9/16.
Kitsap Public Health District Parent-Child Health Program
Washington State Department of Health, Healthy Youth Survey
9
Washington State Department of Health, Center for Health Statistics, Behavioral Risk Factor Surveillance System, supported in part by Centers for Disease Control and
10
11
12
13
14
15
16
17
18
19
20
21
Although data sources remain the same, some data are updated by agencies to reflect the most current data collected and analytical methodologies. The Core Public
Health Indicators report incorporates these data changes on an annual basis; therefore, data that were reported in previous years may not match data reported
currently. These changes are usually small so that the reported proportion or rate does not vary much.
15
BACKGROUND INFORMATION

September 2016
INDICATORS
What is an indicator?
An indicator is a measurement that reflects the status of a system, a measure of health status or a health outcome.
Indicator Selection Criteria*:

Worth measuring: indicator measures an important aspect of the publics health
Readily understood by people who need to act: policy makers, community leaders, health care
Compelling enough to lead to action
Able to be improved: feasible actions have been identified and shown to impact the indicator
Trackable over time: defined in such a way that changes over time are likely to reflect interventions rather than changes in definitions
*Institute of Medicine, Leading Health Indicators for Healthy People 2010: Final Report. 1999.
DATA SOURCES
1. Washington State Office of Financial Management
The Office of Financial Management produces annual population estimates based on Census data by age and gender.
2. Washington State Department of Health Community Health Assessment Tool (CHAT)
The Community Health Assessment Tool (CHAT) is an online repository of public health data maintained by the WA State Department of Health and
available to local public health assessment staff. CHAT includes: birth risk factors, cancer incidence, communicable diseases, sexually transmitted
diseases, tuberculosis, fertility, hospitalizations, infant mortality, life expectancy, mortality, population and pregnancy and abortion data. Sexually
transmitted disease cases include only confirmed classification.
3. U.S. Census and American Community Survey

The Census and American Community Survey collect data about population, housing and economy. The Census is conducted every 10 years; the
American Community Survey is conducted annually in communities with populations of >60,000.
16

September 2016
4. Washington State Office of the Superintendent of Public Instruction
The Office of the Superintendent of Public Instruction provides high school graduation and students eligible for free and reduced-priced meals data.
These data have some limitations. First, eligible students might be underrepresented, as those not signed up in October would not be counted. Eligibility
status might change during the school year resulting in an under or overestimate of program participants. Children who are not enrolled in school, are
home-schooled, or attend private schools were not included.
5. Vital Statistics Databases
The Kitsap Public Health District maintains vital statistics databases with information about all county resident births and deaths. Data are obtained
every year from the Washington State Department of Health. A limitation of vital statistics data is that some information may be missing from the
reporting forms and therefore from the database. Death data are limited by the inconsistency and incompleteness of reported causes of death (usually
done by the attending physician).
6. Bureau of Labor Statistics
The U.S. Department of Labors Bureau of Labor Statistics produces annual Local Area Unemployment Statistics.
7. Feeding America
Feeding America provides Map the Meal Gap research about hunger across America. They analyze the relationship between food insecurity and
indicators of food insecurity and child food insecurity (poverty, unemployment, homeownership, etc.) at the state level then develop county level
estimates.
8. Housing Solutions Center of Kitsap County
The Housing Solutions Center of Kitsap County offers individuals and families who are homeless or at risk of becoming homeless a one-stop location to
access all forms of housing assistance. Client information is input into case the Homeless Management Information System.
17
9. Behavioral Risk Factor Surveillance System

September 2016
The Behavioral Risk Factor Surveillance System (BRFSS) is an annual land-line telephone survey expanded to include cell phones beginning in 2011 conducted continuously throughout the year. It is a collaborative effort of the Centers for Disease Control and the Washington State Department of
Health. The survey collects information from adults on health conditions, health-related behaviors, and risk and protective factors. The survey has
several limitations. First, individuals without land lines or cellular telephones are not included. Surveys are conducted in English only. Potential
respondents are not always available or willing to participate. Because the survey relies on respondents own report, some data may be under or
overestimated. 2011 is the historical baseline for trend overtime due to methodological changes in the survey administration and statistical weighting.
Data prior to 2011 are no longer presented in these indicators.
10. Healthy Youth Survey
The Healthy Youth Survey is conducted every two years among youth in grades 6, 8, 10 and 12. It is a collaborative effort of the Office of the
Superintendent of Public Instruction, the Washington State Department of Health, the Washington State Department of Social and Health Services, the
Liquor Control Board, the Family Policy Council, the Department of Commerce, the Educational Service Department and local health departments. The
survey is voluntary and anonymous. The survey gathers reliable and current data about the perceptions, behaviors, and influences of youth on key
topics affecting them. Because the survey relies on respondents own report, some data may be under or overestimated.
11. Kitsap Public Health District Parent-Child Health Program
Programs offer support and education to pregnant women and parents of young children who are income-eligible.
12. Partners for Our Children Child WellBeing Data Portal

