Tobacco Prevention and Control Coalition

Narrative-Form Needs Assessment Outline

FY2014

Coalition Name: Wichita TPCC

Submission Date: July 15, 2014

Part I – Geographic / Target Population and Coalition Overview

  1. Provide an overview of the target area, including geographic boundaries, zip codes, counties, etc.

Wichita County is described as an urban community with a population of 130,835; with a total area of 606 square miles, the county is comprised of the cities of Burkburnett, Electra, Iowa Park and Wichita Falls, which is the county seat. Wichita Falls is the principle city of the Wichita Falls Metropolitan Statistical Area, which encompasses all of Archer, Clay and Wichita Counties and is the highest population area with in sixteen counties. Wichita County borders the State of Oklahoma, and includes Sheppard Air Force Base, Midwestern State University and Vernon College.

Above is a map with county boundaries and zip codes.

Our target area are the towns of Burkburnett, Electra, Iowa Park and Wichita Falls.

  1. Provide demographic information about the target community.

According to the US Census Bureau American Community Survey from 2007-2011, Wichita County has a total population of 130,835, which is comprised of 51.3% male and 49.7% female. The median age is 34.1 years, with 8% of those being between the ages of 15 and 19; 7% are under 5 years of age. The race composure is as follows: White (80.6%), Black or African American (10.7%), American Indian and Alaska Native (0.8%), Asian (2.2%), Native Hawaiian and Other Pacific Islander (0.1%), and other races (3.3%). Sixteen percent are of Hispanic or Latino descent. Families made up 66% of the households in Wichita County, of which 49% are married couples and 17.5% are other families.

According to the US Census Bureau American Community Survey from 2007-2011, the per capita income (in 2011, inflation-adjusted dollars) for Wichita County is $23,292, which is $2,256 lower than the state average. The median household income (in 2011, inflation-adjusted dollars) for Wichita County is $44,786, which is $6,134 below the average for Texas. The median family income (in 2011, inflation-adjusted dollars) is $54,646, which is $5,358 below the average for Texas. Families below the poverty level are 10%, as compared with 13.2% state-wide.

Description of community-wide health status

According to the Texas Department of State Health Services death statistics for the state of Texas, the leading cause of death in Wichita County is diseases of the heart (24.5%), followed closely by cancer (20.6%), chronic lower respiratory diseases (7.0%), and stroke (5.7%). During the one year period from 2007 to 2008, the death rate for health disease increased by 8.8%.There was a slight increase in chronic respiratory diseases in that same time period.

According to the Texas Department of State Health Services Texas Cardiovascular Health and Wellness Program, the Wichita Falls Metropolitan Statistical Area (MSA) prevalence rate for stroke is 5.7%; the Texas average is 2.8%. The prevalence rate for cardiovascular disease is 8.8%; the Texas average is 8.3%. Heart disease prevalence rates for the community are 6.1%; the Texas average is 6.7%. The risk factor prevalence of current smokers is 28.2%. The cardiovascular disease and stroke age-adjusted mortality rates (per 100,000) for 2001-2005, shows disproportionate outcomes for African Americans.

According to the Selected Metropolitan Area Risk Trends (SMART) from the Behavioral Risk Factor Surveillance System (BRFSS) for 2010, the percentage of adults in Wichita County reporting selected health risks are as follows: adults reporting general health as fair or poor (19.1%), which is higher than Texas (17.4%); adults reporting having smoked at least 100 cigarettes in their lifetime and currently smoke (19.8%), which is higher than Texas (15.8%).

The leading industries in Wichita County were educational services, health care and social assistance followed by retail and industry. The average life expectancy in Wichita County is 75.1 years of age according to the Community Health Status Indicators 2009; the median for all US counties is 76.1 years of age. The leading causes for death in Wichita County are as follows: Ages 15-24: injury, homicide, suicide, cancer; Ages 25-44: injury, cancer, heart disease, suicide, HIV/AIDS, homicide; Ages 45-64: cancer, heart disease; Ages 65 and older: heart disease, cancer.

