Commission District Health Profiles

Shelby County Commission Districts

Board of Commissioners

District 1 – Amber Mills

District 2 – David C. Bradford

District 3 – Mick Wright

District 4 – Brandon Morrison

District 5 – Shante Avant

District 6 – Charlie Caswell, Jr.

District 7 – Henri E. Brooks

District 8 – Mickell M. Lowery, Chairman

District 9 – Edmund Ford, Jr.

District 10 – Britney Thornton

District 11 – Miska Clay-Bibbs, Chair Pro-Tempore

District 12 – Erika Sugarmon

District 13 – Michael Whaley

Shelby County, Tennessee

Overview

Shelby County is situated on the Mississippi River in the southeast corner of Tennessee, bordering five other counties and two other states. It is the largest county in the state in terms of population and geographic area and is home to seven cities: Arlington, Bartlett, Collierville, Germantown, Lakeland, Memphis, and Millington. Memphis is the second largest city in the state and among the 30 largest cities in the nation. The County is divided into 13 commission districts whose commissioners serve as the local legislative body. This report provides a profile for each district and the County overall, including key demographics, social determinants, and health related issues and opportunities.

Demographics: Based on the United States Census Population Estimates⁴¹ Shelby County's population grew steadily from 2010 until 2012 but has gradually declined. In 2020 a new decennial census count estimated that Shelby County has a population of 929,744¹. Based on the Census American Community Survey (ACS)¹, the median age in Shelby County in 2016 – 2020 was 35.7, with about 25% of the population under the age of 18, 61% between 18 and 64, and 14% ages 65 and older. The residents of Shelby County are 53.9% Black or African American, 38% White, and 8% other races or multiracial. There are an estimated 6.4% of Hispanic or Latino residents.¹

Social Determinants: The social determinants of health are the conditions in which people are born, grow, live, work, worship and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. These circumstances are shaped by the distribution of money, power, and resources, and influenced by policy choices. The social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between populations.²

In 2016-2020, the median household income was estimated to be $52,092 within Shelby County.¹ The percent of the population living below the poverty level is 19%, which is 1.7 times the poverty level of the nation overall. Thirty percent of children under 18 are living below the poverty level. In Shelby County, 11.5% of the population did not have health insurance compared to 9.7% of the US population.¹Education levels are similar to national averages, with 66.6% receiving a high school degree or higher and 22.4% receiving a bachelor’s degree or higher.¹ Residents of Shelby County report traveling a mean time of 22.9 minutes to work. Only 1% of residents use public transportation to get to work, compared to about 5% nationally.⁴²

LEADING CAUSES OF DEATH

The five leading causes of death in Shelby County are Heart Disease, Cancer, Cerebrovascular Disease, Unintentional Injuries, and Chronic Lower Respiratory Tract Disease (LRD).4

The leading causes of death in this report are for the combined years of 2018 to 2020 and were determined based on the rankable causes of death for 2019 defined by the National Center for Health Statistics43. Covid-19 is not included as a rankable cause on this list as it was added during 2020; however, deaths due to COVID-19 are noted separately.

From 2018-2020 the number of people in Shelby County that died from heart disease was 6,065. During that same period, 4,997 people died from cancer, 1,440 from cerebrovascular disease, 1,950 from unintentional injuries, and 1,023 from Chronic Lower Respiratory Tract Disease (LRD).4 In 2020, there were 952 deaths due to COVID-19 based on the underlying cause of death, making it the 3rd leading cause of death for 2020.4

Heart Disease

Heart disease, the leading cause of death in Shelby County, accounts for 21.8% of deaths. It is the leading cause of death for both men (22.8%) and women (20.7%) in Shelby County.4 Conditions, including high blood pressure, unhealthy cholesterol levels, diabetes, and obesity, increase the risk of heart disease. Lifestyle behaviors that increase the risk of heart disease include:

1. Eating a diet high in unhealthy fats,

2. Cholesterol, and salt;

3. Not getting enough physical activity;

4. Drinking too much alcohol and,

5. Smoking or exposure to tobacco.

Advanced age and heredity can also play a role.5 About half of all Americans (47%) have at least 1 of 3 key risk factors for heart disease: high blood pressure, high cholesterol, and smoking.5

Cancer

Cancer, the second leading cause of death, accounts for 18.0% of deaths in Shelby County. It is the second leading cause of death for men (17.4%) and women (18.6%).4 Limiting exposures to avoidable risk factors may lower a person’s chances of developing cancer. Exposures that increase risk include cancer-causing substances, such as arsenic and asbestos; radiation (including sunlight); alcohol; tobacco; certain hormones; and certain infections, such as HIV, Hepatitis B and C, and HPV.6,7 Health conditions that may increase cancer risk include obesity, chronic inflammation, and immunosuppression. Advanced age and heredity also play a role.6