Partners for Our Children Child WellBeing Data Portal is an interactive data visualization tool with data from Children's Administration to understand the
vulnerable children and families served by human service systems in Washington State and beyond.
18

September 2016
13. Washington State Department of Health Immunization Program
The Washington State Department of Health Immunization Program has data from two sources: 1) Washington State Immunization Information System
(IIS) which is a lifetime registry tracking immunization records for people of all ages in WA. Healthcare providers voluntary report immunizations for
their patients so estimates of immunization coverage are likely lower than the true rate; and 2) Washington State School Immunization Data which are
data reported by schools for numbers of children entering kindergarten with a complete, conditional, out of compliance (incomplete) immunization
series, or exempt status. School data are collected from parents and not verified with health care providers. Thus, numbers might be under or
overestimates as parents might not recall or know the exact immunization status of their child. Beginning in July 2011, a parent reporting exempt status
must provide a letter signed by their health care provider or proof of membership in a church or religious group that does not allow medical treatment.
14. Washington State Department of Health, Infectious Disease Assessment Unit
All diagnoses of HIV or AIDS must be reported to the local health jurisdiction (WAC 246-101) who in turn must report the case to the Washington State
Department of Health. WA DOH maintains a database of deduplicated individuals living with HIV or AIDS.
15. Kitsap Public Health District Food and Living Environment Program
The Kitsap Public Health District Food and Living Environment Program inspects food establishments annually. The number of routine inspections differs
by establishment type and size. A red violation indicates high risk for food contamination threats to human health and requires follow-up correction.
16. Washington State Department of Social and Health Services Risk and Protection Profiles for Substance Abuse Prevention Planning
The Washington State Department of Social and Health Services publishes biannual Risk and Protection Profiles for Substance Abuse Prevention
Planning. These profiles are comprehensive time-series collections of data related to substance use and abuse, and the risk factors that predict
substance use among youth. The data are organized and presented within a risk and protective factor framework used across the state by substance
abuse prevention planners.
19
17. Puget Sound Clean Air Agency

September 2016
EPA calculates the Air Quality Index (AQI) for five major air pollutants regulated by the Clean Air Act: ground-level ozone, particle pollution (also known
as particulate matter), carbon monoxide, sulfur dioxide, and nitrogen dioxide. For each of these pollutants, EPA has established national air quality
standards to protect public health. The AQI indicates "Good" days when air quality is considered satisfactory and air pollution poses little or no risk. .
The Puget Sound Clean Air Agency collects air quality data in Kitsap County. Particulate Matter (PM) 2.5 is the only pollutant of concern in Kitsap
County, so when daily PM2.5 is below 13.4 /m3, set by the Washington Air Quality Advisory (WAQA), the AQI is "Good." From 2001 April 2012 data
were collected at the Meadowdale monitoring station and from May 2012 to present at the Spruce monitoring station. Stations report a daily average
of micrograms per cubic meter of particulate matter 2.5 calculated from a minimum of 18 1-hour averages. The data are limited to the days a daily
average was calculable.
18. Kitsap Public Health District Drinking Water Program
The Kitsap Public Health District Drinking Water Program works in partnership with the Washington State Department of Health Drinking Water Program
to provide oversight of public drinking water systems. Water systems are required to comply with a bacteriological sampling plan to ensure that drinking
water is safe for consumption. The data have some limitations. Since variation from sampling methods and unstandardized field equipment may
produce invalid or inconsistent results, verification resampling is required for any positive coliform result. Because not all systems are in compliance
with testing requirements, either by not testing at all or failing to re-test after a positive result, results may be under or overestimates.
19. Kitsap Public Health District Water Quality Program
The Kitsap Public Health District Water Quality Program collects water quality samples and data at stream monitoring stations. Water samples are
collected at established stations 12 times annually using a stratified random sampling strategy to designate the date and time of sample collection. Data
representativeness, completeness, and comparability are achieved through consistent sampling methodology and documentation. The data set may be
limited by variations in equipment performance and environmental conditions.
20. U.S. Census County Business Patterns

