The Health of
Calumet County
Community Health Assessment
October 2015
1
Community Health Assessment
Purpose:
• To provide an overview of the health of the
community
•
To look for opportunities for improvement
2
The Community Health
Improvement Process
Work Together
Assess Needs &
Resources
Evaluate Actions
Public
Health
Business
Healthcare
Community
Members
Government
Act on
What’s Important
Education
Philanthropy
& Investors
Community
Development
Nonprofits
Focus on
What’s Important
Communicate
Choose Effective
Policies & Programs
© 2014 County Health Rankings and R oadmaps
3
What Makes a Community Healthy?
4
2015 County Health Rankings
•
Annual ranking of counties
•
Measures use comparable valid, reliable countylevel data sets, often incorporating a range of years
•
2015 Calumet County Rank (of 72 WI counties):
#3 for Health Outcomes—Today’s Health
-length and quality of life
#5 for Health Factors—Tomorrow’s Health
-health behaviors, clinical care, social and
economic factors, and physical environment
5
What Makes a Community Healthy?
3
2
23
11
5
14
4
22
6
Community Health
Assessment Data
•
•
Local Surveys:
◦ Behavioral Risk Factor Surveillance Survey (BRFSS)
◦ Youth Risk Behavior Survey (YRBS)
Other Sources:
◦ US Census Bureau and other federal datasets
◦ Wisconsin Interactive Statistics for Health (WISH)
◦ Wisconsin Department of Health Services
7
Calumet County Survey Methodology
Adults: BRFSS
505 telephone interviews - cell phones and landlines;
randomly selected adults ≥ 18 years of age
Youth: YRBS
1,010 on-line surveys – response rate of 85% of 9th-12th
graders in all five local high schools
8
Demographics: Who Are We?
Age
(2013 data)
•
Percent of population below 18
Calumet County: 25.7%
Wisconsin: 22.8%
•
Percent of population aged 65 and older
Calumet County: 12.9%
Wisconsin: 14.8%
Source: County Health Rankings/US Census
9
Demographics: Who Are We?
Ethnicity and Language
•
Hispanic Ethnicity (2013 data)
Calumet County: 3.8%
Wisconsin: 6.3 %
•
English proficiency—percentage not proficient in
English (2009-2013 data)
Calumet County: 1.5%
Wisconsin: 1.6%
Source: County Health Rankings/US Census
10
Demographics: Geography
Percent of population living in rural area
(2010 data)
Calumet County: 27.5%
Wisconsin: 29.8%
Source: County Health Rankings/US Census
11
Health Outcomes
Mortality: Length of Life
Morbidity: Quality of Life
12
Mortality: Length of Life
Premature Death
Years of potential life lost before age 75
per 100,000 population
(age-adjusted 2010-2012 data)
Calumet County: 3837
Wisconsin: 5881
Source: County Health Rankings/National Vital Statistics System
13
Mortality: Length of Life
Infant Mortality Rate
Infant Mortality Rate per 1000 Live Births
(2009-2013)
Calumet County: 3.5
Tri-County Region: 5.1
(Calumet, Outagamie, Winnebago)
Wisconsin: 6.0
Source: WI Department of Health Services WISH
14
Morbidity: Quality of Life
•
Mental Health
•
Chronic Disease
•
Injury and Violence
15
Mental Health
16
BRFSS Quality of Life: Mental Health
“Now thinking about your mental health, which includes stress, depression, and problems with
emotions, for how many days during the past 30 days was your mental health not good?”
0 days
1-2 days
3 or more days
100%
60%
66%
65%
62%
50%
25%
9%
25%
24%
11%
9%
10%
10%
20%
21%
30%
27%
40%
14%
Percent Response
70%
60%
80%
69%
90%
0%
2015 BRFSS Calumet
*2007 AND 2003 NOT ASKED LOCALLY.
