Behavioral health is vital to a person’s well-being, personal relationships, and living a full and productive life.
According to the National Institute of Mental Health, research shows that mental illnesses are common in the United States, affecting tens of millions of people each year. Estimates suggest that only half of people with mental illnesses receive treatment.
Perceptions about Mental Health Surveys show that students’ and adults’ self-perceptions about mental health have declined.
Behavioral health disorders Hospitalizations for mental disorders have steadily increased over the past two decades.
Suicide Suicide rates continue to increase and are highest among White males.
Prevention Integrating behavioral health objectives within Florida’s State Health Improvement Plan acknowledges an interdisciplinary approach to prevention.
Healthy Weight, Nutrition & Physical Activity
The key to achieving and maintaining a healthy weight is about a leading a lifestyle that includes healthy eating, regular physical activity, and balancing the number of calories you consume with the number of calories your body uses. A healthy weight can also be affected by access to nutritious food. Low income and minority communities often lack food retail environments that offer affordable and healthy foods. When people do not have adequate access to healthy foods, they may settle for foods that are high in calories or have very low nutritional content.
Promoting healthy weight includes both weight loss or gain, depending on one’s current health and weight status. For those who are overweight, even a modest weight loss can have a positive impact on health. Being at a healthy weight is related to a lower risk for several serious health conditions including heart disease, diabetes, stroke and certain cancers. Healthy weight can also impact energy levels, sleep habits, self-esteem, psychological health and health care costs.
For these reasons, Florida’s State Health Improvement Plan addresses healthy weight, nutrition and physical activity as a priority. Florida is working toward improving not only the food environment and nutrition habits, but opportunities for physical activity across the lifespan.
Did you know that in 2019, only 32.8% of adults in Florida were at a healthy weight? Over time, the proportion of Florida’s population who are at a healthy weight has decreased, while obesity and overweight have increased. This condition persists across races, ethnicities, ages and genders. Obesity and being overweight disproportionally impact both Black and Hispanic populations and are also serious concerns among youths. Consider these facts:
- The percent of adults at a healthy weight was 35.6% in 2007 but declined to 32.8% by 2019 (2019: White = 34.2%, Black = 28.5%, Hispanic = 29.9%)
- The percent of overweight or obese adults was 62.1% in 2007 but rose to 64.6% by 2019 (2019: White = 63.2%, Black = 70.1%, Hispanic = 67.2%)
- The percent of middle and high school students who were overweight or obese was 26.7% in 2010 but rose to 30.4% by 2020 (2020: White = 26.7%, Black = 36.1%, Hispanic = 32.2%).
The most significant decline in healthy weight is apparent among women giving birth. Looking at pre-pregnancy weight and height on birth records shows fewer mothers are at a healthy weight as measured by BMI (body mass index).
- The percent of births to mothers who had a healthy weight at the time pregnancy occurred was 50.6% in 2007 but declined to 41.7% by 2019 (2019: White = 43.9%, Black = 32.0%, Hispanic = 40.4%).
- The percent of births to mothers who were obese at the time pregnancy occurred increased from 20.0% in 2007 to 27.1% in 2019 (2019: White = 24.8%, Black = 37.4%, Hispanic = 25.7%).
Food insecurity refers to a lack of available financial resources for food at the household level. For children under 18 years old, food insecurity means they do not have consistent access to enough food for an active, healthy life. Fortunately, this situation appears to be improving.
- Florida’s statewide food insecurity rate declined from 16.2% of the population in 2014 to 13.0% of the population in 2018.
- Florida’s child food insecurity rate decreased from 24.9% of children in 2014 to 19.4% of children in 2018.
Physical activity levels show a declining trend with more adults reporting sedentary behavior and fewer youth reporting physical activity.
- The percent of adults who were sedentary was 25.4% in 2007 and rose to 26.5% by 2019 (2019: White = 24.1%, Black = 28.9%, Hispanic = 31.5%)
- The percent of middle and high school students who were physically active for at least 60 minutes on all 7 of the past 7 days was 23.5% in 2013 and declined to 19.5% in 2020. (2020: White = 24.6%, Black=15.2%, Hispanic = 16.2%)
The Healthy Weight Profile presents key measures of weight, activity and eating habits among adults. It also includes measures about the built environment and surroundings like parks that provide the setting for physical activity. Data is available by county and for Florida. For each measure in the report, trends, quartile maps and data tables are available by clicking the links.