The Census provides data on the number of establishments, employment, and payroll. Establishments are classified according to the North American
Industry Classification System (NAICS).
20

September 2016
17. Washington State Association of Sheriff and Police Chiefs

The Washington State Association of Sheriff and Police Chiefs annually produces the Crime in Washington report compiled from monthly reports
submitted by individual law enforcement agencies. These data have several limitations. First, the amount and type of crime reported may differ due to
reporting practices, law enforcement policies, population characteristics, and attitudes. Crime may not be accurately depicted, as the varying severity of
offenses is not taken into account. The Port Gamble SKlallam Tribal and Suquamish Tribal Police Departments do not provide data. In 2012, WASPC
began reporting data based on the National Incident Based Reporting System (NIBRS) which includes group A offences in three categories: crimes
against people, crimes against property, and crimes against society. Not all Washington State jurisdictions have switched to NIBRS and are therefore not
included in the state rate; the Kitsap County Sheriff and all 4 city police departments are included.
DATA DETAILS
Two distinct types of data have been used to calculate the values reported in the Kitsap County Core Public Health Indicators: survey and incidence. All
data in the indicator report are rounded to the nearest whole number. When there are a small number of events in any given year, the reliability of the
statistical estimate is evaluated using the relative standard error (RSE). When the RSE is large, the estimates are imprecise (RSE is >30%, the estimate
will be presented for 2- or 3-year periods rather than single years, in order to reduce the RSE below 30%).
Survey Data
Survey data are acquired through population surveys, in which a segment or portion of the population of interest is surveyed. Surveys are conducted
because it is unrealistic to obtain information from the whole population of interest. Using statistical methods, the answers of those surveyed can be
generalized to describe the entire population of interest. This method assumes that the group surveyed is statistically the same as the population it
represents.
Survey data are reported as proportions (percentages) rather than counts (raw numbers). Proportions are comparable across groups and time. Examples
of survey data include: current smokers, physical activity, air quality, etc.
They are calculated as follows: (Number with specific answer / Total answering the question) x 100
Incidence Data
Incidence data are counts of new events that occur to members of a specific group during a specific time period. Incidence data are reported as a rate.
Rates are comparable across groups and time. Examples of incidence data include: suicide death rate and Chlamydia and Gonorrhea rates.
They are calculated as follows: (Number of new events / Total persons with potential for event) x 100,000
21
Confidence Intervals

September 2016
A confidence interval (CI) is a range of values that describes the uncertainty surrounding a calculated value. We use confidence intervals as one way to
represent how real a value is. For this report we used a probability of 95% such that, if we were to repeatedly calculate new values using exactly the
same procedures, 95 out of 100 values would be considered real by falling within the range described by the confidence interval. Interpretation of
values should be done with greater caution when confidence intervals are wide as this indicates increased variability in the data.
Trends
To evaluate trend over time, all available data values from earliest to recent year for an indicator are analyzed for a statistical trend over time using
Joinpoint Regression Program 4.3.1.0 April, 2016. These values are also shown in a trend line graph. At times, the earliest and recent data values might
indicate a certain trend direction; however, the trend over time analysis takes into account all values and not just the endpoints. When an increasing or
decreasing trend arrow is present, it means that the p-value is <0.05 for the trend test. As described in the first paragraph of this section on the previous
page, when the RSE is >30%, the estimate will be presented using 2- or 3-year periods, likewise the trend will be run on 2- or 3-year periods of data. If
fewer than 4 years of data are available, the trend will be a statistical comparison of the earliest and recent year of data.
22
Indicator
Birth rate per 1,000 women (ages 15-44)
Infant mortality rate per 1,000 live births
Death rate per 100,000 residents
Premature death rate per 100,000