2011 BRFSS Calumet
2015 Tri-County Area
2014 CDC BRFSS Wisconsin
2014 CDC BRFSS
Nationwide 17
BRFSS Quality of Life: Mental Health—Depression
“Have you ever been told by a doctor, nurse, or other health professional you have a
depressive disorder, including depression, major depression, dysthymia, or minor
depression?” More females (28%) than males (10%) were told they had a depressive
disorder
Yes
No
70%
60%
50%
18%
20%
17%
30%
22%
40%
19%
Percent Response
80%
82%
78%
81%
90%
83%
100%
10%
0%
2015 BRFSS Calumet
2015 Tri-County Area
2014 CDC BRFSS Wisconsin
2014 CDC BRFSS Nationwide
18
2015 YRBS—Mental Health and
Attempted Suicide in Past 12 Months
**2015 data statistically different from 2014 data at p≤0.05
19
BRFSS Quality of Life: Health Effects
“During the past 30 days, for about how many days did poor physical or mental health keep you
from doing your usual activities, such as self-care, work, or recreation?”
0 days
1-2 days
3 or more days
100%
90%
58%
61%
56%
60%
59%
2011 BRFSS Calumet
2015 Tri-County Area
29%
11%
13%
2015 BRFSS Calumet
11%
13%
24%
14%
30%
20%
32%
40%
31%
50%
26%
Percent Response
70%
61%
80%
10%
0%
*2007 AND 2003 NOT ASKED LOCALLY.
2014 CDC BRFSS Wisconsin
2014 CDC BRFSS
Nationwide 20
Chronic Disease
21
BRFSS Chronic Disease: Hypertension
“Have you ever been told by a doctor, nurse or other
health professional that you have high blood pressure?”
Yes
No
100%
72%
74%
73%
72%
80%
80%
90%
60%
20%
28%
19%
30%
26%
40%
27%
50%
28%
Percent Response
70%
10%
0%
2015 BRFSS Calumet
2011 BRFSS Calumet
2007 BRFSS Calumet
2003 BRFSS Calumet
2015 Tri-County Area
22
*IN 2011, 2007, AND 2003 “YES, FEMALE DURING PREGNANCY” AND “NO BOARDERLINE” WERE NOT REPORTED.
*NO 2014 STATE OR NATIONAL DATA.
BRFSS Chronic Disease: High Cholesterol
“Have you ever been told by a doctor or other health professional
that your blood cholesterol is high?”
Yes
No
83%
100%
76%
90%
68%
60%
33%
24%
40%
33%
50%
31%
Percent Response
70%
66%
66%
80%
16%
30%
20%
10%
0%
2015 BRFSS Calumet
2011 BRFSS Calumet
2007 BRFSS Calumet
2003 BRFSS Calumet
2015 Tri-County Area
23
*2015 RESPONDENTS SHOWED A HIGHER DEGREE OF NOT SURE (3%) COMPARED TO OTHER YEARS.
*NO 2014 STATE OR NATIONAL DATA.
Chronic Disease: All Cancers
Incidence per 100,000 population
(age-adjusted, 2007-2011 data)
Calumet County: 480
Wisconsin: 471
Source: WI Department of Health Services WISH
24
Chronic Disease: Cancer--Melanoma
Rate of cases per 100,000 population
(2015 Calumet County Environmental Health Profile:
annual averaged age-adjusted 2006-2010 data)
Calumet County: 29.6
Wisconsin: 18.4
Source: WI Department of Health Services
25
BRFSS Chronic Disease: Diabetes
“Have you ever been told by a doctor that you have diabetes?”
87%
89%
90%
No, pre-diabetes or borderline
89%
87%
89%
100%
No
95%
Yes, female during pregnancy
94%
Yes
80%
60%
50%
40%
30%
2015 BRFSS
Calumet
2011 BRFSS
Calumet
2007 BRFSS
Calumet
2003 BRFSS
Calumet
2015 Tri-County
Area
2014 CDC BRFSS
Wisconsin
2%
1%
11%
1%
1%
9%
3%
1%
8%
1%
5%
0%
0%
0%
0%
6%
3%
1%
8%
10%
5%
20%
7%
2%
Percent Response
70%
2014 CDC BRFSS
Nationwide 26
BRFSS Chronic Disease: Diabetes
“How old were you when you were told you have diabetes?”
10-17
18-24
25-34
35-44
45-54
55-64
65 and over
100%
90%
80%
60%
50%
0%
2015 BRFSS Calumet
*NO LOCAL COMPARISON FOR 2007.