Health equity means attaining the highest level of health for all people. Florida’s State Health Assessment identified health equity, including behavioral health and other key social and economic factors that influence opportunities for good health, as key contributors to health outcomes. As a result, the Florida State Health Improvement Plan addresses health equity as a priority.
Some factors that influence health equity are economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context. One way to quantify equity issues is by comparing rates among one population to rates in another. If all things were equal, rates in different populations would not be drastically different from each other.
The Health Equity Profile report presents key measures of health equity by county and for Florida. The report explores dimensions like distribution of opportunity, community determinants, the physical and economic environments, health services and outcomes among the Black, Hispanic and White populations. It can be used to assess areas of greatest and least disparity in Florida’s counties and statewide by using a statistic called a rate ratio.
A rate ratio is calculated by dividing one population’s rate by a reference population’s rate for the same indicator. For example, if the Black population’s rate is 10 and the White population’s rate is 5, the rate ratio is 2:1 (spoken as “2 to 1”). The Black rate is twice the White rate (calculation: 10/5=2). The graph below, provides examples of some Florida health-related statistics where the Black rate is 1.5 or more times the White rate. For example, the Black rate of children less than 18 years old below poverty level is 1.9 times the White rate.
Data Sources: 1 American Communities Survey, 2015-2019, 2 Florida Vital Statistics, 2019 3 Florida Agency for Health Care Administration, 2019
Leading Causes of Death
Florida’s top five leading causes of death – heart disease, cancer, cerebrovascular diseases such as stroke, unintentional injury and chronic lower respiratory disease (CLRD) – are generally attributed to over 60% of all resident deaths each year. In 2019, they accounted for 63.6% of the 206,975 deaths.
20-year high or low by cause of death. The chance of the 2019 AADR being a 20-year high or low is 1 out of 20 or 5%; so there is a 95% chance that factors other than random variation influenced these AADRs. Age-adjusted rates for three of the five leading causes of death – heart disease, cancer and CLRD – were at their lowest in 2019 when compared to their rates from 2000-2019. None of the five leading causes were at their highest age-adjusted death rates in 2019.
Percentage change over time. In 2019, among these five leading causes, unintentional injury had the greatest percentage increase (+46.8%) in age-adjusted death (AADR) rate compared to 20 years ago. Conversely, the greatest percentage decreases in the past 20 years occurred in heart disease and cancer age-adjusted death rates, Florida’s primary and secondary leading causes of death (-39.2% and -24.0% respectively). The table below shows the proportion of Florida deaths attributed to each of the top five leading causes of death since 2000.
Learn more about leading causes of death by exploring FLHealthCHARTS’ Leading Cause of Death profile report.
Since 2014, cancer has been the second leading cause of death in Florida, after heart disease. Recent data shows that in 2019, 45,562 Floridians died from cancer. Each year, over 110,000 new cases are diagnosed and reported to the state cancer registry, the Florida Cancer Data System.
Although cancer is the second leading cause of death, there are many kinds of cancers that contribute to this statistic. The greatest number of deaths are caused by these types of cancer, in descending order: lung cancer, colorectal cancer, pancreatic cancer, cancer of the female breast and prostate cancer.
The age-adjusted cancer death rate decreased from 154.3 per 100,000 population in 2014 to 142.8 in 2019; however, cancer incidence (new cases) did not. The age-adjusted cancer incidence rate in 2014 of 426.0 per 100,000 population increased to 440.9 by 2017 (latest data available).
Preventive health care services, such as screenings, can detect cancer before symptoms start; treatment is most beneficial when cancers are detected early. The most effective cancer screenings which have led to reduced deaths include screenings for breast, cervical, lung and colorectal cancers. Screening for skin cancer, specifically melanoma of the skin, and prostate cancer has contributed to the reduced morbidity and mortality due to cancer in Florida as well.
Did you know that men have higher cancer incidence and death rates from cancer compared to women? Black females have a lower cancer incidence than White females, but there is no significant difference in their death rates. Historically, Black men have had both a higher incidence and death rate due to cancer than White men. In recent years, the gap has decreased.
|2017 Age-Adjusted Cancer Rates
|Black females: 364.3
||Black females: 130.2
|White females: 418.3
||White females: 126.9
|Black males: 432.2
||Black males: 190.2
|White males: 465.7
||White males: 177.9
|Rates are age-adjusted per 100,000 population.