Cerebrovascular Disease

Cerebrovascular disease, the third leading cause of death, accounts for 5.2% of deaths in Shelby County.4 It is the third leading cause of death for women (5.9%) and the fifth leading cause for men (4.5%). 4 Major risk factors for cerebrovascular disease include high blood pressure, diabetes, heart disease, advanced age, a personal or family history of stroke or TIA (transient ischemic attack), and brain aneurysms or arteriovenous malformations (AVM). Women are more likely to die from strokes, although, at a younger age, men experience more strokes than women. African Americans, Alaska Natives, and American Indians experience more strokes than other races. Additional risk factors include unhealthy cholesterol levels, obesity, lack of physical activity, stress and depression, smoking or exposure to tobacco, alcohol and illegal drug use, use of nonsteroidal anti-inflammatory drugs (NSAIDS) (but not aspirin), and certain medical conditions such as sickle cell disease and bleeding disorders.5

Unintentional Injuries

Unintentional injuries, the fourth leading cause of death, accounts for 7% of deaths in Shelby County.4 It is the third leading cause of death for men (9%) and the fifth leading cause for women (4.8%). Accidental poisoning is the leading type of unintentional injury, accounting for 43%, followed by motor vehicle accidents (30%) and falls (13%). Accidental poisoning was almost three times higher in 2020 (433) compared to 2018 (151), likely impacted by the opioid use disorder epidemic. In 2018-2020, 98% of accidental poisonings were drug overdose-related. Motor vehicle accidents were 1.5 times higher in 2020 (252) compared to 2018 (164).4 Fall-related injuries are the number one reason a person 65 years or older visits the emergency room. Fall risk factors include advanced age, medication use, cognitive impairment, and sensory deficits.8

Chronic Lower Respiratory Tract Disease (LRD).

Lower Respiratory Tract Disease (LRD), the fifth leading cause of death in Shelby County, accounts for 3.7% of the deaths from 2018-2020. It is the sixth leading cause of death for men (3.2%) and women (4.2%).4 Prevention tips for Chronic LRD include managing risk factors (smoking, chemical exposures, radon, and outdoor air pollution), learning new things, staying active, and having regular checkups with your doctor to identify Chronic LRD early.26

LIFE EXPECTANCY

Life expectancy is an estimate of the average age that a person is expected to live. It is a key indicator of population health. High life expectancy rates can be attributed to improved living conditions, better health care, and decreased childhood/early/mid to late life mortality. Increased life expectancy can lead residents to focus more on planning for retirement and healthcare. The U.S. Centers for Medicare and Medicaid Services states that in the U.S., healthcare spending doubles after a person reaches their 65th birthday, and by the time they reach 85 the cost has more than doubled again.10

The life expectancy in Shelby County was 76.3 [1] in 2020, almost three years less than in the United States overall, where the life expectancy was 78.8[2] [3] . In Shelby County, life expectancy was declining slowly from 75.9 in 2012 to 75.2 in 2019 but fell sharply in 2020 to 72.3.

Spotlights on Health

Monkeypox Outbreak 2022

In May 2022, cases of monkeypox began to be reported in countries where the disease is not endemic. As of August 22, 2022, there were 41,664 laboratory confirmed cases reported in 96 locations that have not historically reported monkeypox. In the United States, as of August 31st, 2022, there was a total of 19,591 [1] monkeypox cases, of which 212 were in Tennessee. There have been 36 laboratory-confirmed and probable cases identified in Shelby County as of August 31st, 2022.²⁷ In Shelby County, monkeypox is seen primarily in African American males and those who identify as gay or bisexual, many of whom are HIV positive.

Monkeypox is a rare disease caused by the monkeypox virus. The monkeypox virus is part of the same family of viruses as the variola virus, which causes smallpox. Monkeypox symptoms are similar to smallpox symptoms but milder, and monkeypox is rarely fatal. Monkeypox was discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research. Despite being named “monkeypox,” the source of the disease remains unknown. However, African rodents and non-human primates (like monkeys) might harbor the virus and infect people. Monkeypox is endemic to several countries in Africa. ²⁶

People infected with monkeypox will develop a rash that can look like pimples or blisters that could be painful or itchy. This rash can spread to all body parts, including palms of hands and soles of feet. Other symptoms might include fever, chills, swollen lymph nodes, exhaustion, body aches, cough, and nasal congestion. Symptoms usually start within three weeks of exposure to the virus. Flu-like symptoms will usually develop 1-4 days before the rash. Monkeypox can be spread from when symptoms start until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed. The illness typically lasts 2-4 weeks.²⁶

Monkeypox can spread through direct contact with an infected person’s rash, scab, or body fluid. It can also be spread through touching objects, fabrics (clothing, bedding, or towels), and surfaces used by someone with monkeypox. Intimate or sexual contact (including hugging, massage, kissing, prolonged face-to-face contacts and sharing of fetish gear and sex toys) has been found to be one of the primary ways that monkeypox is being spread in this outbreak. Currently, testing is only recommended if you have a rash consistent with monkeypox and people tested should isolate at home and away from others until results are known.²⁶

Some ways to help prevent monkeypox infection include avoiding close, skin-to-skin contact with people who have a rash that looks like monkeypox, avoid contact with objects and materials that a person with monkeypox has used, and wash your hands often (soap and water or alcohol-based hand sanitizer).

