7. Create a Healthy Austin Program

A person’s health and ability to make healthy choices is directly affected by where they work, live, learn and play. The Healthy Austin Program seeks to improve community health and addresses how health risk factors are directly affected by our surroundings. This priority program works to address key elements of community health including physical activity, recreation, access to healthy foods, strengthening the local food system, tobacco-free living, access to healthcare, and improving the built environment to support healthy living. We want making the healthy choices to be affordable and easier than making unhealthy ones.

Healthy Austin Indicators Summary

We're Improving
percent of residents with health care coverage
property crime rate per 1,000 population
We Haven't Changed
prevalence of tobacco use
prevalence of smoking
prevalence of cardiovascular disease
prevalence of diabetes
percent of population that performs the recommended amount of physical activity
violent crime rate per 1,000 population
Wrong Direction
prevalence of obesity
Austin is a relatively healthy city. Over the last five years Austin/Travis County has trended better than Texas and the nation on key health outcomes including obesity, smoking, physical activity, cardiovascular disease, and diabetes. While this is reassuring, we continue to see disparities along racial, ethnic, and socio-economic lines within these same health outcomes.
Below you will find a detailed analysis and description of each of the Healthy Austin indicators. 

#18 Rates of Disease, Obesity, and Tobacco Use

The prevalence of obesity, cardiovascular disease, smoking, tobacco use, and diabetes are analyzed separately below.

#18.1 prevalence of obesity

Description: This indicator measures the prevalence of obesity among all Travis County adults. It is defined as respondents 18 years and older who have a BMI of 30 or greater, calculated by self-reported height and weight.
The chronic diseases associated with the risk factors of tobacco use, poor nutrition, and lack of physical activity (including some cancers, diabetes, heart disease, stroke, chronic obstructive pulmonary disease, and asthma) are the underlying causes of most deaths in Travis County.

Reducing obesity is a major goal of Imagine Austin.
Analysis of Results
The percentage of Travis County adults who are obese has risen by 21% since 2011.
Disparities in Obesity Prevalence
For combined years 2011-2015 black or African-American residents have the highest prevalence of obesity (40.1%), compared to that of Hispanics (27.2%) and whites (17.8%).

Additional Notes
Data from before 2011 are not comparable to data in 2011 and after due to methodology change in the BRFSS sampling procedure.

Methodology
The BRFSS is conducted by Texas Department of State Health Services on an annual basis. An over sample of the Travis County population is performed to ensure sufficient sample size for population subgroups. Prevalence estimates are obtained on a yearly basis for behavioral risk factors and chronic diseases in adults. Subgroup analysis (e.g. by age group, race/ethnicity, income, education, or health insurance status) is available for combined years only to establish a more stable estimate.
Data Source + Collection Cycle
Behavioral Risk Factor Surveillance System, Department of State Health Services
The BRFSS is completed every year, but the results are released in August of the following year.

#18.2 prevalence of tobacco use

Description: This indicator measures the prevalence of current tobacco use among all Travis County adults. It is defined as respondents 18 years and older who use smokeless tobacco every day or some days and/or are current smokers. 
The chronic diseases associated with the risk factors of tobacco use, poor nutrition, and lack of physical activity (including some cancers, diabetes, heart disease, stroke, chronic obstructive pulmonary disease, and asthma) are the underlying causes of most deaths in Travis County. Tobacco is one of the major causes of death in Travis County.

Reducing tobacco use is a major goal of Imagine Austin.
Analysis of Results
Tobacco use was declining from 2011-2014 but rose again in 2015.
Disparities in Tobacco Use Prevalence
For combined years 2011-2015 black or African-American residents have the highest prevalence of any tobacco use (20.2%), compared to that of Hispanics (17.7%), other race/multiracial adults (17.3%), and whites (15.7%).

Additional Notes
Data from before 2011 are not comparable to data in 2011 and after due to methodology change in the BRFSS sampling procedure.
Methodology
The BRFSS is conducted by Texas Department of State Health Services on an annual basis. On over sample of the Travis County population is performed to ensure sufficient sample size for population subgroups. Prevalence estimates are obtained on a yearly basis for behavioral risk factors and chronic diseases in adults. Subgroup analysis (e.g. by age group, race/ethnicity, income, education, or health insurance status) is available for combined years only to establish a more stable estimate.
Data Source + Collection Cycle
Behavioral Risk Factor Surveillance System, Department of State Health Services 
The BRFSS is completed every year, but the results are released in August of the following year.

