Cancer Screening, Chronic Disease, And Perceptions Of Health In Central .

CO M M U N I T Y H E A LT H R E P ORTCancer Screening, Chronic Disease, and Perceptions of Health inCentral FallsA B O U T T H I S R E P ORTThis report is based on two door-to-door surveys completed in Central Falls in 2011. Residentswere asked about their health, their health behaviors, specific diseases they may have had, andhow their neighborhoods supported healthy living. This report focuses on three specific healthissues – cancer screening, chronic disease, and self-perceptions of mental and physical health.A full summary report for the surveys conducted in Central Falls can be found sessmentsCommunity-based organizations and the Rhode Island Department of Health (HEALTH) can usethese data to design programs and services and seek funding. With this report, policymakers andadvocates in Central Falls can advocate for changes based on clearer understandings of the issuesin their neighborhood.

W H O W E TA L K E D T OIn-person interviews were conducted with 311 randomly-selected individuals who were 18 yearsof age and older. These findings represent about 3,876 adults living in a 40-block section ofCentral Falls. L AN GUAGE: 50% of adults preferred to be interviewed in Spanish. G ENDER : 46% of adults were male, and 54% were female. R ACE/ET HNIC IT Y: 67% of adults were Hispanic. 5% were Black, 20% were White,and 8% identified with another race. A GE: 58% of adults were 18-44 years old. 42% were 45 years or older. I N CO ME: 43% of adults had a household income of less than 25,000 per year.23% made between 25,000 and 49,999 per year, and 13% made 50,000 or moreper year. The household income of 21% of the population was unknown. E MPLOYMENT: 50% of adults were employed, and 50% were not employed. E D U CAT ION: 39% of adults had less than a high school education, and 35% hadfinished high school only. 25% had completed some college or were collegegraduates. The education level of 1% of thepopulation was unknown.The results of the Central Falls surveys werecompared to the results of the 2010 Behavioral Risk Factor Surveillance System(BRFSS), the survey that is used to collecthealth-related information at the national,state, and county levels. Comparison datafor Providence County and statewide areshown when statistically significantdifferences existed between CentralFalls and these populations.

CA N C ER SC R E E N I N GCancer is the second leading cause of death in Rhode Island, after heartdisease (Rhode Island Department of Health, 2011). People with lowerincome, less education, or no health insurance are less likely to getscreened for cancer and more likely to have cancer (U.S. Department ofHealth and Human Services, 2013).CA N CER SCREENING B ASIC SFor some forms of cancer, screening can safely find cancer and reduce the number of peoplewho die from the disease. All types of cancer screenings have benefits and limitations. When thebenefits are greater than the potential for harm, doctors will recommend that people get screened(U.S. Preventive Services Task Force, 2013). Currently, the following screenings below arerecommended: Women 50 through 74 years old get screened for breast cancer- Mammogram every two years Women 21 through 65 years old get screened for cervical cancer- Pap smear every three years- For women ages 30-65, screening with a combination of cytology and human papillomavirus (HPV) testing every 5 years) Adults 50 through 75 years old get screened for colorectal cancer- Fecal occult blood testing, flexible sigmoidoscopy, or colonoscopyCA N CER PREVENT ION B ASIC SCertain measures can be taken to help prevent cancer. Get screened for cancer as recommended by your healthcare provider Get vaccinated against hepatitis B (to reduce the risk for liver cancer) Get vaccinated against human papillomavirus (HPV) (to reduce the risk of cervical, vaginal,anal, and head/neck cancers) Do not use tobacco products and avoid second-hand smoke Eat a diet rich in fruits and vegetables Get at least 150 minutes of physical activity per week Avoid excessive exposure to ultraviolet rays from the sun and tanning beds Practice safer sex (use condoms) Get your home checked for radon and lead Limit alcohol consumptionCA N CER D ATAKey finding: Central Falls has a lower percentage of adults with a history of cancer (5.1%) thanRhode Island (10.7%). In Central Falls, less than 9 percent of the population is 65 years or older,compared to the statewide average of 14 percent, which could contribute to the lower rate, sinceolder populations are more likely to suffer from cancer (2010 Census).

A D ULTS W ITH A HIST ORY OF C ANC E R10.7%Rhode Island5.1%Central FallsCAN CER SCREENINGBREAST CANCER SCREENING AMONG WOMEN AGES 50 TO 74Ever had a mammogramPERCENT99.5%- of those who ever had a mammogram, percentage who had a mammogram in the past two years72.6%CERVICAL CANCER SCREENING AMONG WOMEN AGES 21 TO 65Ever screened for cervical cancer91.7%-o f those who have ever been screened for cervical cancer, percentage who have been screenedin the past three years85.8%COLORECTAL CANCER SCREENING AMONG ADULTS AGES 50 THROUGH 75Had some form of colorectal cancer screeningEver had a blood stool testEver had a colonoscopy or sigmoidoscopy71.3%36.7%63.0%