2015 Tri-County Area
2014 CDC BRFSS Wisconsin
14%
27%
24%
2%
3%
10%
18%
26%
24%
17%
17%
5%
4%
5%
7%
9%
17%
23%
25%
18%
27%
20%
17%
2011 BRFSS Calumet
1%
6%
0%
10%
8%
20%
6%
4%
11%
10%
13%
30%
24%
25%
40%
25%
Percent Response
70%
2014 CDC BRFSS
Nationwide
27
BRFSS Chronic Disease: Asthma
“Have you ever been told by a doctor, nurse, or other
health professional that you have asthma?”
87%
87%
90%
83%
85%
90%
100%
No
91%
Yes
80%
Percent Response
70%
60%
50%
40%
14%
13%
17%
9%
10%
10%
20%
15%
30%
0%
2015 BRFSS Calumet
*NO LOCAL COMPARISON FOR 2007.
2011 BRFSS Calumet
2003 BRFSS Calumet
2015 Tri-County Area
2014 CDC BRFSS
Wisconsin
2014 CDC BRFSS
Nationwide
28
Injury & Violence
29
2015 YRBS—Injury and Violence:
Traffic Safety
30
2015 YRBS—Injury and Violence:
Violence-Related Behaviors in Past 12 Months
31
2015 YRBS—Injury and Violence
Violence-Related Behaviors on School Property
**2015 data statistically different from 2014 data at p≤0.05
32
Selected Health Factors
•
•
•
•
Health Behaviors
Alcohol and Drug Use
Physical Activity and Nutrition
Health Care and Public Health
Access to Care
Social and Economic Factors
Education
Adequate Income
Social Support
Physical Environment
Natural Environment
33
Alcohol & Drug Use
34
BRFSS Alcohol:
Consumption and Binge Drinking
Alcohol Consumption and Binge Drinking
Current
Alcohol
Use
Males,
Alcohol
Use
Females,
Alcohol
Use
Females,
Alcohol
Use
all adults,
age ≥18
age ≥18
age ≥18
childbearing
age, 18-44
Current Binge
Drinking
(5 or more
drinks on an
occasion)
age ≥18
Males,
Binge
Drinking
Females,
Binge
Drinking
Females,
Binge
Drinking
age ≥18
age ≥18
childbearing
age,18-44
Fox Cities
71%
75%
66%
73%
35%
43%
25%
35%
Calumet
County
Outagamie
County
Winnebago
County
Tri-County
72%
81%
63%
64%
42%
56%
23%
25%
75%
78%
73%
80%
33%
47%
19%
18%
60%
61%
59%
56%
29%
37%
20%
47%
69%
71%
66%
72%
33%
43%
22%
25%
Wisconsin
65%
70%
57%
58%
35%
42%
27%
36%
35
BRFSS Alcohol - 5 or More Drinks
“Considering all types of alcoholic beverages, how many times during
the past 30 days did you have 5 or more drinks on an occasion?” 47% of respondents
age 18-24 reported drinking 5 or more drinks 2 to 4 times in the past 30 days.
100%
1
2-4
5 or more
0
45%
60%
65%
60%
58%
50%
11%
12%
7%
14%
13%
9%
13%
12%
8%
6%
11%
10%
14%
20%
12%
17%
13%
30%
17%
20%
18%
40%
13%
19%
8%
Percent Response
70%
67%
69%
80%
69%
90%
0%
2015 BRFSS
Calumet
2011 BRFSS
Calumet
* ONLY THOSE WHO HAVE DRANK WITHIN THE PAST 30 DAYS.
2007 BRFSS
Calumet
2003 BRFSS
Calumet
2015 Tri-County
Area
2014 CDC BRFSS
Wisconsin
2014 CDC BRFSS
Nationwide 36
BRFSS Alcohol: Screening
“At your last routine checkup, were you advised to reduce or quit drinking?”
90%
93%
100%
No
94%
97%
Yes
90%
80%
60%
50%
40%
7%
10%
6%
20%
10%
30%
3%
Percent Response
70%
0%
2015 BRFSS Calumet
2015 Tri-County Area
2014 CDC BRFSS Wisconsin
2014 CDC BRFSS Nationwide
37
BRFSS Alcohol: Drinking and Driving
“During the past 30 days, how many times have you driven
when you’ve had perhaps too much to drink?”