#18.3 prevalence of smoking

Description: This indicator measures the prevalence of smoking among all Travis County adults. It is defined as respondents 18 years and older who have smoked 100 cigarettes in their lifetime and now smoke every day or some days.
Tobacco is a major cause of death in Travis County. Reducing tobacco use (and specifically smoking) is a major goal of Imagine Austin.

Analysis of Results
The percentage of Travis County residents who smoke was declining from 2011-2014 but rose again in 2015. However, there is no statistically significant difference in smoking prevalence between any of the years.
Disparities in Smoking Prevalence
For combined years 2011-2015 black or African-American residents have the highest prevalence of smoking (18.5%), compared to that of whites (13.3%), Hispanics (12.9%), and other race/multiracial adults (13.4%). 
Additional Notes
Data from before 2011 are not comparable to data in 2011 and after due to methodology change in the BRFSS sampling procedure.

Methodology
The BRFSS is conducted by Texas Department of State Health Services on an annual basis. On over sample of the Travis County population is performed to ensure sufficient sample size for population subgroups. Prevalence estimates are obtained on a yearly basis for behavioral risk factors and chronic diseases in adults. Subgroup analysis (e.g. by age group, race/ethnicity, income, education, or health insurance status) is available for combined years only to establish a more stable estimate.
Data Source + Collection Cycle
Behavioral Risk Factor Surveillance System, Department of State Health Services 
The BRFSS is completed every year, but the results are released in August of the following year.

#18.4 prevalence of cardiovascular disease

Description: This indicator measures the prevalence of cardiovasular disease (CVD) among all Travis County adults. It is defined as respondents 18 years and older who were told by a health professional that they had a heart attack, angina/coronary heart disease, or stroke.
The chronic diseases associated with the risk factors of tobacco use, poor nutrition, and lack of physical activity (including some cancers, diabetes, heart disease, stroke, chronic obstructive pulmonary disease, and asthma) are the underlying causes of most deaths in Travis County.

Reducing the prevalence of CVD is a major goal of Imagine Austin.
Analysis of Results
The population of Travis County was not oversampled in 2013, thus prevalence estimates were based on a smaller sample size and do not accurately reflect the prevalence of CVD for that year. 
Disparities in CVD Prevalence
For combined years 2011-2015 black or African-American residents have the highest prevalence of cardiovascular disease (7.5%), compared to that of whites (5.8%), Hispanics (3.2%), and other race/multiracial adults (2.2%)
Additional Notes
Data from before 2011 are not comparable to data in 2011 and after due to methodology change in the BRFSS sampling procedure.

Methodology
The BRFSS is conducted by Texas Department of State Health Services on an annual basis. On over sample of the Travis County population is performed to ensure sufficient sample size for population subgroups. Prevalence estimates are obtained on a yearly basis for behavioral risk factors and chronic diseases in adults. Subgroup analysis (e.g. by age group, race/ethnicity, income, education, or health insurance status) is available for combined years only to establish a more stable estimate.
Data Source + Collection Cycle
Behavioral Risk Factor Surveillance System, Department of State Health Services
The BRFSS is completed every year, but the results are released in August of the following year.

#18.5 prevalence of diabetes

Description: This indicator measures the prevalence of diabetes among all Travis County adults. It is defined as respondents 18 years and older who were told by a health professional that they have diabetes.
The chronic diseases associated with the risk factors of tobacco use, poor nutrition, and lack of physical activity (including some cancers, diabetes, heart disease, stroke, chronic obstructive pulmonary disease, and asthma) are the underlying causes of most deaths in Travis County.

Reducing diabetes is a major goal of Imagine Austin. It is linked to other risk factors such as obesity, poor nutrition, and lack of physical activity.
Analysis of Results
The prevalence of diabetes in Travis County has remained about the same since 2011.
Disparities in Diabetes Prevalence
For combined years 2011-2015 black or African-American residents have the highest prevalence of diabetes (13.4%), compared to that of Hispanics (11.2%), whites (5.4%), and other race/multiracial adults (5.3%)

Additional Notes
Data from before 2011 are not comparable to data in 2011 and after due to methodology change in the BRFSS sampling procedure.

