Category Archives: SC Health Assessment

South Carolina Health at a Glance: Chronic Disease and Risk Factors (Part 1)

Our next installment of the 2018 Live Healthy State Health Assessment summaries covers chronic disease and risk factors. Because this section lists many chronic diseases that affect South Carolina, we will summarize in three sections. Check out our previous posts:  overview of the reportSouth Carolina demographicsleading causes of death and hospitalizationcross-cutting, access to healthcare, and maternal and infant health.

Key Findings

Obesity

  • South Carolina had the 12th highest adult obesity rate in the nation in 2016.
  • In 2016, the prevalence of obesity among non-Hispanic Blacks was 42.8% and was higher compared to non-Hispanic Whites (30.2%).
  • The prevalence of obesity was higher in adults with an annual household income less than $15,000 (40.8%) than among those with income $50,000 and higher (28.4%).

Prediabetes

Prediabetes, sometimes called “borderline diabetes” is a condition in which someone has a blood sugar (glucose) level above normal but not yet in the diabetes range. People with prediabetes are more likely to develop type 2 diabetes, heart disease, or experience a stroke. Without lifestyle changes to improve their health, 15% to 30% of people with prediabetes will develop type 2 diabetes within five years.

  • The prevalence of adults in South Carolina diagnosed with prediabetes increased from 6.7% in 2011 to 9.4% in 2016.
  • In 2016, the prevalence of prediabetes was higher in non-Hispanic Blacks (12.5%) compared to non-Hispanic Whites (8.5%).
  • The prevalence of prediabetes was higher in those with a disability (14.7%) than those without a disability (6.9%).

Diabetes

SC Adults with Diabetes_assessment

  • From 2011 to 2016, South Carolina adults with diabetes have remained higher than the median range of the United States.
  • The prevalence of diabetes was higher among adults aged 65 or older than among those under age 65.
  • In 2016, the prevalence of diabetes was higher in non-Hispanic Blacks (16.9%) than in non-Hispanic Whites (11.7%).

 

Hypertension

SC Adults with hypertension_assessment

Hypertension, commonly known as “high blood pressure,” is often called the silent killer because, apart from extreme cases, it has no symptoms. Nearly one in three United States adults have high blood pressure.

  • More than one-third (39.3%) of adults in South Carolina had hypertension in 2016.
  • Seventeen counties had a prevalence of hypertension higher than the state average at 38.7%.
  • In 2016, the prevalence of hypertension increased with age.

 

Arthritis

Arthritis is the term used to describe more than 100 diseases and conditions that affect joints, the tissues that surround the join, and other connective tissue.

  • The percentage of South Carolina adults who have been told they have arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia increased from 27.9% in 2011 to 30.1% in 2016. The median percentage of arthritis was 25.8% in the United States in 2016.
  • Over 57% of adults ages 65 years or older reported having arthritis in 2016.
  • The prevalence among disabled adults (56.2%) was three times higher than those adults who were not disabled (16.8%).

Heart Disease

About 610,000 Americans die each year from heart disease. Heart disease is the leading cause of death and disability in the United States.

SC heart disease deaths_assessment

  • South Carolina had a lower death rate compared to the United States (94.3 per 100,000) and met the Healthy People 2020 goal of 103.4 coronary heart disease deaths per 100,000 population in 2016.
  • Men (123.3 per 100,000) had a higher death rate than women (57.6 per 100,000) in 2016.
  • Non-Hispanic Blacks (96.0 per 100,000) experienced a higher death rate than non-Hispanic Whites (85.7 per 100,000).

 

Stroke

SC Stroke Deaths_assessment

Stroke was the fifth leading cause of death in the United States in 2016, and is a leading cause of serious, long-term disability in the United States. About 795,000 people in the United States have a stroke each year.

  • In 2016, South Carolina had the sixth highest stroke death rate in the nation and is part of the “Stroke Belt,” a group of Southeastern states with high death rates.
  • Stroke was the fifth leading cause of death in South Carolina, resulting in 2,627 deaths in 2016.
  • Stroke resulted in 16,484 hospitalizations in South Carolina in 2016, with charges of more than $952 million.