Never
97%
*1 or more
96%
5 or more
95%
4
96%
3
95%
100%
2
94%
94%
1 time
90%
Percent Response
80%
70%
60%
50%
40%
30%
*2011, 2007, AND 2003 ONLY INCLUDED CATEGORIES “1 OR MORE” AND “NEVER.”
4%
5%
2007 BRFSS
Calumet
2003 BRFSS
Calumet
2%
1%
0%
0%
0%
2011 BRFSS
Calumet
2%
1%
1%
0%
0%
2015 BRFSS
Calumet
2%
1%
1%
0%
1%
0%
6%
10%
3%
1%
1%
0%
1%
20%
2015 Tri-County
Area
2014 CDC BRFSS
Wisconsin
2014 CDC BRFSS
Nationwide 38
2015 YRBS—Alcohol Use
**2015 data statistically different from 2014 data at p≤0.05
39
2015 YRBS—Perceptions of Alcohol Use
**2015 data statistically different from 2014 data at p≤0.05
40
2015 YRBS—Marijuana Use
41
2015 YRBS—Perceptions of Marijuana Use
**2015 data statistically different from 2014 data at p≤0.05
42
2015 YRBS—Misuse of Prescription Medication
(Without Doctor’s Prescription)
**2015 data statistically different from 2014 data at p≤0.05
43
2015 YRBS—Perceptions of Misuse of
Prescription Medication
**2015 data statistically different from 2014 data at p≤0.05
44
2015 YRBS
AVERAGE AGE OF FIRST SUBSTANCE USE
45
Tobacco Use
46
BRFSS Tobacco Use: Current Smoking
“Do you now smoke cigarettes every day, some days or not at all?”
Every day
Some days
Not at all
86%
100%
58%
60%
13%
1%
9%
10%
24%
22%
6%
10%
8%
20%
10%
30%
29%
40%
29%
50%
19%
Percent Response
70%
60%
67%
72%
80%
76%
90%
0%
2015 BRFSS Calumet
2011 BRFSS Calumet
2007 BRFSS Calumet 2015 Tri-County Area
2014 CDC BRFSS
Wisconsin
*2015 LOCAL DATA AND 2014 STATE AND NATIONAL DATA IS BASED ONLY ON THOSE WHO HAVE SMOKED “100 CIGARETTES IN LIFETIME.”
*2011-2007 INCLUDE ALL RESPONDENTS; “100 CIGARETTE” QUESTION NOT ASKED.
2014 CDC BRFSS
Nationwide
47
BRFSS Tobacco Use: Smokeless Tobacco
“Do you currently use chewing tobacco, snuff, or snus
every day, some days, or not at all?”
96%
97%
Not at all
97%
98%
100%
Some days
99%
Every day
90%
Percent Response
80%
70%
60%
50%
40%
30%
2015 BRFSS Calumet
*NO LOCAL COMPARISON FOR 2007.
2011 BRFSS Calumet
2015 Tri-County Area
2014 CDC BRFSS Wisconsin
2%
2%
2%
2%
1%
2%
0%
0%
1%
1%
10%
1%
20%
2014 CDC BRFSS
Nationwide
48
BRFSS E-Cigarette Use
100%
Every day
Some days
Not at all
95%
96%
“Do you currently use electronic cigarettes (e-cigarettes, NJOY, Bluetip) every day,
some days, or not at all?” Respondents ages 18-24 had the highest rates of e-cig use;
“some days” 18% and “every day” 10%.
90%
Percent Response
80%
70%
60%
50%
40%
30%
3%
2%
2%
10%
2%
20%
0%
2015 BRFSS Calumet
*NO 2014 STATE OR NATIONAL DATA.
2015 Tri-County Area
49
2015 YRBS—Tobacco and E-Cigarette Use
50
2015 YRBS—Perceptions of Tobacco Use
**2015 data statistically different from 2014 data at p≤0.05
51
Physical Activity &
Nutrition
52
BRFSS Physical Activity & Nutrition: BMI
100%
BMI is calculated as {weight in pounds/(height in inches)(height in inches)} X 703
Respondents age 65 and over were most likely to be obese (40%) and those 25-34 were
the most likely to be overweight (49%).
