Physical & Mental Health

Persons With Depression In United States

While the health of women and girls in Northeast Florida is benefiting from some trends, by other measures the picture is getting worse. Regardless of comparative standing on health indicators, work remains to be done to provide all women and girls access to quality care and to the information that will encourage them to make better health choices. Organizations with effective programs exist. Enough funding to reach all vulnerable groups remains a challenge.

Florida ranks 32nd (a C-) in the U.S. on the health indicators tracked by the Institute of Women’s Policy Research (IWPR). With only 11 states receiving a grade of A or B, it is clear more work needs to be done to improve women’s health status nationally. Northeast Florida’s results, compared to the state’s results, on the IWPR physical and mental indicators are mixed.

Better than Florida are the local rates of diabetes (except Baker and Clay county) and incidence of chlamydia.
Worse than Florida are female suicide rates that exceed both the state and national rates as a percent of population.

The IWPR indicators tell just part of the health status of women in Northeast Florida. Further assessment points to:

An array of reproductive health issues and needs;
Some critical areas of health behavior such as the incidence of obesity and overweight trending upward and the rates of preventive care such as mammograms and PAP smears particularly low.

The cost of care prevented 23 percent of Florida women from seeing a physician in the past year. Women’s experience in Baker County is worse, in Clay and Duval about the same, and in Nassau and St. Johns better than the state.

Many local governmental and non-profit organizations continue their efforts to tackle the challenges and improve health outcomes but struggle with insufficient funding.

Mental Health

WGA’s 2010-11 research identified the need to address the unique mental health needs of women and girls. Since 2012, WGA has directed its grant-making to improve the capacity and capability of service providers.

At the same time, other community organizations also focused efforts to understand the scope of mental health needs and to implement pilot programs and other strategies to address them.

In 2010 Jacksonville was selected for a $9 million multi-year federal grant to facilitate the transformation of mental health services for youth with serious emotional disturbances into an integrated system of care. The grant has been renewed through 2019.
A Jacksonville Community Council, Inc., (JCCI) community inquiry resulted in a 2014 report, “Unlocking the Pieces: Mental Health in Northeast Florida.” Implementation efforts are underway.
The state of Florida put in place a system of managing entities to streamline and increase efficiency of the dollars directed to care for uninsured adults.

Themes and priorities have emerged from WGA’s grantmaking and expanded community efforts, each of which has significant implications for addressing the mental health needs of women and girls:

Given the central role of trauma in behavioral health disorders, the need for more mental health professionals trained to provide gender-responsive, trauma-informed counseling.
The shortage of psychiatrists.
The need for Advanced Registered Nurse Practitioners to be allowed to independently prescribe medications for behavioral health issues.
The need for increased and easier access to affordable services.
The need for coordination of care for people who are involved in several systems of care (criminal justice, state hospital, crisis services, child welfare).
Recognition that substance abuse and co-occurring disorders require special therapies.
The need for strategies to address the stigma related to mental health.
The need for a plan and resources to influence legislative and policy priorities, particularly as Florida ranks 49th in public funding for mental health.

The increased attention does not mean that the work is done nor is there a comprehensive community approach to address the complex issues surrounding mental illness. However, the first phase of ground-breaking work and changes has resulted in an array of initiatives underway with more to come.

Physical Health

The physical health of women in Northeast Florida shows progress on some measures; on others, more attention on improvement is needed.

Chronic Diseases
- Outcomes reflect significant disparities for African American women who are more likely than women of all other racial and ethnic groups to die from heart disease and breast cancer.
- Mortality rates from heart disease and lung and breast cancer have improved.
- HIV/AIDS has moved from a fatal disease to a chronic one.
- The incidence of diabetes has increased nationally and in Florida. The rates in Baker and Clay counties trend higher than the state.
- Obesity is now classified as a chronic disease. Florida and Northeast Florida, measured as the percent of adults who are obese, fare better than the U.S.
Reproductive Health
- Data reflect significantly worse outcomes among women/girls with low socio-economic status and those without a high school degree.
- Births have declined among mothers ages 12-19. However, Baker and Duval Counties continue to trend above the state rate. Further analysis of teen births in Duval County indicates that one third of teens who gave birth in 2014 live in the 11 local zip codes with the highest poverty rates.
- The infant mortality rate in Northeast Florida compares unfavorably to the state and national data. The biggest issue is the disparity between black and white infants, with a higher incidence of black infant mortality.
- The rate of unplanned pregnancies in Florida is 59 percent. The Guttmacher Institute reports that 50 percent of pregnancies nationally are unplanned or mistimed.
- The occurrence of bacterial STDs in women 15 to 34 years old has steadily increased in the last 20 years. Duval and Baker counties have consistently remained above the state rate.
- Chlamydia rates have remained static or declined in Northeast Florida, contrary to the national trend of an increased incidence rate.
Behavioral Health
- The decline in smoking nationwide is most likely due to the increased awareness of the harms of tobacco and the spread of “no-smoking” policies.
- While Florida’s obesity rate is better than the national rate, when overweight and obesity are combined, the rate is not good and has continued an upward trend.
- Exercise habits in Florida are not tracked, but the number of adult women in Northeast Florida who report being sedentary ranges from a low of 18 percent in St. Johns to a high of 40 percent in Baker.
Preventive Care
- Debate exists about the appropriate age and frequency for some screenings. Still, the local rates are low and need to improve.
  - Mammograms. The incidence of regular screenings among women in Northeast Florida, at 48 to 66 percent, falls well below the national average of 80 percent.
  - Pap Smears. Pap smear compliance in Northeast Florida counties ranges from 51 to 60 percent compared to 80 percent nationally.