CONTENTS

1 County Executives and Directors Messages 2 Organization Chart 4 Our Vision and Mission 5 Portfolio of Highlights p. 16 8 Animal Care and Control Moves to New Shelter 10 The 2011 Community Health Needs Assessment 11 Private P.O.D. Successes 12 No Flu For You 14 The Lets Face It Campaign 16 Recycling Successes in 2011 18 2011 E. coli Investigation 20 Social Media Successes 2011 p. 11 p. 8 22 CDC Statistics and Financial Data 23 Vital Statistics

p. 20

p. 14

p. 10

Pictures (clockwise from the top): 1) an RBM ad from the campaign (see page 16); 2) Adoption Counselor Rhonda Belics displaying a kitten in the Pet Adoption Center; 3) stock photo; 4) AirO2Dynamic Leadership Team member Victor Jordan signing the No Tobacco Pledge; 5) supplies stacked up for a P.O.D. exercise; 6) stock photo.

COUNTY EXECUTIVES MESSAGE

I would like to personally thank the Saint Louis County Department of Health for another year of outstanding service to the residents of Saint Louis County. For over 100 years, the Health Department has helped keep Saint Louis County one of the best places to live in Missouri. It serves as a vibrant and vital voice for public health issues in our state that consistently and effectively offers a wide array of health and environmental services to the residents of Saint Louis County. I look forward to the departments continued success in the future and wish it the best in 2012.

DIRECTORS MESSAGE
I am pleased to present the 2011 Annual Report for the Saint Louis County Department of Health. While an annual report cannot capture all of the departments daily activities, it should provide anyone interested with an accurate snapshot of the scope and nature of our work. Every day, the nearly 500 employees of the Health Department and our service partners strive to keep Saint Louis County one of the best places to live, work, and visit by ensuring that its public health needs are addressed. That is our mission. The range of activities that this involves is quite broad including ensuring compliance with public health standards, addressing the social components of effective public health efforts, maintaining a healthy environment, and maintaining accessible medical services throughout the county. I am personally proud of the work done by all department staff in meeting the challenges faced in 2011, and I look forward to addressing the challenges of the coming years.

Above: County Executive Charlie A. Dooley greeting county residents

Charlie A. Dooley
Saint Louis County Executive

Health Department Director Dr. Dolores J. Gunn making remarks during the America Recycles Day 2011 RBM Fashion Show (see page 16)

The Health Department being recognized for its No Flu For You campaign (see page 12)

Dolores J. Gunn, M.D.

Director of the Department of Health

Saint Louis County Department of Health Annual Report 2011

Health Department Organization Chart

Health Department
Administration Customer Service CDC Services Environmental Protection Fiscal Services Medical Examiner Personnel Research and Medical Services

314-615-0600
314-615-1600 314-615-5000 314-615-1630 314-615-1698 314-615-8902 314-615-8308 314-615-0800 314-615-6490 314-615-1600

Communicable Disease Control Services Faisal Khan, MBBS, MPH Director of CDC Services

Environmental Health, Air and Waste Management Environmental Health, Food and Michael J. Zlatic, PE Environmental Environmental Laboratory Administrator Joyce Theard, MPA, REHS Environmental Administrator

Executive Administration Edward Mueth Director of Executive Administration

Saint Louis County Department of Health Annual Report 2011

The Honorable Charlie A. Dooley County Executive

Dolores Gunn, MD Director of the Health Department

Fiscal Services Mark Barry, MBA Director of Fiscal Services Medical Examiners Office Mary Case, MD Chief Medical Examiner

Personnel Sharon Gardner, MBA Director of Personnel Research and Medical Services Felicia Bown, MD Director of Research and Medical Services

Saint Louis County Department of Health Annual Report 2011

Our Vision and Mission

We will be a progressive public health department providing a full array of services which includes assessment, policy development and assurances for health information, disease and injury prevention, and environmental health.

Vision:

Mission: The

Saint Louis County Department of Health promotes optimal health for people who live, work, or visit the county. This is accomplished by monitoring and assessing the public health status of the county, and developing programs and/or policies that prevent illness or injury.