Neither overweight or obese
Overweight
Obese
90%
80%
37%
33%
31%
33%
36%
31%
36%
35%
29%
2015 Tri-County
Area
2014 CDC BRFSS
Wisconsin
2014 CDC BRFSS
Nationwide
21%
37%
33%
30%
26%
30%
37%
37%
40%
38%
33%
50%
42%
37%
60%
29%
Percent Response
70%
20%
10%
0%
2015 BRFSS
Calumet
2011 BRFSS
Calumet
2007 BRFSS
Calumet
2003 BRFSS
Calumet
53
2015 YRBS—Physical Health and Exercise
**2015 data statistically different from 2014 data at p≤0.05
54
BRFSS Physical Activity & Nutrition: Exercise
“During the past month, other than your regular job, did you participate in any physical activities
or exercises such as running, calisthenics, golf, gardening, or walking for exercise?”
Yes
No
76%
75%
75%
80%
78%
90%
79%
83%
100%
60%
50%
20%
24%
21%
25%
17%
30%
25%
40%
22%
Percent Response
70%
10%
0%
2015 BRFSS Calumet 2011 BRFSS Calumet 2003 BRFSS Calumet 2015 Tri-County Area
*NO LOCAL COMPARISON FOR 2007.
2014 CDC BRFSS
Wisconsin
2014 CDC BRFSS
Nationwide
55
Physical Activity & Nutrition:
Access to Exercise Opportunities
Percent of the population with adequate
access to locations for physical activity
(2010 & 2013 data)
Calumet County: 65%
Wisconsin: 83%
Source: County Health Rankings/OneSource Global Business Browser
56
BRFSS Physical Activity & Nutrition: Fruits
“On an average day, not counting juice, how many servings of fruit do you eat?”
One
Two
Three
Four
Five or More
Not at all
100%
90%
80%
60%
6%
6%
3%
6%
3%
8%
17%
20%
33%
33%
29%
34%
7%
6%
12%
13%
6%
3%
8%
10%
6%
2%
10%
20%
15%
30%
13%
33%
29%
40%
35%
34%
50%
32%
35%
Percent Response
70%
0%
2015 BRFSS Calumet
2011 BRFSS Calumet
2007 BRFSS Calumet
2003 BRFSS Calumet
2015 Tri-County Area
57
*2007 AND 2003 INCLUDED 6 OUNCES OF FRUIT JUICE. ONE SERVING IS ½ CUP OF CANNED OR COOKED FRUIT, 1 MEDIUM PIECE OF FRUIT, OR ¼ CUP OF DRIED FRUIT.
* NO 2014 STATE OR NATIONAL DATA.
BRFSS Physical Activity & Nutrition: Vegetables
“On an average day, how many servings of vegetables do you eat? The highest
percentage in the “5 or more” category was for respondents with an annual household
income of <$10,000 (17%), while 17% making $25,001-$35,000 reported “not at all.”
100%
90%
One
Two
Three
Four
Five or More
Not at all
80%
60%
6%
8%
6%
7%
4%
3%
16%
18%
31%
31%
33%
36%
4%
2%
8%
13%
8%
6%
2%
6%
5%
6%
10%
14%
20%
18%
30%
30%
30%
34%
40%
42%
50%
34%
36%
Percent Response
70%
0%
2015 BRFSS Calumet
2011 BRFSS Calumet
2007 BRFSS Calumet
2003 BRFSS Calumet
2015 Tri-County Area
58
*2007 AND 2003 INCLUDED 6 OUNCES OF VEGETABLE JUICE. ONE SERVINS IS A ½ CUP OF COOKED OR RAW VEGETABLES, 1 CUP OF LEAFY GREENS.
*NO 2014 STATE OR NATIONAL DATA.
2015 YRBS—Healthy Eating and School Habits
1
Fruit and vegetable consumption time frame changed from “yesterday” to “past seven days”
**2015 data statistically different from 2014 data at p≤0.05
59
Physical Activity & Nutrition: Breastfeeding
.
