Cancer is one of the leading causes of death in Maine. Through Maine’s statewide population-based cancer surveillance system, cancer incidence and mortality patterns are monitored and evaluated to better understand cancer, identify areas in need of public health interventions, and improve cancer prevention, treatment and control. The State Health Assessment presents data on the most common and preventable types of cancer in Maine, but additional data can be found via the Maine Cancer Registry, and on the Maine Tracking Network. Screening data can be further analyzed on Maine BRFSS website. The US CDC presents data on cancer as well as other chronic diseases through the Chronic Disease Indicators Project.

Cancer 2012 State Health Assessment Summary

Linking the public to health care is one of the ten essential public health services. This includes physical, mental and dental health services. In addition, assuring a competent health care and public health workforce can significantly improve access to health care. While health insurance facilitates access, there are additional measures of access to health care that focus on primary care, preventive care and health professional shortage areas. The Maine CDC's Rural Health and Primary Care monitors additional health care access data.

Access 2012 State Health Assessment Summary

Dental disease, an infectious disease that affects children and adults, may be both the most prevalent yet preventable disease known. Public health approaches to oral health include environmental strategies, such as community water fluoridation, other prevention activities such as school-based/school-linked programs that offer sealants, fluoride rinses and varnishes, and education, along with activities that aim to increase access to dental care, including preventive and restorative care. The Oral Health Program at the Maine CDC coordinates many of these activities. For maps describing - professional and prevention- resources, go to: www.maine.gov/dhhs/mecdc/population-health/odh/maps.shtml. The US CDC also provides extensive information and data on oral health nationally, with some reference to Maine. To view the state oral health improvement plan (2007) and the report of the the Governor’s Task Force on Expanding Access to Oral Health Care for Maine People, as well as other documents, go to: www.maine.gov/dhhs/mecdc/population-health/odh/news.shtml

Oral Health 2012 State Health Assessment Summary

Cardiovascular disease is a leading cause of death and health care costs. The burden of disease is measured by mortality and hospitalizations. Awareness of the risk factors related to stroke and heart disease is a first step towards prevention and health promotion. A major risk factor in cardiovascular disease is obesity. Additional information and data on cardiovascular health is tracked by Maine CDC’s Cardiovascular Health program. The US CDC presents data on cardiovascular health as well as other chronic disease topics through the Chronic Disease Indicators Project. The BRFSS has additional questions that measure health behaviors of those at higher risk for cardiovascular disease. The Maine Tracking Network also provides some additional analysis of myocardial infarctions (heart attacks)

Cardiovascular Disease 2012 State Health Assessment summary

Public health district data is available for 139 indicators and County level data is available for 142 indicators. For more information on our Public Health Districts is available from the Division of Public Health Systems.

The briefs provided here are intended to update the 2010 district comparison tables, and the 2010 “Call the District Action.”

The burden of diabetes on the health of Maine people can be measured by prevalence, hospitalizations, and complications of the disease, such as in the feet and eyes. In addition to the measures included in this State Health Assessment, BRFSS measures completion of a diabetes self- management training program. Other information and data on diabetes is tracked by Maine CDC’s Diabetes program. The US CDC presents data on diabetes as well as other chronic diseases through the Chronic Disease Indicators Project. A major risk factor in diabetes is obesity.

Diabetes 2012 State Health Assessment summary

Increases in overweight and obesity, clearly linked to both physical inactivity and poor nutritional choices, are a major driver of chronic disease in Maine as in other states. Food insecurity is a contributing factor to poor nutrition since access to healthy food choices can be more difficult for those with limited resources. The BRFSS and MIYHS both are key data sources for both the population’s weight status and reports of physical activity and nutritional intake. The US CDC presents data on physical activity, nutrition and weight status, as well as chronic diseases through the Chronic Disease Indicators Project.