In our next section, we will summarize nutrition, physical activity, and cigarette smoking in South Carolina adults. For more detailed information about chronic diseases and risk factors that affect our state, visit https://www.livehealthysc.com/uploads/1/2/2/3/122303641/chronic_disease_and_risk_factors_sc_sha.pdf.

South Carolina Health at a Glance: Access to Healthcare

Our next installment of the 2018 Live Healthy State Health Assessment summaries covers access to healthcare.  Because the document is 346 pages, we will summarize each section.  Check out our previous posts:  overview of the report, South Carolina demographics, leading causes of death and hospitalization, and cross-cutting.  Data is analyzed from 2010-2016.

Access to health care refers to the ability of residents in a community to find a consistent medical provider for their primary and specialty care needs and ability to receive that care without encountering significant barriers.  Special populations who may face unique barriers include those who are experiencing homelessness or mental illness, lacking adequate health insurance, or non-English speakers such as some immigrants and refugees.

Primary Care Physicians

Primary care physicians specialize in family medicine, internal medicine, obstetrics/gynecology, and pediatrics.  They provide preventative care, identify and treat common conditions, and make referrals to specialists as needed.  Typically people with familiar primary care physicians have better chronic disease management, lower overall health care costs, and a higher level of satisfaction with their care.

According to America’s Health Rankings, in 2017, South Carolina ranked 36th in the nation for the number of primary care physicians per 10,000 residents.  The counties with the highest rates of primary care physicians in 2015 were Charleston, Greenwood, and Greenville.

Physician Assistants

Physician assistants are certified medical professionals who can give medical and surgical care in teams with physicians.  They can practice under the direction of a physician to diagnose, treat, and prescribe medicine.  The ratio of physician assistants increased from 1.5 physician assistants per 10,000 residents in 2009 to 2.5 physician assistants per 10,000 residents in 2015.

Nurse Practitioners

Nurse practitioners have clinical knowledge and skills to provide direct patient care.  They have the authority to prescribe medications and can also be utilized in rural communities, which often lack primary care providers.  South Carolina saw a 50% increase in the ratio of nurse practitioners from 2009 to 2015.

Health Insurance Coverage Among Adults

The Kaiser Family Foundation estimated 550,000 South Carolinians were without health insurance in 2016.  Although the number of insured adults in South Carolina increased from 2008 to 2015, the rate was below the United States, as well as the Healthy People 2020 target.  In 2015, 85.7% of South Carolina women were insured compared to 81.6% of men.

Health Care Insurance_Health Assessment

Delayed Medical Care

Worse health outcomes and higher medical expenditures are often results of delayed medical care.  Late diagnosis and advanced disease may require more extensive services.  Being insured and having access to affordable medical care could increase utilization of preventive health care services.

Delayed medical care_Health assessment

In South Carolina in 2016, 21.2% of Hispanic/Latinos delayed healthcare due to cost, compared to 18.8% of non-Hispanic Blacks and 13.7% of non-Hispanic Whites.  More women delayed medical care due to cost than men.

For more information about avoidable hospitalizations and emergency department visits, the leading causes of hospitalizations among children, and oral health, read the full chapter about Access to Health Care.

 

South Carolina Health at a Glance: Cross-Cutting

Our next installment of the 2018 Live Healthy State Health Assessment covers cross-cutting.  Because the document is 346 pages, we will summarize each section.  Check out our previous posts:  overview of the report, South Carolina demographics, and leading causes of death and hospitalization.  Data is analyzed from 2010-2016.

Cross-cutting analyzes homelessness, income inequality, concentrated disadvantage, crime, incarceration, transportation, safe neighborhoods, and adverse childhood experiences.

Homelessness

Although the rate of homelessness in South Carolina was less than the rate in the United States in 2016, it was higher in 2016 than it was in 2010 (96.5 in 2010 compared to 101.8 in 2016 per 100,000).  More individuals (3,758) were homeless than people in families with children (1,293).