The Youth Risk Behavior Survey (YRBS) data at the national level is used to draw conclusions about the youth in the Wichita County community as well. Data in that survey indicated that 44.7% of youth had tried cigarette smoking, 18.1% had ever smoked cigarettes on at least one day during the last 30 days, and 6.4% has smoked cigarette on 20 or more days during the last 30 days.

In April of 2011, the Wichita Falls Wichita County Public Health District (WFWCPHD) produced a report entitled Results of Local Health System and the Community Health Status Assessment for Wichita County, Texas. In June of 2012, a subsequent report entitled Wichita County Health Facts was released. The County Health Rankings are also reviewed and disseminated each year. These reports were the basis for the Community Health Improvement Plan (CHIP) developed by the Health Coalition of Wichita County. The findings of the assessment indicate some areas of weakness for Wichita County. Twenty-five percent and released in June 2013 of Wichita County’s population indicated current smoking compared to 18.5% for Texas. According to data the residents of Wichita County have good access to primary care providers; however, Wichita County had comparatively high mortality rates on a number of causes of death associated with lifestyle choices such as smoking.

Those populations who are disproportionately affected by cardiovascular disease (CVD), stroke, and other tobacco related diseases include African Americans, Hispanics, undereducated individuals, adults and children in poverty. The cardiovascular disease and stroke age-adjusted mortality rates (per 100,000) for 2001-2005, follows with the state and national trends with disproportionate outcomes for African Americans. For example, the age adjusted mortality rates for CVD for African American’s in the Wichita MSA is 27% higher than their White and Hispanic peers. The same holds true for stroke, with the rate being 45% higher than their peers. The trend is the same for heart disease, with the African American population at 21% higher mortality rates than others in the Wichita MSA.

There may be specific barriers that are faced during the course of the activities of this proposal. Those individuals experiencing health disparities in our community include African Americans, Hispanics, undereducated individuals, adults and children in poverty. Each population will have unique needs while some of the needs span all groups experiencing disparities. According to the 2005-2009 census profile, 12% of the population spoke a language other than English and of those that spoke another language, 43% reported they did not speak English very well. Providing language appropriate materials as well as Health District translators for these individuals will help to address the barrier faced by those who do not speak English as their primary language. Another issue facing many in the disparate group includes a low literacy level. A survey conducted by the United Way of Greater Wichita Falls and the Wichita Adult Literacy Council found that among citizens in Wichita County, 23% are functionally illiterate. Educational material will be developed in appropriate reading levels to address those with lower literacy levels. Educational programs will be located in individual communities with the support of trusted community leaders.

  1. Provide information about your coalition to explain your how the coalition formed and the coalition’s purpose and role in the community.

Our coalition is still in the process of forming. A first meeting is scheduled for August 2014.

  1. Provide any other relevant information about your targeted area or population that you have identified.

Wichita Falls is not unlike other communities in the state and nation, there are several factors that contribute to population-level chronic disease burdens impacted by tobacco use. The lack of a comprehensive smoking ordinance is one of the leading barriers to tobacco free living in our area. An ordinance was passed in 1994, which called for separate smoking and non-smoking areas in places such as restaurants. The ordinance disallowed smoking in public buildings, but did not impact establishments that only cater adult clientele. In 2005, an attempt was made to develop a more comprehensive smoking ordinance; at that time, there was not support from City Council for an ordinance revision.

In fact, Wichita Falls achieved a score of 87.5 points with 1 bonus point out of a possible 104, earning a recognition level of silver on the Texas Council on Cardiovascular Disease and Stroke; Heart and Stroke Healthy City Recognition program. The leading reason for not achieving gold status was the lack of a strong smoking ordinance.

Wichita Falls has an adult tobacco use rate of 19.8% according the BRFSS in 2010, as compared to the national average of 17.3%. Some of our youth obtain their tobacco products either from their parents or friends. According to the Wichita Falls Independent School District 2006 Texas School Survey of Drug and Alcohol Use, 31% of 10th graders reported experimental use of tobacco products as compared to 27% statewide. In our community, some youth are sometimes seen in public places sharing cigarettes with their peers.