Physical Activity and Nutrition 2012 State Health Assessment Summary

Maine adults have a high burden of Asthma compared to the national rate. Chronic lower respiratory disease, which includes asthma and chronic obstructive pulmonary disease (COPD, is a leading cause of death. The Maine CDC’s Asthma Program analyzes additional data on Asthma including statewide and regional prevalence, health care utilization and socio-economic disparities. Link to Maine Asthma Program Data page. The Maine Tracking Network also present some asthma related data

Respiratory Disease 2012 State Health Assessment Summary

The majority of data that describes the population of Maine is from the US Census, which provides State, County and community profiles, other data briefs and detailing tables through the American Fact finder. Data on sexual orientation is from the Maine Behavior Risk factor Surveillance System, as US Census data is based on households, rather than individuals.

Demographics 2012 State Health Assessment Summary

The conditions in which people live can have a significant effect on their health. Indicators under socio-economic status are a small selection of the social determinants of health, along with some of the data presented in the demographic section and other indicators not presented in the State Health Assessment. Healthy People 2020 further discusses social determinants of health.

Socio-Economic Status 2012 State Health Assessment Summary

Most public health measures of emergency preparedness focus on the capacity of the public health and healthcare systems to plan for, respond to, and recover from local or statewide public health emergencies. The State Health Assessment indicators were chosen to reflect the possible burden public health emergencies have on our state, by measuring the responses that actually occur, as well as an assessment of natural, technological and human hazards and our vulnerability to these. The US CDC provides a state-by-state overview of preparedness (pdf).

Emergency Preparedness 2012 State Health Assessment Summary

Work, home, school and play environments affect human health. Environmental health data links environmental hazards with health effects. The State Health Assessment includes a small selection of indicators that demonstrate these linkages. The Maine Tracking Network provides more extensive data on environmental health issues, including data on asthma, birth defects, birth outcomes, cancer, carbon monoxide, lead poisoning, heart attacks, and air and water quality.

Environmental Health 2012 State Health Assessment Summary

Self-reported data on physical and mental health can be analyzed is a variety of ways. While the State Health Assessment presents the average number of days that people were not well, BRFSS provides other methods to analyze this data. Life expectancy, leading causes of death and year of potential life lost are all methods to measure the relative burden of mortality on different populations.

General Health Status and Mortality 2012 State Health Assessment Summary

While most of the State Health Assessment focuses on health status and secondarily on behaviors that promote health, the quality of the health care we provide also impacts our health. The Maine Quality Forum focuses on the data that can drive high quality health care and consumer knowledge in making choices regarding their care. The State Health Assessment focuses on a few indicators that provide a small sample of the status of health care quality in Maine.

Health Care Quality 2012 State Health Assessment Summary

Immunization from infectious disease has led to a major public health accomplishment in the last century. Continued immunization can significantly reduce illness and death from a number of causes. Recommendations for immunizations have expanded from those for children and the elderly to all populations for some diseases. The US CDC tracks childhood immunizations at the state level via the National Immunization Survey and Adult immunizations through the Behavioral Risk Factor Surveillance System.

Immunization 2012 State Health Assessment Summary

Maine has 71 reportable diseases, including diseases that spread via the air and direct contact, via recreational water, via insects and other arthropods, or via animals, via foods. Some of these are vaccine preventable, and others are relatively rare, but still important to track. The State Health Assessment focuses on the more common diseases that cause greater concerns. Maine CDC produces monthly and annual reports of infectious diseases

Infectious Diseases Including STDs 2012 State Health Assessment Summary

Injuries and related morbidity and mortality can be grouped into intentional injury and those injuries caused by actions not intended to cause harm. Leading causes of these injuries in Maine are suicide, motor vehicle crashes, falls, fires and burns, drowning, poisoning and aspirations. For this State Health Assessment, crime is included in this category, even if it does not result in an actual injury. Crime data can be found at Maine Public Safety. BRFSS data is used for intimate partner violence and sexual assault due to the under-reporting of these crimes to law enforcement. The Maine Integrated Youth Health Survey has additional prevention behaviors and measures of both self-harm and inter-personal violence such and physical fighting, harassment and bullying The Maine CDC’s Injury Prevention Program produces additional analyses of both intentional and unintentional Injury The Office of Substance Abuse and Mental Health Services tracks some types of injuries related to substance misuse. Additional data links include the Northern New England Poison Center.