Methodology
The BRFSS is conducted by Texas Department of State Health Services on an annual basis. On over sample of the Travis County population is performed to ensure sufficient sample size for population subgroups. Prevalence estimates are obtained on a yearly basis for behavioral risk factors and chronic diseases in adults. Subgroup analysis (e.g. by age group, race/ethnicity, income, education, or health insurance status) is available for combined years only to establish a more stable estimate.
Data Source + Collection Cycle
Behavioral Risk Factor Surveillance System, Department of State Health Services
The BRFSS is completed every year, but the results are released in August of the following year.

#102 percent of residents with health care coverage

Description: This indicator measures the percent of Travis County residents with health care coverage defined as respondents 18 years to 64 years of age who report having any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicaid or MAP. Adults over 64 years of age are automatically covered by Medicare and are not included.
Increasing access to health care is a major goal of Imagine Austin. Having health care is associated with improved management of chronic conditions and improved health outcomes.
Analysis of Results
Overall the percentage of Travis County residents with health insurance is increasing; however, lower income families are less likely to be covered. Additionally, the lowest percentage of health insurance coverage occurs among Hispanics compared to whites, blacks/African-Americans, and other race/multiracial adults.
Disparities in Health Care Coverage
Lower income families are less likely to be covered: only 48.7% of individuals with an annual income  less than $25,000 have health care coverage as compared to 96% of individuals with an annual income of $75,000 or more.
Additionally, the lowest percentage of health insurance coverage occurs among Hispanics (55.2%) compared to whites (89%), blacks/African-Americans (75.2%), and other race/multiracial adults (77%).
Additional Notes
Data from before 2011 are not comparable to data in 2011 and after due to methodology change in the BRFSS sampling procedure.

Methodology
The BRFSS is conducted by Texas Department of State Health Services on an annual basis. On over sample of the Travis County population is performed to ensure sufficient sample size for population subgroups. Prevalence estimates are obtained on a yearly basis for behavioral risk factors and chronic diseases in adults. Subgroup analysis (e.g. by age group, race/ethnicity, income, education, or health insurance status) is available for combined years only to establish a more stable estimate.
Data Source + Collection Cycle
Behavioral Risk Factor Surveillance System, Department of State Health Services
The BRFSS is completed every year, but the results are released in August of the following year.

#114 percent of population that performs the recommended amount of physical activity

Description: This indicator measures the percent of Travis County adults that participate in at least 150 minutes of moderate to vigorous physical activity per week.
Exercise is part of the Healthy Austin program. Investing in accessible walking and biking networks and open space will provide residents increased opportunities for outdoor exercise as part of their daily routines.

Increasing the percentage of Travis County adults who perform the recommended physical activity each week is a major goal of Imagine Austin and is linked to other chronic diseases such as diabetes, obesity, and CVD.
Analysis of Results
There is no statistically significant trend in the results of this indicator from 2011 to 2015.
Disparities Among Adults who Perform the Recommended Amount of Physical Activity
For combined years 2011-2015 the lowest percentage of adults performing the recommended physical activity each week occurs in African-Americans (36.3%), followed by Hispanics (39.7%), and Whites (50.1%).
Additional Notes
Data from before 2011 are not comparable to data in 2011 and after due to methodology change in the BRFSS sampling procedure.
Methodology
The BRFSS is conducted by Texas Department of State Health Services on an annual basis. On over sample of the Travis County population is performed to ensure sufficient sample size for population subgroups. Prevalence estimates are obtained on a yearly basis for behavioral risk factors and chronic diseases in adults. Subgroup analysis (e.g. by age group, race/ethnicity, income, education, or health insurance status) is available for combined years only to establish a more stable estimate.
Data Source + Collection Cycle
Behavioral Risk Factor Surveillance System, Department of State Health Services
The BRFSS only asks about physical activity every other year. For that reason, data is only available for years 2011, 2013, and 2015. In August 2018, data for 2017 will be released.

