Resident Population
Virginia, 1940-2010
9 000 000
8 000 000
7 000 000
6 000 000
5 000 000
4 000 000
3 000 000
2 000 000
1 000 000
0
1940 1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010
Year
Note: Population figures for 1976-1978 do not add to the total because of rounding.
Source: U.S. Census Bureau
Total
White
Non-
White
Black
Other

Average Age at Death
Virginia, 1940-2010
80
75
70
65
Female
White
Age 60
55
50
45
40
1940 1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010
Year
Note: Age at death was not available for year s 1947-1948.
Source: VDH, Division of Health Statistics, April, 2011
Total
Male
Black

Infant Mortality
– The last Sixty
Years

Estimated 3.5 million adults in Virginia have at least one or more chronic health conditions: arthritis, asthma, cancer, coronary heart disease, heart attack, stroke, high blood pressure, high cholesterol or diabetes
1.6 million have more than one type of chronic disease

Cancer Control
Diabetes Prevention and Control
Heart Disease Prevention and Control
Tobacco Use Control
Chronic Disease Self Management
Healthy Communities

Community environment, genetics
Lifestyle, diet, activity
Blood pressure, cholesterol and other risk factor mitigation
Angioplasty
Percutaneous intervention post-
MI,
Improved medical management
Coronary Bypass procedure

45
%
Drop in overall heart attack mortality rates
† between 2000-
2009
Virginia Heart Attacks
^
1,872
Fewer Virginians died from heart attacks in 2009 than 2000
49%
Drop in heart attack mortality rates
† among females between
2000-2009
% disparity between white and black female heart attack rates ‡
22%
2000
1%
2009
^ Myocardial infarctions (MI)
†
Age-adjusted mortality rates / 100,000 population. Population data from U.S. Census Bureau
‡  Unadjusted hospitalization rates / 100,000 population. Population data from U.S. Census Bureau
Data Source: Mortality rate data
– VDH Division of Health Statistics. Hospitalization rate data - Virginia Health Information via the VDH Data Warehouse
Prepared by: Health Informatics & Integrated Surveillance Systems
– Division of Disease Prevention - Office of Epidemiology

Heart Attack
^
Rates
†
Among Virginia Residents by Race, 2000 - 2009
250
200
150
100
50
0
400
350
300
2000 2001 2002 2003 2004 2005
Year of Diagnosis
^ Acute myocardial infarctions, based on ICD-9 code 410.
†
Unadjusted rates of reported Virginia hospitalization data / 100,000 population. Population data from U.S. Census Bureau
Data Source: Hospital inpatient data provided to VDH Data Warehouse via Virginia Health Information.
Prepared by: Health Informatics & Integrated Surveillance Systems staff
– Division of Disease Prevention - Office of Epidemiology
2006
White
2007
Black
2008
Other
2009

Community environment, genetics
Lifestyle, diet, activity
Blood pressure, cholesterol and other risk factor mitigation
Angioplasty
Percutaneous intervention post-
MI,
Improved medical management
Coronary Bypass procedure

Western Tidewater Health District, 2008
20,00%
15,00%
10,00%
5,00%
0,00%
Isle of Wight Couny Franklin City Southampton
County
Individuals Living Below Poverty Level
Suffolk City
Percent Uninsured
Source: http://www.communityhealth.hhs.gov

Western Tidewater Health District
Deaths from Heart Disease age-adjusted rate/100,000
500
300
250
200
150
450
400
350
100
50
0
Isle of Wight Couny
Suffolk City
2004
268,4
215,4
Southampton County 250,2
Franklin City
Virginia
448,5
185,7
2005
184,5
215,3
293
312,8
186,7
2006
211,1
247,3
213,3
263,4
182,2
2007
213,9
231,7
250,3
279,2
181,5
2008
232,2
211,7
228,3
270,9
176,2
HEART DISEASE____
Heart disease death is measured as the age-adjusted rate of deaths per
100,000 people. People at risk are those with high cholesterol and/or high blood pressure, those over the age 65, those who use tobacco and those who are overweight or obese.
In 2008, 319 people died from Diseases of the Heart in Western Tidewater
Health District.
Although there was an average 30%
decrease in the death rate for the localities from 2004 to 2008, their rates were still higher than the State.
Virginia’s death rate in 2008 was 176.2