Saint Louis County Department of Health Annual Report 2011

Portfolio of Highlights
and Healthy Homes
16,752 Children Screened and Tested for Lead Poisoning 679 Vapor Recovery Inspections 91 Air Pollution Control Source Inspections Air

Health Centers
30,714 Adult Medicine and Dental Visits 16,978 Walk-in Immunizations 8,986 Womens Health Visits 8,443 Sexually Transmitted Disease Visits 4,934 Pediatric Visits 1,768 Travel Immunizations $6.6 Million Value of WIC Food Vouchers Issued
Saint Louis County Department of Health Annual Report 2011

Portfolio of Highlights
Food and Environmental Health
10,097 Food Inspections 7,601 Pool and Spa Inspections 7,379 Dairy Product Samples Analyzed 680 Day Care Inspections 307 Lodging Inspections 744 Complaint Investigations

Health Education
13,577 Students in ten Saint Louis County school districts participated in Health Educations, Teenage Health Consultants Program (TAHC)
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Saint Louis County Department of Health Annual Report 2011

Portfolio of Highlights
Medical Examiner
7,668 Reports of Death 1,055 Deaths Handled 543 Examinations Performed

Animal Control
8,911 Animals Handled 2,061 Animals Placed in Homes 1,213 Animals Placed with Rescue Groups

Saint Louis County Department of Health Annual Report 2011

Animal Care and Control Moves to New Shelter

An inviting Pet Adoption Center! More space for the animals. Opened in November of 2011. Located at 10521 Baur Boulevard in Olivette.

Saint Louis County Department of Health Annual Report 2011

The departments Animal Care and Control Services program moved into its new $4.5 million state-of-the-art adoption center in November of 2011. The facility at 10521 Baur Boulevard in Olivette includes more space for animals, more convenient business hours for the public, and is more centrally located than the previous two shelters. The Pet Adoption Center is the latest accomplishment in the Animal Control programs efforts to expand services such as community outreach and education, and increased animal rescues and adoptions. During the grand opening ceremonies, County Executive Charlie Dooley noted that the building was entirely built using existing funds and did not require a tax increase or bond issue. The new facility includes: separate areas for dog and cat adoptions meet-and-greet rooms for potential adopters to interact with pets a state-of-the-art veterinary suite for spay/neuter surgeries separate areas for quarantined and aggressive animals

an outdoor play/training area The new facility combines all animal program activities at one location instead of dividing the operations between two previous overcrowded and outdated shelters. The program has reported significant increases in animals received, animals distributed to rescue groups, and animals successfully returned to owners. Joint activities with other organizations such as the Humane Society of Missouri and the Animal Protective Association of Missouri have continued as the program explores new ways to increase adoptions, responsible pet ownership, the micro-chipping of animals, and the promotion of spaying and neutering to reduce the problem of pet overpopulation. Vector Control The Vector Control program is also housed at the new facility. They have been cross-trained at the new facility with the Animal Care and Control staff to care for the animals.

All picture captions are listed from top to bottom for each page. Page 4: 1) an Emergency Preparedness Dispensing Exercise in progress; 2) stock photo; 3) Health Education Coordinator Viviane McKay, MPH, CHES, displaying pig lungs that demonstrate the ill effects of tobacco use. Page 5: 1) and 2) stock photos; 3) sign in front of the departments South County Health Center. Page 6: All are stock photos. Page 7: 1) County Executive Charlie A. Dooley making remarks at the grand opening of the new Animal Care and Control Center in Olivette (see page 8); 2) the front entrance of the new Animal Care and Control building; 3) Animal Control Officer Sarah Foshee holding a cat in the new Pet Adoption Center. Page 8: 1) County Executive Charlie A. Dooley cutting the red ribbon at the grand opening of the new Animal Care and Control Center; 2) Dr. Stephanie Nelson examining a dog; 3) the entire Animal Care and Control and Vector Control teams standing in front of the new facility. Page 9: Animal Control Officer Rick Maurer holding a cat in the new Pet Adoption Center.