Intentional Injury 2012 State Health Assessment Summary

Injuries and related morbidity and mortality can be grouped into intentional injury and those injuries caused by actions not intended to cause harm. Leading causes of these injuries in Maine are suicide, motor vehicle crashes, falls, fires and burns, drowning, poisoning and aspirations. BRFSS data and the Maine Integrated Youth Health Survey has information on seat belt use. The Maine CDC’s Injury Prevention Program produces additional analyses of both intentional and unintentional Injury The Office of Substance Abuse and Mental Health Services also tracks some types of injuries related to substance misuse. Additional data links include the Northern New England Poison Center and the Maine Transportation Safety Coalition.

Unintentional Injury 2012 State Health Assessment Summary

Every five years, the Maine CDC conducts a comprehensive maternal and child health strengths and needs assessment, focusing on preventive and primary care services for all pregnant women, mothers and infants up to age one; preventive and primary care services for all children; and services for children with special health care needs. Annually, the MECDC reports on federal and state performance measures, health systems and the health status of women, children and children with special health care needs. Measures include a focus on prenatal health, behaviors and care; birth outcomes; teen births and related prevention behaviors, and the prevalence of children with special health needs. PRAMS monitors a variety of prenatal and post natal health behaviors and conditions. The National Data for Children with Special Health Needs in Maine provides additional data for children with special health needs in Maine

Maternal and Child Health 2012 State Health Assessment Summary

While the Office of Substance Abuse and Mental Health Services has primary responsibility within state government for addressing the mental health needs of Maine people, physical and mental health intersect and influence each other. Population-based health measures of mental health come primarily from the BRFSS, including depression and anxiety, the most common, but not necessarily the most severe mental health diagnoses. The Office of Substance Abuse and Mental Health Services collects patient-based data on the severely and persistently mentally ill as well as on adult and child assess to mental health treatment.

Mental Health 2012 State Health Assessment Summary

While the Office of Substance Abuse and Mental Health Services has primary responsibility for substance abuse surveillance, prevention, intervention, treatment, and recovery, there is a clear link between the public’s health and substance abuse issues. There are many partnerships throughout the state that result collaborative work on substance abuse and public health issues. The BRFSS and MIYHS have further data on adult and youth substance use, respectively. The federal agency, SAMHSA, has many substance abuse data sources.

Substance Abuse 2012 State Health Assessment Summary

Smoking and other tobacco use kills more people from the state than alcohol, AIDS, car crashes, illegal drugs, murders and suicides combined. The Tobacco and Substance Use Prevention and Control, a program of the Maine CDC, monitors the use of tobacco and the incidence and prevalence of tobacco-related disease, including those affecting cardiovascular health respiratory health and cancer. The US CDC presents data on tobacco and tobacco-related diseases as well as other chronic diseases through the Chronic Disease Indicators Project.

Tobacco Use 2012 State Health Assessment Summary

Workplace environments and activities have an enormous impact on the working population’s health, given that 45% of Americans spend a third of a 24 hour day at work. Nationally, millions of workers are injured or fall ill every year due to hazards in their workplaces, and thousands die. The indicators in the State Health Assessment focus primarily on injuries, but illness and long-term disabilities are additional health risks that can stem from unhealthy workplace environments. The Council of State and Territorial Epidemiologists provides data for the US and selected states on 20 Occupational Health Indicators: Additional data on work-related health issues are provided by the Maine Department of Labor, and the Federal Bureau of Labor Statistics.

Occupational Health 2012 State Health Assessment Summary