Homelessness in SC

Income Inequality

Income inequality affects health, poverty, crime, violence, and more.  Counties in the Pee Dee region of the state, such as Williamsburg, Geogetown, Marion, and Clarendon, had the highest rates of income inequality.

Concentrated Disadvantage

Concentrated disadvantage is comprised of five United State Census variables:

  1. Percent of individuals below the poverty line
  2. Percent of individuals on public assistance
  3. Percent of female-headed households
  4. Percent of unemployed individuals
  5. Percent of households with individuals less than 18 years of age

These variables may help identify resource-poor areas that have barriers to heath care, education and social services, employment, and healthy foods.  In some counties, more than 50% of the census tracts were determined to have a high level of concentrated disadvantage (from 2011-2015).  The areas of high concentrated disadvantage in South Carolina characteristically are also rural and of low-income, and with a higher proportion of minorities compared to areas of lower concentrated disadvantage.  Some counties with high levels of concentrated disadvantage include:  Lee, , Dillion, Marion, Allendale, and Marlboro.

Crime

Factors such as alcohol and drug use, demographics, social and economic inequality, and the availability of firearms can impact the incidence of crime.  Although there was a decline in violence crime from 2007-2016 in South Carolina, the violent crime rate was higher than the national rate.  Property crime also saw a decrease over the decade, but was still higher than the national rate.

Violent Crime in SC

Incarceration

South Carolina is the 2nd lowest incarcerated state in the Southeastern region with a rate of 414 (per 100,000 population).

In South Carolina:

  • Incarcerated Inmates, by Gender: 93% Men and 7% Women
  • Incarcerated Inmates, by Race: 60% Black and 37% White

Adverse Childhood Experiences

Adverse childhood experiences (ACEs) include three broad categories:

  • Household dysfunction (i.e. violence, substance abuse, mental illness, parental separation)
  • Emotional or physical abuse (i.e. excessive profanity, violence, and/or insults toward a child)
  • Sexual abuse (i.e. a person at least five years old who has ever touched a child in a sexual way, tried to make the child touch their body in a sexual way, or attempted physical intercourse with the child)

More women reportedly suffered from household dysfunction, emotional/physical abuse, and sexual abuse than men.  Non-Hispanic Black adults reported household dysfunction during childhood more than non-Hispanic Whites.  There was no significant difference between non-Hispanic Blacks and non-Hispanic Whites regarding emotional/physical abuse and sexual abuse.

Adervse Childhood Experiences

For more demographics, charts, and graphs about every Cross-Cutting section, view the full report.

South Carolina Health at a Glance: Leading Causes of Death and Hospitalizations

Released in 2018, the assessment analyzes major health statistics to address health concerns and uncover possible outcomes. Because the document is approximately 346 pages, we will summarize key points in upcoming blog posts.  So far we have given an overview of the report and covered South Carolina demographics.

The next installment of the 2018 Live Healthy State Health Assessment summary covers the leading causes of death and hospitalizations for South Carolina residents.

Why is finding this information important?

Monitoring types of hospitalizations provides information about health conditions that affect our state.  Programs can be created and implemented to reduce the prevalence of certain preventable causes of hospitalization.  Leading causes of death describe the health profile of a population, which sets priorities for health policy makers and evaluates the impact of preventive programs.  Lastly, by examining premature mortality rates, resources can be targeted toward strategies that will extend years of life.  Many of the causes of death are considered avoidable or preventable.

Top 5 Causes of Hospitalizations in South Carolina in 2016

  • Circulatory System Disease (which includes heart disease and stroke) – 85,725 people
  • Births and Pregnancy Complications – 57,467 people
  • Digestive System Disease – 47,435 people
  • Respiratory System Disease – 45,201 people
  • Injury and Poisoning – 41,390 people

Leading Causes of Death in South Carolina in 2016

  • Cancer – 10,349 people
  • Heart Disease – 10,183 people
  • Unintentional Injuries – 2,998 people
  • Chronic Lower Respiratory Disease – 2,873 people
  • Stroke – 2,627 people
  • Alzheimer’s Disease – 2,481 people
  • Diabetes Mellitus – 1,369 people
  • Kidney Disease – 902 people
  • Septicemia – 871 people
  • Suicide – 818 people

Potential Life Lost_SC Health Assessment

Premature deaths are described as deaths that occur before a person reaches the expected age of 75 years.  Years of potential life lost (YPLL) is a cumulative measure based on the average years a person would have lived if they had not died prematurely.