Saint Louis County Department of Health Annual Report 2011

Community Health Needs Assessment

First health assessment with sub- county level data. Will help guide the mission of the department by focusing on what needs to be addressed. Written in conjunction with the University of New England.

One of the most basic purposes of public health is defined by three core functions: 1) the assessment of the health needs of a community; 2) the development of policies to address those 2011 Commu needs; and 3) the assurance Health Neednity Assessment s that those needs are being adequately addressed. In 2011, the Saint Louis County Department of Health in conjunction with the University of New England made a great leap forward by issuing the first ever countywide health needs assessment that included data from the sub-county level. Moving forward, the department will be able to not only analyze health data from the county, but compare how the various regions of the county are faring as compared to one another.

community, it cant know where to direct its resources for maximum impact. As part of the bigger picture, the 2011 Community Health Needs Assessment was part of a larger process through which the department aims to achieve national accreditation by the Public Health Accreditation Board (PHAB).

Assessments like this are important because they help To view the 2011 Community guide the mission of the health Health Needs Assessment, please department by shining a light visit the following website: on what issues need addressing. Unless an agency knows which Stlouisco.com/HealthandWellness/ chronic health HealthEducationandInformation/ problems are 2011CommunityHealthNeedsAssessment prevalent in a 10 Saint Louis County Department of Health Annual Report 2011

Private P.O.D. Successes

Department dramatically expands emergency preparedness partnerships. Partnerships include businesses and universities. Over 700,000 residents now eligible for worksite distribution of medicine in the event of a public health emergency.

Great strides were made in 2011 to prepare our community for possible public health emergencies. At the start of the year, approximately three-fourths of the countys one million residents would have had to visit one of 15 distribution sites to receive medicine in the event of a public health crisis. Staffing those locations would have required at least 3,000 people or 75% of all Saint Louis County government employees. Those numbers have been dramatically reduced as the result of a health department campaign to enlist major employers and universities as distribution sites for employees, students, and their families. In a dramatic reversal, by the end of the year three-fourths of the population was eligible to receive medication at one of these specially arranged sites, known as Private P.O.D.s (or Points of Distribution). The health department partnered with Pandemic Prep.Org, a non-profit organization, to

create the Bio-Defense Network to recruit the areas largest employers, universities, and other entities into the medication distribution program. The effort has dramatically increased the number of covered county residents from 270,000 to more than 700,000. The recruiting effort is part of ongoing health department efforts to prepare for emergencies ranging from terrorism to flu pandemics to severe weather. Once an organization joins the program, periodic exercises are staged to ensure readiness and address specific issues. The campaign has received national recognition and efforts are continuing to expand coverage and reduce the need for public sites.

Saint Louis County Department of Health Annual Report 2011

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No Flu For You

The campaign aims to increase the percentage of health care workers in the region that get vaccinated against the flu. The department made it mandatory for its employees to be vaccinated. The department achieved 100% compliance in 2011.

12 Saint Louis County Department of Health Annual Report 2011

The department was concerned when it discovered that a large number of healthcare workers choose not to be vaccinated against the seasonal flu each year. A survey of area healthcare workers conducted for the department showed that 25% do not plan to get vaccinated. The department decided that something needed to be done. People who get flu shots might automatically assume that the nurse who vaccinates them has also gotten a shot, said Department Director Dr. Dolores J. Gunn, but its possible that not all the medical office staff have been vaccinated. The department embarked on a new campaign in 2011 the No Flu for You campaign that aimed to encourage area healthcare workers to get vaccinated. The department also decided to lead by example, establishing a policy that required all department employees to get the current flu vaccine (unless they had a medical condition that precluded them from being vaccinated). During the first year, all but a handful of the health departments approximately

500 employees received a flu shot as part of the campaign (and those that didnt had a medical excuse meaning the department achieved 100% compliance). The new vaccination policy applies both to those employees who do patient care and deal with the public and those employees who work in clerical and managerial positions. The No Flu for You campaign also features a website that urges healthcare workers to make sure employees at their office, or other medical facility, get vaccinated. The website offers advice on how to organize an office campaign. The effort is part of the departments ongoing efforts to encourage everyone to be vaccinated against the seasonal flu each year, as is recommended by the Centers for Disease Control and Prevention (the CDC).