#115 violent crime rate per 1,000 population

Description: This indicator measures the rate of violent crime in the community. It is defined by the number of Part I violent and property crimes, as defined by the FBI UCR (uniform crime reporting) program, and includes murder, rape, robbery, and aggravated assault. The crime rate is expressed as total offenses divided by Austin population/1,000.
Reducing crime is one of the goals of the comprehensive plan. The plan calls for improved collaboration between public safety providers and city planners to employ best development practices to reduce crime through urban design, density, mixed use development, and improved lighting, and others strategies.
Analysis of Results
The violent crime rate in the 2015-16 fiscal year was up 11% compared to the previous fiscal year. In calendar year 2015, Austin’s violent crime rate was 3.73 per 1,000 population, which was 52% below the rate of 7.75 for large US cities. Overall, the rate of violent crime has remained relatively stable over the past five years, though the actual number of crimes has increased from 3,353 in 2012 to 3,774 in 2016, the corresponding growth of Austin's total population from 819,866 in 2012 to 913,917 in 2016 has kept the rate fairly constant.
To compare other violent crime components, during FY 2015-16, Austin’s homicide rate was 0.04 per 1,000 residents (35 murders), 57% higher than the previous year with 23 murders.  In FY 2015-16, Austin's rate of 0.7 rapes was 35% higher than the previous year, but overall, it was 10% lower compared to other large US cities. In FY 2015-16, Austin’s rate of 1.1 robberies was 10% higher than the previous year but 62% lower compared to other large US cities. Austin’s rate of 2.3 aggravated assaults was 5% higher compared to FY 2014-15 but was 51% lower than large US cities.  
Methodology
Violent crimes are counted by either number of victims (murder, rape, aggravated assault) or number of offenses (robbery). The violent crime rate is calculated by dividing the total violent crime count by a population factor (Austin population divided by 1,000).
For prior years (FY 2014-15 and earlier), APD reports the FBI’s UCR violent crime rate. This rate is considered official, and it is calculated using the calendar year and Austin’s US census population. For FY 2015-16, the violent crime rate is based on a fiscal year and the full-purpose population. The FBI will release its official, final results in 2017.
Data Source + Collection Cycle
data collected quarterly, analyzed annually
Contact Information

#116 property crime rate per 1,000 population

Description: This indicator measures the rate of property crime in the community. It is defined by the number of Part I violent and property crimes, as defined by the FBI UCR (uniform crime reporting) program, and includes burglary, theft, and auto theft. Crime rate is expressed as total offenses divided by Austin population/1,000.
Reducing crime is one of the goals of the comprehensive plan. Property crime in Austin has been higher than other major cities. The plan calls for improved collaboration between public safety providers and city planners to employ best development practices to reduce crime through urban design, density, mixed use development, and improved lighting, among others.
Analysis of Results
The 2015-16 fiscal year result showed a slight decrease from the previous fiscal year. Austin’s property crime rate in calendar year 2015 (the most recent official results) was 37.71 per 1,000 population, 6% lower than the rate of 40.11 for large US cities. The FY 2014-15 result was 2% below the FY 2013-14 result and 16% lower than the average of the last four years. Austin’s property crime rate in calendar year 2014 (the most recent official results) was 41.42, which was 6% lower than the rate of 44.01 for large US cities.
Overall, the rate of property crime has decreased over the past five years. The actual number of property crimes dropped from 42,788 in 2012 to 34,143 in 2016 while Austin's total population grew by 11% from 2012 to 2016. In FY 2015-16, Austin ranked 17th as the safest city in property crime rates out of large US cities (population 500,000 and greater). 
To compare the component rates during FY 2015-16, Austin’s rate of 5.6 burglaries per 1,000 population was 6% higher compared to the previous year, but was 31% lower than the rate for other large US cities.  Austin’s rate of 29.3 thefts was 2% lower compared to the previous year, but was 9% higher than the rate for other large US cities in FY 2015-16.  Austin’s rate of 2.5 auto thefts was 1% lower compared to the previous year, and 50% lower than the rate for other large US cities. 
Methodology
Property crimes are counted by number of premises entered (burglary), number of offenses (theft), or number of vehicles (auto theft). Property crime rates are calculated by dividing the property crime count by a population factor (Austin’s population divided by 1,000).
For prior years (FY 2014-15 and earlier), APD reports the FBI's UCR property crime rate based on a calendar year and the City of Austin’s US census population. For the current year (FY 2015-16), the property crime rate is based on a fiscal year and Austin’s full-purpose population. This result will be considered unofficial until the FBI releases its final results in late 2017.
Contact Information

Priority Program #7
Cassie DeLeon of the Austin Public Health Department is the Healthy Austin Priority Program Champion. 
Contributing departments include: Austin Public Health; Planning and Zoning, Parks and Recreation, Public Works, Austin Transportation, Office of Sustainability