The State Health Improvement Plan aims to reduce cancer incidence and increase cancer survival. FLHealthCHARTS.com offers additional information through its cancer incidence and death indicators as well as the death query system. To learn more about cancer control efforts in Florida, please visit this page: http://www.floridahealth.gov/diseases-and-conditions/cancer/cancer-control-florida.html
Injury, Safety and Violence
Unintentional injuries are the fourth leading cause of death in Florida overall after heart disease, cancer and stroke. Unintentional injuries include other events such as falls, drowning, and car crashes. Intentional injuries include events such as homicide or suicide. Overall, suicides are the eighth leading cause of death, while homicides are the fifteenth leading cause of death in Florida.
Unintentional injuries such as falls and motor vehicle crashes, and intentional injuries such as intimate partner violence are a major cause of death for people ages 1 to 44; however, most injuries are predictable and preventable. In 2019, unintentional injuries were the fourth leading cause of death overall after heart disease, cancer and stroke, accounting for 13,213 deaths while suicides were the eighth leading cause with 3,427 deaths. Including all injury deaths, both unintentional and intentional, over 18,100 Floridians lost their lives. Moreover, injury caused 144,050 hospitalizations and 1,891,631 emergency department visits.
For this reason, Florida’s State Health Improvement Plan is working to prevent and reduce unintentional and intentional injuries and deaths in Florida. Specific strategies include:
- promoting evidence-based falls prevention programs serving elders,
- preventing child drowning,
- addressing violence through partnerships that focus on common risk and protective factors,
- improving the transportation network to reduce motor vehicle fatalities and injuries on our streets and highways, and
- decreasing morbidity and mortality from injury through effective support and monitoring of Emergency Medical Services (EMS) and Trauma Systems of Care.
Recently the Injury, Safety and Violence priority area workgroup invited the Behavioral Health workgroup to begin a discussion on overlapping goals, including suicide prevention, drug use, and Adverse Childhood Experiences (ACEs).
FLHealthCHARTS.com offers additional information through its Fatal Injury, Non-Fatal Injury Dashboard, Non-Fatal Injury Hospitalization, and Non-Fatal Injury Emergency Department Visit Reports. To learn more about the Florida Department of Health’s Violence and Injury Prevention Section and its priorities, please visit this page: http://www.floridahealth.gov/programs-and-services/prevention/injury-prevention/index.html.
Sexually Transmitted Disease (STD)
Syphilis is a sexually transmitted disease caused by the bacterium treponema pallidum. It has often been called "the great imitator" because so many signs and symptoms are indistinguishable from those of other diseases. When not adequately treated, syphilis can lead to visual impairment, hearing loss, stroke, and other neurological problems. Congenital syphilis is a severe, disabling, and often life-threatening infection seen in infants. A pregnant mother who has syphilis can transmit the disease through the placenta to the unborn infant. Congenital syphilis can cause miscarriage, stillbirth, or early infant death, and infected infants can experience lifelong physical and neurologic problems. Florida reports cases of congenital syphilis based on a standardized surveillance case definition developed by the Council of State and Territorial Epidemiologists.
The Centers for Disease Control (CDC) and Prevention reported increases in syphilis nearly every year since 2001. In 2018, Florida’s primary and secondary syphilis (syphilis that is infectious) rate was 13.7 per 100,000 population, surpassed only by six other states: Louisiana (14.3), New Mexico (14.9), Georgia (15.4), Alabama (15.5), California (19.2) and Nevada (22.7). 1
Florida’s syphilis rates are increasing. Early syphilis (syphilis acquired within a year) rates increased, from 8.3 per 100,000 population in 2006 to 34.8 in 2019 (Figure 1). Among males ages 15–44, rates of total syphilis increased from 42.4 per 100,000 population in 2006 to 176.0 in 2019; among females, rates increased from 19.1 per 100,000 population to 46.3 in 2019 (Figure 2). Florida’s congenital syphilis rates have increased from 8.8 per 100,000 live births and fetal deaths in 2006 to 65.9 in 2019 (Figure 3).