Part II – Prevention Resources, Capacities and Gaps

  1. What prevention resources currently exist in your target community? Please discuss the following as specifically as possible in regards to how they are engaged or could be engaged in assisting the coalition’s efforts.
  2. Prevention Resource Center (PRC): Abilene Regional Council on Alcohol and Drug Abuse (ARCADA) offers substance abuse resources in our county. We will contact them by August 1st. Behavioral Health Groupis a non- profit community based organization providing substance abuse services.
  3. Other coalitions (DFC and CCP Coalitions, other tobacco Coalitions, etc.) The Health Coalition of Wichita Falls, North Texas Planning Council; the Wichita County TPCC currently does not know of any others but will continue to research this.
  4. Other state or federally funded prevention providers: Community Healthcare Center, North Texas State Hospital, Indigent Healthcare
  5. Schools and/or school programs (Communities in Schools, etc.):School: Wichita Falls ISD, City View ISD, Iowa Park ISD, Burkburnett ISD and Electra ISD

Programs:Communities in Schools, Pals, athletics, student council, taking four Rider High School Peer, Assistance & Leadership (PALS)students to Say What! Youth Tobacco Conference. Contacted all school counselors in the WFISD school system at the end of last year. We have begun contacting school principals in the county for the next school year to implement TATU in the schools.

  1. Community programs and services: YMCA, Boys and Girls Clubs, The RAC, Straight Street, Youth Opportunity Center, Pueblo Boxing, Faith Based Organizations, Faith Mission, Faith Refuge, Public Housing, Interfaith ministries We have begun the TATU program in the Boys and Girl’s Clubs. We have discussed the TATU program at the RAC on Iowa Park, as well as hosting Freshstart classes there.
  2. Parent programs (PTA, etc.): There is a PTA within the WFISD. Athletic Booster clubs and Band Booster clubs exist as well.
  3. Direct prevention service providers: Wichita Falls – Wichita County Public Health District, Behavioral Health Group, MSU Vincent Health Center,
  4. Treatment Providers: Helen Farabee,Employee Assistance Program (EAP) Associates, We will be taking over the City of Wichita Falls EAP smoking cessation classes beginning this month. Red River Hospital, North Texas State Hospital
  5. Healthcare providers: Clinics of North Texas, North Texas State Hospital, United Regional Health Care System, Red River Hospital., Kell West, Electra Memorial Hospital, and other independent physician’s groups. We have begun offering Freshstart cessation classes through the Clinics of North Texas. The providers are able to schedule the patients into classes through the EHR system and classes will be held at the Clinics of North Texas. United Regional is currently offering cessation classes of their own, they charge $25.00 per class.
  6. Higher Education Prevention:A health care center is offered for free due to a medical fee applied to tuition at Vernon College. Midwestern State University has a mental health counseling center, this free for students. Vincent Health Center is also available to students. This is available at available at a low cost to students
  7. Law Enforcement:D.A.R.E, Jail and Jail Annex of Wichita County, Juvenile Detention, Teen Court
  8. Others identified:American Cancer Society, Leadership Wichita Falls, Rotary Wichita Falls, Kiwanis Club, Elk’s Lodge, Lion’s Club, Junior League, Youth Leadership Wichita Falls, Jaycees, Shriners, Optimus Club, The Food Bank
  1. Identify and explain existing smoke free ordinances and organizational/school policies.

Attached to this document is a copy of the Wichita Falls Smoke Free Ordinance. The schools in Wichita Country comply by the Texas Tobacco Free Schools Act of 1995.

  1. What prevention gaps exist in your target community?

While teaching Teens Against Tobacco Use (TATU) we noticed a gap in teen cessation. The youth that are smoking do not like being tobacco users and know the harmful effects of it. However, there are no classes in the community to successfully help them quit. Wichita TPCC is researching options to best fit our community for this need.

We also have a need for a faith based outreach. With the help of our regional coordinator we are working on a faith based outreach.