CHR O N I C D I S E A S EChronic diseases are long-lasting health problems that cannot be cured and require ongoing care(Rhode Island Department of Health). In Rhode Island, two chronic diseases, heart disease andstroke, cause more deaths among men and women than any other, among all racial and ethnicgroups. Another chronic disease, diabetes, is the eighth leading cause of death in the state (RhodeIsland Department of Health).PREV ENTION B ASIC SAdults can reduce their risk for chronic disease by choosing healthy behaviors. Eating an unhealthy diet, not getting enough exercise, and using tobacco cause most chronic diseases for bothmen and women (Centers for Disease Control and Prevention, 2011). Overweight and obesity canalso increase risk for chronic disease (World Health Organization, 2011).M ANA GEMENT B ASIC SChronic diseases can usually be controlled once they are diagnosed (Rhode Island Department ofHealth). For patients with high blood pressure, eating a healthier diet, reducing the amount of salt eaten,exercising more, having a healthy weight, drinking less alcohol, quitting smoking, and taking yourmedication (if prescribed) can help reduce blood pressure. To manage cholesterol, a healthy diet, healthy weight, and exercise can also help control the condition. For some patients, doctors prescribe medication to keep cholesterol under control. To help prevent heart disease, doctors may suggest taking aspirin for some patients.CH RO NIC D IS EASE DATAKey findings:- A higher proportion of adults living in Central Falls did not participate in physical activity orexercise in the past 30 days than adults living in Providence County or Rhode Island.- A lower proportion of adults living in Central Falls have been tested for high cholesterol thanadults living in Providence County or Rhode Island.- Central Falls has a higher proportion of adults who have been diagnosed with diabetes thanRhode Island.A D ULTS DIA GNOSED WIT H DIAB E T E S7%Rhode Island14.6%Central Falls

Rhode IslandRhode IslandCentral FallsCentral FallsA D ULTS W HO DID NOT PARTIC IPAT E I NPH YSICAL A CTIVIT Y OR EXER C ISE I NT H E PAST 30 DAYSA D ULT S T E S T E D F O R HI G H C HO L E S T E R O LRhode IslandRhode IslandRhode IslandRhode IslandProvidence County24.9% 24.9%Providence CountyProvidence CountyProvidence County85.8% 85.8%Central FallsCentral FallsCentral FallsCentral Falls86.8% 86.8%27.1% 27.1%73.1% 73.1%41.8% 41.8%0%20%40% 20%60% 40%80% 60%100% 80%0%100%0%20%40% 20%60% 40%80% 60%100% 80%0%100%CH RO NIC D IS EASEHEALTH BEHAVIORSDo not smokeGets recommended minimum amounts ofphysical activityParticipated in physical activity or exercise inpast monthIs not overweight or obeseEats recommended five servings of fruits andvegetables per day80.8%48.0%SCREENINGAdults tested for high cholesterolAdults tested for diabetes in past three years73.1%59.4%CHRONIC DISEASEPREVALENCEAdults diagnosed with diabetesAdults with high blood pressureAdults with high cholesterolAdults who have heart disease or have had a stroke14.6%34.8%37.2%10.6%HIGH BLOOD PRESSUREMANAGEMENTTaking medication for high blood pressureChanging eating habits to help lower or controlhigh blood pressureReduce salt intakeReduce alcohol useExercising to reduce or control high blood pressure71.7%76.5%HIGH CHOLESTEROLMANAGEMENTTaking medication for high cholesterol61.9%HEART DISEASEMANAGEMENTTake aspirin daily or every other day if safe to do so26.4%58.2%31.5%25.1%81.5%29.6%56.6%

PE R C EPTI O N S O F M E N TA L AND P HYS I CAL HE ALT HEmotional well-being and mental health play important roles in the physical health of RhodeIslanders. Stress, depression, and anxiety can manifest themselves as physical conditions suchas digestive disorders, sleep disturbances, and lack of energy (Harvard Medical School). Whenpeople feel well physically, mentally, and socially, they are considered to be healthy. For peopleto have productive lives with fulfilling relationships, mental health is just as important asphysical health (U.S. Department of Health and Human Services, 2013).Factors that can affect mental health: (Chronic) stress Traumatic events (such as exposure toviolence) Substance abuse Unemployment Poverty Low education Difficult working conditions Discrimination Unhealthy lifestyleS E L F -R AT E D HE A LT H S TAT USA M O N G A D ULT SRhode Island85.8%Providence County86.8%73.1%Central Falls0%20%40%60%80%100%Good/Better Health(Cutrona, Wallace, Wesner, 2006; Druss, Walker, 2011; World Health Organization, 2013)PERCEPTIONS OF HEALT HGENERAL HEALTH RATINGAdults with good or better health70.1%DAYS PHYSICAL HEALTH NOT GOODNoneLess than two weeksTwo weeks or more64.9%21.1%14.1%DAYS MENTAL HEALTH NOT GOODNoneLess than two weeksTwo weeks or more71.3%20.1%8.6%DAYS NORMAL ACTIVITIES LIMITEDDUE TO POOR PHYSICAL OR POORMENTAL HEALTHNoneLess than two weeksTwo weeks or more56.3%30.2%13.5%IN PAST 30 DAYS