The Florida Department of Health, in partnership with the CDC; Healthy Start Coalitions of Miami-Dade, Broward, Orange and Duval Counties; The Gay, Lesbian, Bisexual, Transgender, Queer Center of Central Florida; BLISS Healthcare Services and Florida Department of Education, are working to reduce syphilis rates. Florida’s State Health Improvement Plan includes objectives for reducing rates of early syphilis, syphilis cases among women of reproductive age (15–44), and congenital syphilis cases.
Figure 1. Early Syphilis
Figure 2. Total Syphilis
Figure 3. Congenital Syphilis
Immunizations & Influenza
Vaccination protects adults and children from serious disease. Being immunized also reduces the risk of complications from certain diseases, especially among those with compromised immune systems, by reducing the chance of passing on serious diseases to others. The World Health Organization (WHO) cites multiple benefits of vaccination including elimination of diseases, reduction of morbidity and complications, protection of the unvaccinated population, and prevention of related diseases and certain cancers. As the 2020 flu season approaches, the Centers for Disease Control and Prevention is recommending early flu vaccine for children 6 months through 8 years of age who need 2 doses and later vaccinations (starting September) for older adults.
Florida’s State Health Improvement Plan addresses vaccination and influenza as a priority, and we are working toward improving access to vaccines across the lifespan. Specific objectives focus on improving access to vaccines for pregnant women, infants, children and teens. Approximately 83.5% of 2-year olds received the basic vaccine series, and 93.5% and 96.1% of kindergarten and 7th grade students, respectively, were up to date with recommended vaccines during school year 2019-20.
National & International
Suicide is among the top 10 leading causes of death in the United States (CDC). In Florida, suicide is the 8th leading cause of death, claiming over 3,427 lives in 2019. Additionally, suicide attempts result in an even larger number of non-fatal, intentional self-harm injuries. In 2018, the latest data currently available, over 20,000 non-fatal intentional self-harm hospitalizations and emergency department visits occurred. These conditions prompted Florida to focus on suicide prevention as a priority in the State Health Improvement Plan by taking the following actions:
- Providing training on suicide prevention and related behaviors to community and clinical service providers.
- Increasing suicide prevention efforts for high-risk populations.
- Collaborating across agencies to develop messaging and initiatives around suicide surveillance data from the Florida Violent Death Reporting System.
The Department of Children and Families coordinates these activities with its participating partners, the Florida Department of Health and the Florida Behavioral Health Association.
Hepatitis A is a vaccine-preventable, communicable disease of the liver caused by the hepatitis A virus. Nationally, hepatitis A infection rates have increased since 2016, when reported cases went from 0.6 per 100,000 population to nearly 4.0 per 100,000 population in 2018.
Source: CDC, https://www.cdc.gov/hepatitis/hav/havfaq.htm#general
Florida also saw an increase in hepatitis A infections in recent years. After several years of relative stability, the number of reported hepatitis A cases more than doubled from 2016 to 2017 and dramatically increased in 2019. Since February 2020, the number of cases reported each month decreased but still remain above expected levels. Since January 2018, 98% of Florida’s cases were likely acquired in Florida and share several common risk factors including both injection and non-injection drug use and recently experiencing homelessness. The best way to prevent hepatitis A infection is through vaccination.
Hepatitis A Cases, Florida
Source: Florida Department of Health, as of 6/20/20 www.flhealth.gov/hepadata
Learn More: www.flhealth.gov/hepadata
Get Data: Hepatitis A
Alzheimer’s Disease and Related Dementias
Alzheimer’s disease slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. It is the most common cause of dementia among the senior population. African Americans are twice as likely, and Hispanics are one and a half times as likely as older whites to have Alzheimer’s disease and other dementias. Prevalence is higher among women compared to men; two-thirds of Americans with Alzheimer’s disease are women.
Dementia is one of the major causes of disability and dependency among older people worldwide. Dementia has a physical, psychological, social, and economic impact, not only on people with dementia, but also on their careers, families and society at large. (WHO). There is no known cure, however, innovative research may provide hope for effective and novel treatment for this incapacitating disease.
In Florida, in 2018, Alzheimer’s’ disease was the 6th leading cause of death statewide, and an estimated 553,734 Floridians 65 years and older had probable Alzheimer’s. About 8.5% of Floridians over 65 years and older reported having a cognitive disability; moreover, 24.4% of this age-group lived alone (2014-18 US Census). These conditions prompted Florida to focus on Alzheimer’s disease and other dementias as a priority in the State Health Improvement Plan. The Florida Department of Health and participating partners are working to support the specific needs of this vulnerable population by taking the following actions:
- Identifying a statewide system of resources and support to formalize the Alzheimer’s disease and related dementias (ADRD) network.