Source: Wisconsin WIC Program
60
Access to Care
61
BRFSS Access to Care: Health Insurance
“What is the primary source of your health care coverage? Is it…”
A plan purchased through an employer or union
Medicare
TRICARE, VA, or Military
Some other source
A plan that you or another family members buys on your own
Medicaid or other state program
Alaska Native, Indian Health Service, Tribal Health Services
None
100%
90%
60%
54%
56%
55%
70%
66%
50%
40%
2015 BRFSS Calumet
2015 Tri-County Area
2014 CDC BRFSS Wisconsin
3%
0%
3%
1%
9%
20%
11%
12%
17%
7%
3%
0%
4%
0%
0%
6%
4%
0%
1%
3%
10%
4%
2%
0%
0%
1%
20%
13%
17%
30%
10%
17%
Percent Response
80%
2014 CDC BRFSS Nationwide
62
Education
63
Education: High School Graduation
Percent of 9th grade cohort that graduates
in four years
(2011-2012 data)
Calumet County: 94%
Wisconsin: 88%
Source: County Health Rankings/WI Department of Public Instruction
64
Education: Completed Some College
Percent of adults age 25-44 with some college
or associate’s degree
(2009-2013 data)
Calumet County: 68.7%
Wisconsin: 65.9%
Source: County Health Rankings/US Census
65
Adequate Income
66
Adequate Income:
Median Household Income
Median household income
for all residents of a household over age 18
(2015 data)
Calumet County: $66,657
Wisconsin: $51,474
Source: County Health Rankings/US Census
67
Adequate Income: Children in Poverty
Percent of children under 18
living below the Federal Poverty Line
(2013 data)
Calumet County: 8%
Wisconsin: 18%
Source: County Health Rankings/US Census
68
Adequate Income: Food Insecurity
Percent of people who did not have adequate
access to food during the past year
(2015 data)
Calumet County: 8%
Wisconsin: 13%
Source: County Health Rankings/Feeding America
69
Social Support
70
BRFSS Social Support: Frequency
“How often do you get the social and emotional support you need?”
Always
Usually
Sometimes
Rarely
Never
100%
90%
80%
57%
3%
2%
9%
29%
5%
2%
4%
12%
10%
5%
2%
10%
9%
20%
3%
30%
25%
40%
31%
35%
50%
49%
50%
60%
55%
Percent Response
70%
0%
2015 BRFSS Calumet
2011 BRFSS Calumet
2015 Tri-County Area
2014 CDC BRFSS Nationwide
71
*2015 RESPONDENTS SHOWED A HIGHER DEGREE OF NOT SURE (4%).
*NO 2014 STATE DATA.
Social Support:
Single-Parent Households
Percent of children that live in a household
headed by a single parent
(2009-2013 data)
Calumet County: 21%
Wisconsin: 31%
Source: County Health Rankings/US Census/American Communities Survey
72
BRFSS Social Support: Family Mealtime
“During the past week, how many times did all, or most, of your family living in your household
eat a meal together?”
More respondents without children under the age of 18 years old living with them (53%) reported
eating with family members more than 7 ti
100%
90%
Never
1-2 times
3-4 times
5-6 times
7 times
More than 7 times
Live alone
80%
60%
50%
40%
33%
37%
Percent Response
70%
17%
15%
13%
7%
4%
11%
14%
13%
7%
6%
10%
12%
20%
11%
30%
0%
2015 BRFSS Calumet
*NO 2014 STATE OR NATIONAL DATA.
2015 Tri-County Area
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Healthiest Calumet County
Community Health Improvement Priorities
•
Physical Activity and Nutrition
•
Alcohol and Other Drug Use
•
Mental Health (incorporated into the above priorities)
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Natural Environment
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Natural Environment: Air Quality
Ground Level Ozone
Annual number of days above standard
(2015 Calumet County Environmental Health Profile: 2011 data)
Calumet County: 2.0
Wisconsin: 0.7
Source: WI Department of Health Services
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Natural Environment: Air Quality
Particulate Matter (PM 2.5)
Annual average
(2015 Calumet County Environmental Health Profile: 2011 data)
Calumet County: 10.6
Wisconsin: 9.4
Source: WI Department of Health Services
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Healthiest Calumet County
Community Health Improvement Initiative
Healthiest Calumet County Steering Committee
U-CAN—Physical activity and nutrition
REACH—Alcohol and other drug use
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Links of Interest
Calumet County Health Rankings Snapshot
http://www.countyhealthrankings.org/app/wisconsin/2015/rankings/
calumet/county/outcomes/overall/snapshot
Calumet County Environmental Health Profile
https://www.dhs.wisconsin.gov/publications/p0/p00719-calumet.pdf
Thank You!
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