PART III – Community Consumption Patterns

Overall, the ranking of the Wichita Falls-Wichita County Health District went from 152 in the state to 151, out of a total of 232 ranked counties. This was based on a composite of mortality, morbidity, health factors, health behaviors, clinical care, social and economic factors, and physical environment. Improvements were seen in all composite categories, except for mortality – where the district remained the same at 176th in the state. The adult smoking rate increased from 20% to 21% (data source is 2012 BRFSS data); the adult obesity rate also increased from 31% to 33% (data source is 2010 CDC data), yet the physical inactivity rate dropped from 31% to 29%. Some new indicators were also added this year - food environment index, access to exercise opportunities, severe housing problems, and number of mental health providers.

The Wichita Falls-Wichita County Health District (WFWCHD), within a public healthsystem, is pro-active in identifying and addressing issues facing the health and well-being of our community. Over the past two years, the district has joined with many other health facilities, organizations, businesses, and agencies to form the Health Coalition of Wichita County to actively address these issues to make a significant difference in the lives of families and individuals in the community.

PART IV – Community Consequences

Data Type / Already
Have / Where to Find / Target Groups / Unlikely
to Get / Availability Date / Person Responsible for Data / Column1 / Column2
Underage youth smoking rates / No / School surveys conducted in school districts, Tobacco Youth Survey / Youth / No
Underage youth chewing tobacco use rates / No / School surveys conducted in school districts, Tobacco Youth Survey / Youth / No
Underage tobacco rates (All tobacco products combined) / No / School surveys conducted in school districts, Tobacco Youth Survey / Youth
College student use rates / No / Possibly from local university sources / College Age Population / Yes
Adult smoking rate / Yes / Most recent data is the 2010 BRFSS results for Wichita County. New data is being collected / Sample of the adult population / No / 19.70%
Adult chewing tobacco use rates / Yes / Most recent data is the 2010 BRFSS results for Wichita County. New data is being collected / Sample of the adult population / No
Adult tobacco use rates / Yes / Most recent data is the 2010 BRFSS results for Wichita County. New data is being collected / Sample of the adult population / No
Citations for underage tobacco possession / No / Local police and sheriff's departments / Youth / No
Citations for selling tobacco to minors / No / Local police and sheriff's departments / Youth / No
Asthma rates / Yes / 2010 BRFSS data / Adult
Cancer rates / Yes / State data and cancer registry data.
NCI link /
State Map Link /
Heart disease rates / Yes / DSHS
ER visits for heart attacks / No / Local hospital data
ER visits for asthma / No / Local hospital data
Healthcare costs associated with tobacco-related diseases / No / Could use national data to approximate costs / Adult / Yes
Details of Current smoke-free ordinance (if applicable) / Yes / Wichita Falls comprehensive smoke free ordience / All / No
Number/percentage of restaurants that are smoke-free / Don't know / Should be available
Number/percentage of bars that are smoke-free / Don't know / Should be available / 2 bars
Number/percentage of hospitals that are smoke-free / Yes / United Regional; after July 17 the following due to ordiance: North Texas State, Red River, and Kell west. Electra Memorial is out of city limits
Number/percentage of campuses that are smoke-free / Yes / MSU is tobacco and ecigarette free. Vernon college WF campus is as well; Started 6/18
Number of tobacco retailers / yes
Cost of cigarettes / yes / $5 per pack
Local regulations on tobacco
advertising on store windows / yes / Complies currently with state comptroller regulations / new city ordinance
Local regulations regarding distance between tobacco retailers and schools / Don’t know / / The measurement of the distance between the sign containing an advertisement for
cigarettes or tobacco products and an institution listed in Subsection (a) is from the nearest
property line of the institution to a point on a street or highway closest to the sign, along
street lines and in direct lines across intersections Outdoor advertising is prohibited within 1,000 feet of a church or school
Cessation services available / Yes / TPCC- FreshStart, Dear Oaks EAP, United Regional Respiratory care department.
Quitline use rates from your area / No
Youth truancy rates / No / School districts / Youth / Yes, in near term
Tobacco tax receipts / No / State comptroller, County, and City / All / Yes, in near term
Other data:

Part V – Intervening Variables