- Strengthening the capacity of care organizations to assess, diagnose and treat individuals with ADRD and expand support for their caregivers.
- Protecting individuals with ADRD from further vulnerability.
Participating partners include the University of South Florida Morsani College of Medicine, Alzheimer’s Association, Mayo Clinic, University of South Florida Byrd Alzheimer’s Center and Research Institute, Florida Association of Community Health Centers, Florida Atlantic University, Florida A&M University, Alzheimer’s advocate and University of South Florida College of Public Health.
For additional data about Florida’s older population, see FLHealthlCHARTS.com’s Aging In Florida Profile and the Florida Department of Elder Affairs’ Demographic Profiles and Statistics.
Behavioral health disorders, including mental illness and substance abuse, are often inter-connected with other general medical conditions. People who grow up in good physical health are more likely to also have good mental health. Similarly, good mental health often contributes to maintenance of good physical health. National Research Council and Institute of Medicine.
Consider the following statistics for Florida:
- 28.3% of middle and high school students reported that, within in the past year, they felt sad or hopeless for two or more weeks in a row and stopped doing usual activities (YTS, 2019).
- 12.1% of middle and high school students reported that within the past year, they did something to purposely hurt themselves without wanting to die (YTS, 2019)
- 15.6% of adults reported ever having had a depressive disorder. (BRFSS, 2018)
- 12.8% of adults reported having poor mental health on 14 or more of the past 30 days (BRFSS, 2018)
Recent research suggests that preventing mental, emotional, and behavioral disorders is inherently interdisciplinary and draws on a variety of different strategies1. For example, improving family functioning and positive parenting has positive effects on mental health and can reduce poverty-related risk. Integrating behavioral health objectives within Florida’s State Health Improvement Plan acknowledges this interdisciplinary approach. One goal is to reduce mental, emotional and behavioral health disorders in children through improved identification and treatment of behavioral health disorders in parents who come in contact with the child welfare system. Other goals include decreasing the number of newborns experiencing neonatal abstinence syndrome, reducing the number of opioid overdose deaths among individuals with opioid use disorders and reducing the number of suicides in Florida.
National & International
1 Lando J, Marshall Williams S, Sturgis S, et al. A logic model for the integration of mental health into chronic disease prevention and health promotion. Prev Chronic Dis. 2006 April;3(2):A61.
Healthy Weight, Nutrition & Physical Activity
Healthy eating and physical activity are keys to maintaining a healthy weight. Being at a healthy weight is related to a lower risk for several serious health conditions including heart disease, diabetes, stroke, and certain cancers. Promoting healthy weight includes both weight loss or gain, depending on one’s current health and weight status. For those who are overweight, even a modest weight loss can have a positive impact on health. Healthy weight can also impact energy levels, sleep habits, self-esteem, psychological health and health care costs. For these reasons, Florida’s State Health Improvement Plan addresses healthy weight, nutrition and physical activity as a priority. Florida is working toward improving not only the food environment and nutrition habits, but opportunities for physical activity across the lifespan.
Did you know that in 2018, only 32.2% of adults in Florida were at a healthy weight? Overweight and obesity is also a serious concern among our youth and disproportionally impacts black and Hispanic youths. The Healthiest Weight Profile presents key measures of weight, activity, and eating habits among adults and also includes measures about the built environment. Data is available by county and for Florida. For each measure in the report, trends, quartile maps and data tables are available by clicking the links.
Health equity means attaining the highest level of health for all people. Florida’s State Health Assessment identified health equity, including social and economic factors, as key contributors to health outcomes. Consequently, Florida’s State Health Improvement Plan addresses health equity as a priority. The Health Equity Profile presents key measures of health equity by county and for Florida. The report explores dimensions like distribution of opportunity, community determinants, the physical and economic environments, health services and outcomes. Rate ratios are provided to understand health equity issues in Florida’s counties. The Community Social and Economic Factors report displays contextual factors such as poverty, employment, educational attainment, income, health insurance and more by census tract, by county and for Florida.
Click here for more data.