Western Tidewater Health District
Deaths from Cerebrovascular Disease ageadjusted rate/100,000
140
120
100
80
60
40
20
0
Isle of Wight Couny
Suffolk City
Southampton County
Franklin City
Virginia
2004
39,7
62,7
56,9
23,6
49,3
2005
51,6
44,3
92,1
78,1
48,4
2006
54,6
63,3
78,6
111,7
46
2007
41,7
51,7
60
120,9
42,9
2008
64,1
53
99,4
58,4
42
CEREBROVASCULAR DISEASE_
Since 2004, Western Tidewater deaths due to stroke increased significantly while the Suffolk City and State rate declined.
Cerebrovascular disease deaths, including stroke, are increasing in Isle of Wight, Southampton County and
Franklin! Suffolk has shown a moderate decrease.
Uncontrolled hypertension is a major cause of stroke.
“The real tragedy is that overweight and obesity , and their related chronic diseases, are largely preventable.”
~ Robert Beaglehole

State 15.3
WTHD 18.6

Age-Adjusted Estimates of the
Percentage of
Adults with Diagnosed Diabetes
12
2005 Diabetes Hospital Discharges per 100,000 population
10
8
6
4
2
0
Franklin City
Isle of Wight
Southampton
County
Suffolk City
Virginia
2004
9
7,8
9,2
8,4
7,1
2005
7,5
8,6
9,3
8,2
7,2
2006
10,2
9
9,3
8,9
7,6
2007
8,4
10
10,2
9,7
7,8
450
400
350
300
250
200
150
100
50
0

Western Tidewater Health District
Diabetes Mellitus Deaths, age-adjusted rate/100,000
120
100
80
60
40
20
0
Isle of Wight Couny
Suffolk City
Southampton County
Franklin City
Virginia
2004
33,6
39,2
28,4
82,6
20,8
2005
27,2
55,1
33,9
46,9
20,5
2006
38,2
42,5
39,3
113,3
20,5
2007
46,2
28,5
24
33
19,6
2008
26
40,2
12,9
0
20
In 2006, diabetes mortality rates for contributing cause of death were significantly higher in the Portsmouth
(51.0/100,000) and Western
Tidewater(43.4/100,000)health districts than any other district in the State.*
*Diabetes in Virginia: A Comprehensive Data
Report,2009, pg. 19

35
30
25
20
15
10
Age-Adjusted Estimates of the Percentage of
Adults* Who are Obese
The future looks ominous.
Currently, one of every three children is overweight or obese, and more children than ever in our history have diabetes. Some predict that this pattern will result in a decrease in life expectancy for the first time in our country.
*http://apps.nccd.cdc.gov/
5
0
2004
Franklin City
2005
Isle of Wight
2006 2007
Southampton County
2008
Suffolk City
“It’s bizarre that the produce manager is more important to my children’s health than the pediatrician.”
_ Meryl Streep

As the population ages, the numbers of individuals needing nursing home pre-admission screening will increase.
Majority of screening services used by individuals are those age 65 and older.
2009 estimated, 960,060 Virginians are age 65 and older
(VDH, Division of Health Statistics)

Local health department staff serve as members of the community-based screening teams.
In 2010 10,036 pre-admission nursing home screenings were performed by LHDs in Virginia
(VDH, WV Data).
Western Tidewater Health District performed 365 screenings

Over the past 2 years LHDS have experienced a 41% increase in the number of families with disabled children seeking waiver services through this process.
Western Tidewater conducts an average of 22 preadmission nursing home screens per year on disabled children seeking long term care services.

Established in Virginia in 1984 to offer in-home care in lieu of nursing home placement to Medicaid –eligible individuals (if the in-home care was less expensive than the cost of nursing home placement).
Western Tidewater is one of two districts statewide that still offers this service.

Western Tidewater Health District covers a largely rural area.
The private sector has been unable to meet the total demand for personal care services. WTHD helps to close this gap.

In FY 09, 245 individuals were provided personal care services compared to 200 individuals in FY 10.
Western Tidewater Health District was the direct provider of personal care services to 94% of these individuals.
Public health nurses generate over 3, 000 home visits to these clients every year.

Local health departments conduct various screening tests such as pap smears, and clinical breast exams. We also check for hypertension and diabetes.
The Breast and Cervical Cancer Screening Program supports screening mammography to detect breast cancer in the pre-symptomatic stage. Services are offered at the Western Tidewater Free Clinic

WTHD has a diabetes/chronic disease program to assist patients with evaluation, screening, education, and referral for area residents living with chronic diseases.
This community-based program provide patients with comprehensive care and case management.

Second program in WTHD to assist those with chronic diseases is Medication Assistance Program (MAP) established with Franklin/Southampton Charities.
Assists medically indigent individuals obtain prescription and non-prescription items recommended by their physician that will benefit their health status and is not covered by their insurance coverage.