residents (<75 years old)
Children aged 3-4 enrolled in early
education programs
High school graduation rate (5-year
cohort)
Adults aged 25-64 with more than high
school education
Civilian pregnant women with more than
high school education
Civilian adults currently employed
September 2016
3004
42430
48552
64.4
72.1
61.9
3.5
2.1
64.0
69.6
59.7
Lower
9.3
7.0
64.8
74.7
64.1
Upper
95% Confidence Interval
1998
3060
1381770
5.9
4.0
Rate
2015
89000
3060
3004
Total
2015
18
12
Number
2015
686.3
85.9
698.2
5.3
58.4
86.6
117.7
4.4
692.3
82.5
4.8
71.1
80.9
89000
7061410
98.9
431
154777
83.7
2015
54513
138974
675.5
109
4154705
36.4
840.7
2015
131
34.2
48.3
618.6
1998
3440
35.3
45.8
40.7
761.0
2015
7200
47.0
40.3
86.3
646.4
2015
2540
6038
40.5
83.9
85.7
800.1
2005
2840
182134
85.1
83.0
81.3
258200
2014
73793
3215
84.4
80.8
189731
2014
2737
2930
81.1
72.7
68.6
2147
2010-11
2473
78850
72.3
68.1
1580
2014-15
63930
72.5
68.3
2015
2014-15
132998
127756
69.1
96412
69.0
87292
69.0
2014
3791968
65.4
2617411
95.6
2014
64.8
94.6
71.0
95.3
94.4
49.6
65.1
94.4
67.2
95.5
94.3
45.2
84884
94.5
69.1
93808
94.3
47.4
55267
115211
2318
89559
3544242
2025
2015
108896
960
1998
3343992
1602
2015
2015
2015
1998
2005
1998
1998
Year

Location
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
23
Statistical % Change
Over Time
0.7%
--
-1.7%
--
--
--
0.7%
2.0%
-0.1%
p<0.05
Residents living below 100% of poverty
Youth (ages 5-17) living below 100% of

poverty
Older adults (age 65 and older) living
below 100% of poverty
Residents experiencing food insecurity
Public school students (grades K-12)

enrolled in free or reduced lunch program
Civilian births paid by Medicaid
Households paying more than 30% of

monthly income on housing costs
Individuals currently or imminently
experiencing homelessness and seeking
housing ^^
Homelessness youth (age 5-17)
2014
27187
19599
247146
231389
11.0
8.5
10.9
8.4
11.1
8.6
4.7
16.9
13.2
16.8
9.9
13.2
4.2
8.5
13.2
16.9
9.3
6927889
4.5
8.4
913619
1138365
9.6
2014
25972
8.4
6.6
191890
39697
11.4
1158
971314
13.7
6.1
2014
3821
12.9
13.8
10.8
2005
81927
13.3
13.0
13.8
6.3
2014
33400
13.4
13.6
26.0
11.1
2014
4442
34040
13.7
25.1
36.1
38322
2012
4561
970150
25.5
35.2
42713
2014
132911
42665
35.7
4250
2014
10899
36578
2700
1998-99
13041
2014
2015-16
42.7
44.5
33.0
44.3
42.0
34.2
44.4
32.4
33.9
1074011
42.3
33.5
477154
32.7
33.8
2015-16
84410
33.8
42.5
89650
33.9
40.3
35735
95249
38.5
29337
2679601
1.6
36.1
2015
32241
1.5
1.9
40.5
2005
907313
1.5
1.8
0.9
38.2
2014
251133
1.8
0.7
3.1
2318
2014
3881
155900
0.8
2.8
3.4
2095
2011
4681
39033
2.9
3.3
938
2015
316
35799
3.3
800
2006-07
1047
1070756
2015
2014-15
35511
NO DATA
2014-15
1998
2005
2005
September 2016

Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
24
3.8%
6.2%
--
N/A
p<0.05
2.8%
0.5%
--
--
15.8%
Civilian adults aged 18-64 report having