All picture captions are listed from top to bottom for each page, unless stated otherwise. Page 10: 1) the cover of the 2011 Community Health Needs Assessment; 2) stock photo. Page 11 (from left to right): 1) Jenelle Leighton, RN, Nurse Supervisor for Communicable Disease Control Services (on left), working with two employees from other area health departments at a P.O.D. exercise; 2) volunteers being trained on how to work at a dispensing site. Page 12: 1) County Executive Charlie A. Dooley filling out the forms to get his annual flu vaccination; 2) Dr. Dolores J. Gunn addressing the media at the annual seasonal flu kickoff event; 3) Jenelle Leighton, RN, Nurse Supervisor for Communicable Disease Control Services, and Karla Howell, RN, Communicable Disease Nurse Specialist, ready to administer flu vaccinations. Page 13: Mike Jones, Senior Policy Advisor for the County Executive, waiting to receive his annual flu vaccination from Jenelle Leighton, RN, Nurse Supervisor for Communicable Disease Control Services.

NoFluForYou.com
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Saint Louis County Department of Health Annual Report 2011

The Lets Face It Campaign

Encouraging youth to avoid tobacco products. Helping smokers give up the habit. Educating people about the dangers of secondhand smoke.

14 Saint Louis County Department of Health Annual Report 2011

In 2010, the Saint Louis County Department of Health was awarded a $7.6 million grant by the U.S. Centers for Disease Control and Prevention (CDC) to educate people about the dangers of tobacco use. As the two year grant was awarded in March of that year, it is expected to last until at least March of 2012. The grant was part of a CDC initiative called Communities Putting Prevention to Work or CPPW. Nationwide the CPPW program awarded grants to over 50 communities, states, and tribes some for tobacco education, some for obesity prevention, and some for both. The grant to Saint Louis County was only for tobacco education and tobacco use prevention efforts. The local program adopted the name Lets Face It and then built a campaign around that theme. The local initiative has three main goals: 1) educate youth about the dangers of tobacco to reduce the initiation of use; 2) provide smoking cessation resources to existing smokers who wish to quit; and 3) educate the general public about the dangers associated with secondhand smoke to build support for clean indoor air policies. The public campaign was kicked off on January 2nd, 2011 the

same day a new, voter-approved clean indoor air ordinance went into effect in Saint Louis County. A portion of the campaign that portion aimed at youth adopted the name AirO2Dynamic a name selected by the youth themselves. The AirO2Dynamic team appeared at events throughout the county to promote the idea of smokefree living and to encourage their peers not to use tobacco. The AirO2Dynamic efforts peaked in the fall of 2011, culminating in a countywide multimedia contest for middle and high school students. Winners were presented their awards and prizes at a gala O2 Awards ceremony in December. The Lets Face It campaign also worked with employers throughout the region to provide onsite smoking cessation classes for employees. In addition to these classes, the same was offered to the general public through several different venues. Nicotine replacement therapy (patches and gum) was provided free of charge to those who participated. In addition, area smokers unable to attend classes but still wanting to quit were encouraged to call the Missouri Quitline at 1-800-QUIT-NOW (1-800784-8669). To reach the general public with information about the dangers of

secondhand smoke, two methods were employed. The first was a direct media campaign that involved outdoor advertising such as billboards and bus kongs, TV and radio spots, web-based advertising, and earned media events, many of which were staged at local sporting venues. The second was the use of community-partnership grants to enlist the aid of various community groups to help spread the word. Finally, the Lets Face It Campaign also worked directly with schools both secondary and higher education institutions to encourage them to adopt the Gold Standard tobacco-free campus policy. This was intended to not only protect students from the dangers of secondhand smoke, but to provide them with a smoke-free living experience as an example going forward. This local CPPW initiative the Lets Face It campaign remains a work in progress. The program is expected to wind down in the spring of 2012.