For more details about the leading causes of death and hospitalization in South Carolina, view the report.

South Carolina Health at a Glance: 2018 Live Healthy State Health Assessment Report Demographics

The first and award-winning South Carolina State Health Assessment  was released in 2018 as a snapshot of South Carolina’s health indicators, issues, and potential outcomes.  Because the document is pretty lengthy (approximately 346 pages to be exact), we will tackle each section at a glance and summarize the most pertinent information.  Our first blog post introduced general information about the assessment, including contributors, definitions of indicators, issues, and possible outcomes, and why the assessment is important.

What is the demographic makeup of South Carolina?

South Carolina’s population is growing consistently.  The state population has increased from 4.6 million in 2010 to about 5 million in 2017, an increase of 8.6% compared to an overall 5.5% increase in the United States.  In 2016, there were 4,961,119 residents in South Carolina.  The five most populated counties in the state were:

  • Greenville (482,191)
  • Richland (401,743)
  • Charleston (380,673)
  • Horry (300,418)
  • Spartanburg (294,229)

Men made up 48.5% of the population, while women were 51.5%.

Why is South Carolina’s population increasing?

The state’s growth is attributable to three main drivers:

  • People within the country moving to South Carolina (67% increase)
  • More births to South Carolina residents (23% increase)
  • People outside of the United States moving to the state (10% increase)

Another factor can be attributed to the growing elderly community.  The proportion of South Carolinians who are over 65 years old increased from 13.7% in 2010 to 16.7% in 2017.

Race/Ethnicity Makeup of South Carolina

The three largest racial/ethnic groups in South Carolina in 2016 were non-Hispanic Whites (3.1 million), non-Hispanic Blacks (1.3 million) and Hispanic/Latino (272,791).  Of the Hispanic/Latino residents, 55.3% were of Mexican origin, 12% were from Puerto Rico, 5.2% from Guatemala, and 5.0% Honduras.

Marital Status

In 2016, nearly half of South Carolina residents – 15 years old and older, were married (46.2%); 32.7% of residents had never been married; 11.1% were divorced; 7.0% were widowed; and 3.0% were separated.  The median age of first marriage was 29.9 years for men and 28.4 years for women.

Education Factors

From 2002 to 2017, the percentage of South Carolina students who graduated from high school increased from 77.3% in 2002 to 84.6% in 2017.  In 2017, the South Carolina graduation rate was the highest it had been in 17 years.

In nationwide comparison, South Carolina fairs well in educational attainment among adults.  See below.

SC Education_SCHA Report

Income Levels

The median income for individuals varied based on the level of education obtained.  As the level of education increased so did the median earnings.  Individuals with a bachelor’s degree in South Carolina had median earnings of $46,083, compared to $51,676 for the United States.  Median household income for South Carolina in 2016 was $48,501, compared to $57,617 for the United States.

SC Income_SCHA Report

Approximately 735,960 individuals (15.3%) lived below the federal poverty level (FPL).  The 2018 FPL for individuals is $12,140 and for a family of four is $25,100.  More than one-third of South Carolinians lived under 200% of the FPL (35.4%).  This is higher than the percent of United States residents.

Housing

In 2016, 68.6% of homes in South Carolina were owner-occupied, while 31.4% were renter-occupied.  The median rent was $841.  The highest median rent was seen in Beaufort County at $1,170.  Most homeowners paid between $1,000-$1,499 or $500-$999 on monthly owner costs.  Selected monthly owner costs were calculated from the sum of payment for mortgages, real estate taxes, various insurances, utilities, fuels, mobile home costs, and condominium fees.  The median South Carolina homeowner spent $1,182 on selected monthly owner costs.

South Carolina is a diverse and growing population.  For more demographics, including disability status, languages spoken at home, and veteran status, view the full report.