health insurance
Adults report having visited a dentist or
dental clinic in the past 12 months
Youth (grade 8) report having had a dental
checkup, exam or cleaning in the past 12
months
Low-income civilian women start prenatal
care in the first trimester
Non-low-income civilian women start
prenatal care in the first trimester
Babies born at low birth weight (less than
2500 grams)
Adults report that in general their health is
excellent, very good, or good during the
past 30 days
Adults report activities not limited by poor
physical or mental health during the past
30 days
2014
134660
120203
147838
143784
91.1
83.6
90.9
83.4
91.2
83.8
84.8
73.9
67.0
83.8
82.4
71.3
65.9
85.9
85.9
76.4
68.0
87.2
1159
84.9
87.2
11107
963
87.2
857
4637
71.5
4382463
2015
816
65.0
72.7
3821928
2006
3936
68.4
66.8
72.5
2014
2014
771
69.9
71.5
88.0
74.9
2014
527
926
72.0
84.2
85.9
72.0
1998
647
33970
86.2
82.0
86.6
63.5
2015
24462
1240
84.0
86.0
5.7
54.3
2015
1069
1315
86.3
3.9
6.0
69.5
1998
1105
46906
4.7
4.2
63.6
2015
40485
2098
5.0
5.2
403
2015
99
2238
4.9
154
1998
113
5.0
2015
2015
82925
85.9
4161
50.2
2015
84.3
60.9
91.8
35.9
57.4
88.2
85.1
45.8
85.6
42.9
54.5
77.7
13504
53.4
89.1
139
55.9
83.6
2015
175
479
2011
4699
273
2015
2015
2015
2011
2011
2008
September 2016

Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
25
--
--
1.9%
--
-0.3%
--
--
--
Alzheimer's Death rate per 100,000

residents
Older adult (age 65 and older) fall-related
100,000 residents
Adults report never having a permanent
tooth extracted because of decay or gum
disease
Youth (grade 6) report being bullied in the
last month
Youth (grade 8) report having an adult to
turn to for help when feeling sad or
hopeless
Adults report that they and people in their
community do favors for each other very
often or often
Adults report mental distress (14 or more
days of poor mental health during the past
30 days)
Youth (grade 8) report seriously
considering attempting suicide during the
past 12 months
Suicide hospitalization (nonfatal) rate per
100,000 residents
49.3
1717.9
25.5
62.9
34.8
1664.2
72.3
12.6
52.2
63.6
41.4
1690.8
51.9
29.7
18.2
57.6
59.5
31.9
258200
15781
62.7
24.2
31.9
229841
201
61.6
27.0
68.0
34
2014
116
26.9
29.9
67.8
139
2012
3621
992
29.4
62.0
68.1
2015
2014
267
1356
30.9
61.4
58.9
1998
2014
399
8668
65.1
65.2
61.5
46.4
2006
2678
963
64.7
47.9
49.0
43.4
2014
627
845
66.7
46.4
22.0
44.9
2014
546
3909
53.4
46.1
15.7
7061410
2006
2606
54.0
10.5
11.9
3489
2014
307
47.5
8.1
2015
2014
191
15.4
10.5
1426.0
2012
4798
11.3
1580.6
2014
37
11.2
14.0
1195.8
2014
54
10.3
21.5
1274.4
2011
1554
12.0
18.2
16.8
1306.8
2015
1231
19.8
15.4
65.3
1421.3
2015
148
2152
16.1
45.6
53.4
42778
2006
426
10401
54.8
35.7
49.8
24432
2014
1675
230142
43.8
46.5
527
2014
127
255726
48.1
341
1998
107
6968170
2014
2014
3301
978086
2014
1998
September 2016

Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
26
--
-1.3%
N/A
--
--
N/A
--
6.7%
--
Suicide death rate per 100,000 residents
Adults report NO Adverse Childhood

Experiences
Adults report 3 or more Adverse Childhood
Experiences
Low-income pregnant or parenting home
visitation clients reporting 3 or more
Adverse Childhood Experiences
Children who entered out-of-home care
(CPS removals)
Youth (grades 8, 10, 12) report ever being
physically hurt on purpose by an adult
Youth (grades 8, 10, 12) report parents not
engaged in the details of daily life or not
setting clear rules
Youth (grades 8, 10, 12) report
opportunities for positive participation in
the family setting
Babies (age 19-35 months) with complete
immunizations
1136
35.9
34.1
15.6
27.1
22.4
34.5
27.3
14.7
29.8
35.7
37.2
41.6
16.6
26.4
114
28.6
18.4
2015
5383
28.4
58.0
8.4
2011
75
44.0
6.7
14.7
2011
3229
51.0
5.5
3.9
19.8
2011
194
6.0
3.0
4.1
12.6
2011
99
61512
3.4
3.9
26.7
258200
2014
374
56598
4.0
23.4
25.1
229842
2000
193
1586386
25.0
23.6
35.2
42.6
55
2014
6409
2587
24.3
31.6
37.9
28
2014
647
11749
33.4
40.2
2015
2014
2859.51
2526
1665
2014
2014
2006
2014
73865
2124
7164
1520
1008
3700
127227
4160
11541
2559
1644
11443
58.1
51.1
62.1
59.4
61.3
32.3
57.8
49.5
61.2
57.5
58.9
31.5
58.3
52.6
63.0
61.3
63.6
33.2
7061410
2014
843
669
2015
pending
2015
N/A
2014
2006
1998
September 2016

Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
27
--
N/A
N/A
N/A
-4.9%
p<0.05
N/A
-2.9%
--
p<0.05
N/A
p<0.05
Kindergarten children with complete

immunizations
Adults with influenza vaccine in the past
year
Chlamydia rate per 100,000 adolescents
and adults (aged 15-44)
Gonorrhea rate per 100,000 adolescents
and adults (aged 15-44)
Rate of persons living with HIV per 100,000
residents
Routine food establishment inspections
resulting in one or more red violations
Adults ever told by a health care provider
that they have high blood pressure
that they have cardiovascular disease
Heart disease-related hospitalization (fatal
and nonfatal) rate per 100,000 residents
2015-16
2441
2986
2738
3303
89.2
90.4
87.9
89.4
90.3
91.4
519.0
43.3
890.5
884.0
476.5
42.1
912.6
1007.8
565.2
44.4
85.2
943.9
84.7
100972
901.5
85.0
7364
93866
84239
524
2800658
155.0
71575
2015
886
110.3
201.3
2015-16
2000
25248
130.7
148.0
204.0
52.4
2014
100972
172.6
193.5
67.0
49.4
2014
132
93866
198.7
48.4
132.1
40.4
2000
162
2800658
57.0
105.5
189.1
35.6
2014
5564
254500
118.0
182.7
53.4
46.3
2014
145
256693
185.9
42.7
39.4
42.4
2000
303
7005840
47.9
30.7
256
2015
13021
1352
35.0
153
2015
648
2013
2015
2008
704
28.1
38.8
40.8
30.9
7.5
9.4
8.0
890.5
600.1
27.9
29.0
2.9
5.0
7.0
809.3
545.6
663.2
33.3
29.9
4.7
6.9
7.5
849.2
572.2
651.5
34.0
230142
255726
657.4
227
6158
24
63
1762
1719
1849
6968170
136
2015
2011
2015
2015
1998
2014
50834
2015
2014
2011
N/A
2015
2011
1998-99
September 2016

Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
28
-0.6%
--
5.0%
--
4.1%
--
N/A
--
-2.5%

that they have diabetes
Births to women diagnosed with
gestational diabetes during their
pregnancy
Diabetes-related hospitalization (fatal and
nonfatal) rate per 100,000 residents
Adults at a healthy weight (BMI=18.5-24.9)
Youth (grade 8) at a healthy weight (below

85th percentile for BMI)
Adults report engaging in 1 or more hours
of physical activity on average each day
per week
Youth (grade 8) report engaging in 1 or
more hours of physical activity five or
more days per week
Youth (grade 8) report 2 hours or less of
screen time for fun on school days
Youth (grade 8) report eating 5 or more
fruits/ vegetables daily
2015
1998
2015
2015
1998
2014
2011
2015
1798
83
243
7232
1826
3261
38
61
3004
3060
88733
230142
255726
1114.9
8.5
2.8
7.9
8.2
891.5
1026.8
9.2
9.7
1107.3
8.0
2.2
7.0
8.0
850.9
990.6
6.4
6.8
1122.5
9.1
3.4
9.0
8.3
933.6
1064.3
13.1
13.6
78.3
6968170
47.9
85960
75.9
48.0
2014
32.4
37.0
47.1
43.2
40.5
77.1
34.8
33.1
31.8
38.2
39.9
34.6
39.9
37.3
39.3
3562
41.3
123
196
5517
155
35.8
45.1
2011
2015
2015
2014
193
39.5
66.9
78.9
2011
4851
42.2
61.2
59.6
76.1
2015
1186
64.1
57.0
81.0
73.5
2015
501
1089
58.3
77.8
78.8
70.7
2006
698
5206
79.4
75.3
77.7
76.3
2014
3035
2477
77.1
76.2
33.4
73.5
2014
1967
2253
77.0
27.6
26.1
965
2006
1730
13029
30.4
21.1
25.7
1018
2014
10026
983
23.5
23.4
736
2014
299
1088
24.5
748
2006
256
5212
2014
2014
1276.94
4620
2014
2006
September 2016

Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
29
--
6.4%
--
--
--
--
6.5%
--
--
Youth (grade 8) report drinking no sugary

beverages in past 7 days at school
Adults report currently smoking
Civilian women report smoking during

pregnancy
Youth (grade 10) report smoking in the
past 30 days
Youth (grade 10) report using electronic
cigarettes in the past 30 days
Youth (grade 10) report using alcohol in
the past 30 days
Youth (grade 10) report using marijuana in
the past 30 days
Drug-associated nonfatal hospitalization
rate per 100,000 residents
Opiod drug-associated nonfatal
hospitalization rate per 100,000 residents
2014
637
345
1102
1204
57.8
28.7
54.9
26.2
60.7
31.3
20.0
15.0
7.2
8.7
18.3
14.1
7.6
11.1
21.7
15.8
61.0
9.8
58.4
2118
7.4
59.7
1843
2319
5251
423
85140
16.6
3134.8
2015
228
13.7
11.9
2014
1998
6285
15.1
9.2
8.5
22.1
2015
2263
10.5
7.3
7.7
24.8
2015
341
2009
7.9
4.8
25.4
12.8
2006
211
8619
6.1
20.3
20.0
13.4
2014
681
1066
22.7
18.0
23.1
32.3
16.9
2014
65
1029
19.0
19.6
28.5
18.4
2012
234
5441
21.3
30.4
64
2014
1033
2002
2252
47
2014
426
684
2015
2014
21.5
18.9
19.8
213.8
20.6
17.3
353.1
8604
176.9
516.1
1772
18.1
306.5
2014
194.7
505.4
21.4
8579
329.1
19.0
230142
510.7
17.9
1553
255726
15.8
444
6969170
58.4
19.6
2014
839
39.7
165.1
17.3
1998
36182
48.3
133.5
227.2
1997
2014
230142
148.6
220.2
2249
2014
111
255726
223.7
391
1998
374
6968170
390
2014
16115
2014
2014
2006
2006
2011
2006
September 2016

Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
30
--
--
-3.8%
-5.4%
p<0.05
p<0.05
-4.2%
1.6%
4.2%
9.8%
Drug-associated death rate per 100,000

residents
Opiod drug-associated death rate per

100,000 residents
Publicly funded substance abuse

treatment rates per 1,000 residents
Healthy air days (Air Quality Index = Good)

Group A/B water systems meet standards
for acceptable levels of total coliform
bacteria
Fresh water streams meet standards for
acceptable levels of fecal coliform bacteria
Shoreline miles classified as open for
shellfish harvesting
Motor vehicle injury-related
100,000 residents
Fast food and convenience store density
per 100,000 residents
15.1
7.7
11.8
5.4
19.0
10.8
16.2
514100
14.8
459409
15.5
81
14029580
8.6
4.2
36
2254
3.9
1.2
2014-15
2014-15
5.8
2.3
9.0
514100
8.0
11.2
10.6
459409
8.5
9.7
31
14029580
10.3
11
1218
10.8
10.2
2014-15
2014-15
199294
173142
12.2
2145
12.0
1757
12.1
2013
5303669
85.3
64348
83.9
93.2
2013
84.6
89.1
94.2
98.7
10005
91.4
90.8
52.3
86.5
8463
729
92.7
19.1
64.0
95.3
2015
666
904
32.7
26.6
74.3
78.6
2000
838
52
42.3
62.3
89.0
97.5
2015
17
52
68.5
79.7
75.4
82.9
2004
22
226
85.0
54.0
48.0
358
2015
155
226
64.0
32.0
45.9
346
2000
192
230142
39.3
42.7
349
2015
147
255726
44.3
80.6
76.1
287
1998
107
6968170
60.1
55.2
2015
2014
3167
69.6
64.8
N/A
N/A
N/A
2014
255900
78.8
229841
74.7
178
76.7
130
6968170
2014
2014
5346
1998
2001
2002
1998-99
1998-99
September 2016

Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
31
2.4%
4.8%
p<0.05
--
1.2%
--
--
0.6%
-3.3%
0.7%
Kitsap resident workers who walk or bike

to work
Youth (grade 8) who walk or bike to school
at least one day per week
Group A offense crime rate per 100,000
residents
Firearm death rate per 100,000 residents
Households with firearms that are loaded

and unlocked
2014
7627
3137
118462
110455
6.4
2.8
6.3
2.7
6.6
2.9
32.9
5658.1
6366.4
35.3
4.5
6178.1
5772.8
4.5
34.1
5481.2
4.5
6271.5
5735.5
3309730
6156
5568.9
148264
254500
5754.1
2014
2099
258200
31.6
15961
5973820
13.0
36.0
2014
14379
4.8
16.0
26.1
2012
343740
8.2
7.2
10.7
30.6
2015
229841
10.9
9.2
28.8
2015
18
258200
9.9
31.1
33.3
1998
30
7061410
13.9
23.6
1067
2015
714
21.3
9.4
21.3
1157
2015
27
15.2
18.1
307
2013
24
19.7
385
2015
921
2014
2015
2008
2006
September 2016

Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
Kitsap
WA
32
8.0%
--
p<0.05
-3.8%
--
N/A

2016 Health Indicators

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2016 Health Indicators

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MEMO

Kitsap Public Health Board

Siri Kushner and Kari Hunter, Epidemiologists

2016 Kitsap County Core Public Health Indicators Report

Kitsap education and

Kitsap still has room

Immunization status is mixed: only half of toddlers have complete

Emotional well-being indicators (this includes suicide related hospitalizations

Sexual and substance

Kitsap has an ongoing worsening trend in residents experiencing chlamydia

Kitsap has improving trends in kindergarteners with complete immunizations,

KITSAP COUNTY CORE PUBLIC HEALTH INDICATORS

Babies (age 19-35 months) with complete immunizations

Children in out-of-home care (CPS removals)

Low-income pregnant/parenting home visitation clients reporting 3 or more ACEs

Suicide hospitalization (nonfatal) rate per 100,000 residents

Alzheimer's Death rate per 100,000 residents

Pregnant women eligible for evidence-based home visiting programs

Homeless youth (age 5-17)

Residents experiencing food insecurity

Older adults (age 65 and older) living below 100% of poverty

Households with firearms that are loaded and unlocked

Kitsap resident workers who walk or bike to work

Publicly funded substance abuse treatment rates per 1,000 residents

Opiod drug-associated death rate per 100,000 residents

Opiod drug-associated nonfatal hospitalization rate per 100,000 residents

Births to women diagnosed with gestational diabetes during pregnancy

Heart disease-related hospitalization (fatal & nonfatal) rate per 100,000

Adults ever told they have high blood pressure

Rate of persons living with HIV or AIDS per 100,000 residents

Adults with influenza vaccine in the past year

NEW INDICATORS REPLACING FORMER INDICATORS

Homelessness rate per 100,000 residents

Individuals currently or imminently experiencing homelessness and seeking housing

Adults report always or usually getting needed social/emotional support

Low-income civilian women start prenatal care in the first trimester

Youth (grades 8,10,12) report risk factor of poor family management

Adults ever told they have cardiovascular disease or diabetes

Chlamydia rate per 100,000 adolescents and adults (aged 15-44).

INDICATORS CALCULATED WITH 1-YEAR PREVIOUSLY 3-YEARS OF DATA

INDICATORS CALCULATED WITH 2-YEARS PREVIOUSLY 3-YEARS OF DATA

INDICATOR STATISTICAL TREND CHANGES FROM LAST RELEASE

CHANGES IN COMPARISON OF KITSAP TO WASHINGTON FROM LAST RELEASE

Earliest Year (2000)

Recent Year (2015)

Earliest Year (2000)

Recent Year (2015)

Kitsap County Total Population 1

Recent Year, 2015

Recent Year, 2015

Earliest Year, 2000

Earliest Year Recent Year Recent Year

Population by Age Group and Gender1

BIRTH AND DEATH RATES 2

Birth rate per 1,000 women (ages 15-44)

Infant mortality rate per 1,000 live births

Death rate per 100,000 residents

Premature death rate per 100,000 residents

Earliest Year Recent Year

I. WHO ARE WE?

Children ages 3-4 enrolled in early education

Adults aged 25-64 with more than high school

Youth (age 5-17) living below 100% of