LetsFaceItSTL.com
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Saint Louis County Department of Health Annual Report 2011

Recycling Successes in 2011

The department was selected by a national organization for a localized education campaign. The campaign encourages everyone to recycle as much as they can! The department is moving forward with plans for a permanent household hazardous waste collection site.

16 Saint Louis County Department of Health Annual Report 2011

For the last several years, the departments Solid Waste Management Program has been encouraging residents to follow the Three Rs: 1) Reduce (the amount of waste being generated); 2) Reuse (anything that can be reused); and 3) Recycle (as much as possible). The year 2011 was no exception. Over the last 12 months, the program has conducted 40 community presentations and 93 school presentations that directly reached over 7,600 residents. In addition, it was chosen as one of two 2011 partners by the national organization Curbside Value Partnership (CVP). On behalf of the department (and at no cost to the County), CVP created a public education campaign called Recycling Becomes Me (RBM) to increase curbside recycling participation. The campaign was launched in November of 2011 and included newspaper and radio advertisements, direct mail, participation at events, a Facebook fan page, and a campaign website: RecyclingBecomesMe.com. All these efforts, it seems, are paying off. A survey conducted in the fall of 2011 in partnership with the St. Louis Jefferson Solid

Waste Management District showed that 81% of county residents think recycling is very important and 94% reported that they recycle. The goal of the RBM campaign is to motivate residents to become even more diligent recyclers and to get those who dont recycle to start. The campaigns full effect wont be known until 2012 tonnage numbers are received. To provide further options for the safe disposal of waste, steps were also taken in 2011 to construct the first permanent household hazardous waste (HHW) collection site. The site will be located at 291 Hoffmeister, on the grounds of the Metropolitan Sewer District Lemay Waste Water Treatment Plant. Proposals for the development of a reservation website and the waste management contract were also issued. The permanent program will replace the oneday collection events previously held by the department and provide a more sustainable and convenient option for the management of HHW. Construction of the first site should be completed in 2012. A second site is planned in North County in the now-vacated North County Animal Shelter building. 17

All picture captions are listed clockwise from the top of each page. Page 14: 1) the Lets face It message being displayed at a Cardinals game in Busch Stadium; 2) a group of AirO2Dynamic members tossing T-shirts to the crowd at a Cardinals game; 3) AirO2Dynamic Leadership Team member Jenna Witkowski from Eureka High School addressing the crowd at a World No Tobacco Day event; also pictured from left to right are Dan Duncan from the National Council on Alcoholism and Drug Abuse (NCADA), Justin Dioneda from Webster Groves High School, and Victor Jordan from McCluer Senior High School; 4) former St. Louis Blues player Bernie Federko signing autographs at a Lets Face It event. Page 16: 1) students from Clayton High School at the America Recycles Day 2011 RBM Fashion Show; 2) one of the many featured RBM ads; 3) students from St. Francis of Assisi learning about paper recycling; 4) Kurt Copeland from Z107-7 with a local character actor at an RBM event. Page 17: Ron Atkins of Jennings being recognized by the RBM prize patrol for having been caught recycling!

Saint Louis County Department of Health Annual Report 2011

2011 E. coli Investigation

Local reports of symptoms appeared in early October. The initial investigation suggested produce from local salad bars. The national investigation concluded that the culprit was romaine lettuce from a farm outside Missouri.

18 Saint Louis County Department of Health Annual Report 2011

In October of 2011, reports started coming in of gastrointestinal symptoms that were indicative of a possible foodborne illness. As is the norm in such situations, the Saint Louis County Department of Healths Communicable Disease Control Services Division began an investigation. Since this particular disease was foodborne, the assistance of the departments Food and Environmental Division was also needed. The goal of an investigation of this type is to 1) identify what is spreading; 2) determine the source of the outbreak; and then 3) decide if any action is needed to mitigate the situation. With foodborne illnesses, this can often prove to be quite challenging since most people eat multiple meals each day and depending on the type of illness, symptoms can fail to appear until hours or even days after the meal in question. The department began the

investigation by interviewing those affected both to obtain laboratory samples and to ask them what they had eaten in the days leading up to the onset of symptoms. Laboratory results confirmed that the department was dealing with an outbreak of E. coli a relatively common bacteria but this was a particularly nasty strain (E. coli O157:H7). Epidemiologists use information gathered from interviews to determine if they can identify a specific food that had been eaten by most or all of those affected. In this case, the evidence suggested that the foodborne illness had been carried by items found at salad bars in grocery stores but initially, no one food item or store could be pinpointed as the definitive source. Generally speaking, when everyone affected by a foodborne disease ate at the same location, it can indicate that contamination likely occurred during the preparation of the food. When everyone affected lives in the same area, but didnt eat at the same event or location, it can indicate that contamination likely occurred during the distribution of the food. And when people are affected in many different areas around the country, it can indicate that contamination likely occurred at the original source for the food.

In this particular case, it quickly became apparent that not only were there cases from all around the St. Louis region, but in several surrounding states as well. At that point, additional entities became involved, including the Missouri Department of Health and Senior Services (DHSS), the Centers for Disease Control and Prevention (CDC), and the Food and Drug Administration (FDA). At the local level, much of the departments efforts went into managing the information (and misinformation) being reported by an increasingly impatient media they wanted answers and didnt want to wait for further investigation. Although not all those affected were in the St. Louis area (multiple states were affected), much of the local media attention focused on the possibility of a local source for the contamination. However, the national investigation concluded that the source was actually romaine lettuce shipped in from another state. The entire outbreak lasted less than a month the first local case was reported on October 9th and the last local case was reported on November 7th. In all, there were around 60 confirmed cases in the St. Louis area. 19

Saint Louis County Department of Health Annual Report 2011

Social Media Successes

Social media is the newest way to reach residents. The department aggressively moved forward in 2011 with Facebook and Twitter. Over 2,500 likes and follows by the end of 2011.

20 Saint Louis County Department of Health Annual Report 2011

Over the last ten years, websites such as Friendster, MySpace, Facebook, and Twitter have served as a new media for online social connections the so-called social media. The popularity of individual sites has waxed and waned, but what is clear is that this new form of communication and interaction is fertile ground for use by the public health community. The Saint Louis County Department of Health first set up accounts on Facebook and Twitter in 2009; however, it wasnt until 2011 that the real potential of these sites was more fully realized by the department. The department now makes regular postings about upcoming events and healthier behaviors.

primary sources of information if desired. Third, the information is permanently presented in a stable online location that can be accessed from anywhere with a web connection. This permits teachers, educators, and members of the general public to direct people to the information on an ongoing basis. By the end of 2011, the departments Facebook page had been liked by over 1,700 people and its Twitter account was being followed by over 800 people. While not all these likes and follows result in the daily exchange of information, it certainly represents a new audience through which the department is able to spread its message of healthy living.

Page 18 (pictures are listed from top to bottom): 1) health department chemist Nora Pullen looking through a microscope [staged photo not part of the E. coli investigation]; 2) laboratory technician Myrna Mercer washing used laboratory equipment [staged photo not part of the E. coli investigation]. Page 19: stock photo. Page 20 (pictures are listed clockwise from the top): 1) logos from various social media sites; 2) stock photo; 3) screen capture from the departments Twitter page; 4) educational slide about pertussis created for use on the departments social media pages. Page 21: screen capture of the departments Facebook page.

There are many advantages to this Going forward, the department hopes to continue to expand type of public health messaging. its social media presence in the First, everything is done in the public sphere, so members of the county by exploring new ways to reach its existing audience and public can see questions that are by exploring new social media posed and the answers that are given. This reduces the time staff venues to reach new audiences. Check back with us again next spends responding to the same year! types of inquiries over and over. Second, the format allows for clickable links, so readers facebook.com/StLCountyDOH can move twitter.com/StLCountyDOH directly to
Saint Louis County Department of Health Annual Report 2011

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Communicable Disease Statistics

Communicable Disease Control Services
Enteric Diseases Campylobacteriosis E. Coli O157:H7 Salmonellosis Shigellosis Total enteric diseases: Respiratory Diseases Legionellosis Influenza (Oct - Apr) Tuberculosis Total respiratory diseases: Vaccine Preventable Diseases Hepatitis B Measles Mumps Pertussis Rubella Total vaccine preventable diseases: 2007 143 17 113 685 958 2007 9 3550 24 3583 2007 5 0 0 16 0 21 2008 138 7 105 85 335 2008 18 1176 20 1214 2008 7 0 0 222 0 229

Department Financial Summary - 2011

2009 93 6 94 340 533 2009 17 2228 19 2264 2009 6 0 0 337 0 343 2010 130 5 127 335 597 2010 2 1220 22 1244 2010 9 0 2 234 0 245 2011 101 43 105 11 260 2011 14 1455 22 1491 2011 2 0 5 238 0 245
Administration $10,520,522 Medical Care Services $18,410,914 Environmental Health $7,890,392 Public Health Services $9,468,470

Reported Cases of Selected Communicable Diseases, 2007 - 2011

Health Fund Service Expenditures - 2011

Medical Examiner $1,578,078 Corrections Medicine $4,734,235

Health Fund Revenue Sources - 2011

Other Revenue $1,673,782 Patient Revenue $2,471,872

neurological Diseases Meningococcal Meningitis West Nile, Neuroinvasive Total neurological diseases: STD Chlamydia Gonorrhea HIV Syphilis (Primary and Secondary) Total STD:

2007 0 10 10 2007 4925 2312 79 35 7351

2008 3 4 7 2008 5089 1711 101 35 6936

2009 2 1 3 2009 5249 1315 99 26 6689

2010 1 1 2 2010 5255 1441 127 40 6863

2011 1 1 2 2011 5439 1807 30 7373

County Tax Revenue $35,621,944 Grants and Contracts $7,253,054 Licenses, Permits and Fees $8,368,908

22 Saint Louis County Department of Health Annual Report 2011

Saint Louis County Vitals

Vital and Health Statistics
Compiled Data, 2007 - 2010
selected vital statistics Live Births1 Deaths1 Infant Deaths3 Population2 leading causes of death4 Heart Disease Cancer Cerebrovascular Disease Chronic Lower Respiratory Diseases Unintentional Injuries5 2007 Number 12,334 8,978 115 993,690 2008 Number 2,627 2,110 569 493 384 Rate 206.1 177.3 44.3 40.5 35.3 Rate 12.4 9.0 9.3 2008 Number 12,175 9,467 83 992,331 2009 Number 2,529 2,077 547 429 360 Rate 196.0 173.0 42.2 34.5 33.3 Rate 12.3 9.5 6.8 2009 Number 11,785 9,069 85 992,408 2010 Number 2,487 2,102 542 394 398 Rate 190.6 170.8 41.5 31.1 37.2 Rate 11.9 9.1 7.2

1 Missouri Vital Statistics 2004-2010, MO Department of Health and Senior Services, Table 17:http://www.dhss.mo.gov/VitalStatistics/ 2 Rate for Vital Statistics per 1,000 persons; crude rate 3 Missouri Vital Statistics 2004-2010, MO Department of Health and Senior Services, Table 23A: http://http://health.mo.gov/data/ vitalstatistics/index.php 4 MICA: http://www.dhss.mo.gov/mica/death.php 5 Definition of Unintentional Injuries: Missouri Vital Statistics 2004-2010, MO Department of Health and Senior Services, Table 27B: http:// www.dhss.mo.gov/VitalStatistics/; rates extracted by selecting Motor vehicle accidents and All other accidents & adverse effects from http://www.dhss.mo.gov/mica/death.php

Saint Louis County Department of Health Annual Report 2011

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SAINT LOUIS COUNTY DEPARTMENT OF HEALTH 6121 North Hanley Road, Berkeley, MO 63134 www.stlouisco.com/healthandwellness (314) 615-0600