COVID-19

COVID-19 (coronavirus disease 2019) is a viral disease caused by the SARS-CoV-2 virus, which was discovered in December 2019 in Wuhan, China. It is highly contagious and has spread rapidly around the globe. The word corona means crown and refers to the structural appearance of the spike proteins that stick out from the virus. The virus uses the spike protein to attach to human cells to infect them. Scientific communities study mutations leading to changes in the virus, particularly those that result in changes to the spike protein, which plays a crucial role in the infectivity of the virus. Variants of the virus arise when mutations occur that significantly change how quickly the virus spreads, the severity of illness caused, or the effectiveness of treatments.^44,45

COVID-19 virus can quickly spread through respiratory droplets and frequently causes upper and lower respiratory infections that feel like a cold, flu, or pneumonia. Additionally, other body parts may be infected by COVID-19 resulting in a wide variety of symptoms and outcomes related to the virus. Most people with COVID-19 have mild symptoms or may even be asymptomatic, but some have a severe infection, and some may suffer from post-COVID-19 conditions (“long COVID”), even if they have mild or no symptoms. Older adults and people with co-morbidities or underlying medical conditions are at higher risk of severe COVID-19. Some risk factors that may be associated with severe disease include but are not limited to older age, obesity, smoking or substance abuse, low physical activity, asthma, chronic obstructive pulmonary disease (COPD), cardiovascular disease, cerebrovascular disease, cancer, immunocompromising conditions, etc.The best protection against COVID-19 disease is vaccination.^44,45

Globally, COVID-19 cases have surpassed 600 million, and in the United States alone, over 94 million cases have been reported since the beginning of the pandemic. Over 6 million people have succumbed to COVID-19 globally, including just over 1 million in the United States as of early September 2022.^46,47

The total number of reported COVID-19 cases in Shelby County as of 31^st, 2022, is 267,149, with a cumulative case rate of 28,523 per 100,000 population and 3,399 deaths with a cumulative death rate of 363 per 100,000.²⁷

Vaccinated by zip code

Only 61.8% of residents in Shelby County have received at least one dose of vaccine as of July 31, 2022. Only 14% of residents are up-to-date with COVID-19 vaccinations, meaning they have received all recommended doses in the primary series and all recommended boosters for which they are eligible.²⁸

For residents who have received at least one dose, the highest rate of vaccination is among older adults aged 65-74yrs (92.4%), followed by those aged 75yrs and older (91.1%), then 55-64yrs old (79.9%), and 45-54yrs old (76.9%), respectively. The lowest vaccination rate is among children aged 0 - 4yrs (2.7%), followed by 5 – 11yrs (24%) and 12-17yrs (54.7%).³⁶

OVERWEIGHT AND OBESITY

Obesity and a sedentary lifestyle are risk factors for the top three leading causes of death in S[1] helby County: heart disease, cancer, and cerebrovascular disease. In Shelby County, 40% of adults aged 18 and older reported being obese and 29% report having no leisure-time physical activity in 2020.¹²

According to the Tennessee Department of Education, 38.8% of public school students in Shelby County were overweight or obese.¹³ Among high school students who participated in the Youth Risk Behavior Survey in Shelby [2] County, 19.2% were overweight or obese compared to 15.5% for students participating nationally.¹⁴ Among these Shelby County students, 28% reported that in the past week they were not physically active for at least 60 minutes on any one day and 27.7% reported that they watched television for 3 or more hours per day on an average school day. Twice as many high school students report not eating any vegetables in the previous seven days in Shelby County compared to nationally^.14

Evidence suggests that food deserts are correlated with overweight and obesity. The County Health Rankings reports a food environment index of 7.3 in Shelby County compared to Tennessee at 6.2.¹⁶ The index ranges from 0 (worst) to 10 (best) taking into account proximity to healthy foods and income.

AGING POPULATION

The proportion of the population aged 65 and older is increasing in Shelby County. There were about 12,500 more people 65 and older in 2020 than there were in 2017. The number of Alzheimer’s deaths has decreased by 54% in the same time period.⁴ Additionally, with an aging population, falls and injuries become important issues. Families will increasingly be caring for elderly loved ones and may be unprepared to handle their new caregiver role. Habitat for Humanity in Shelby County has an initiative to assess home environments and make them safer, to enable more Shelby County residents to safely age in place rather than having to relocate to assisted living facilities.¹⁷ Partnering with organizations focused on housing issues and serving our aging population and supporting these kinds of initiatives would be an excellent way to serve our communities as the number of older residents continues to increase.

HIV AND SEXUALLY TRANSMITTED INFECTIONS

There were 6,605 people living with HIV/AIDS (PLWHA) by the end of 2020 with a rate of 705.2 per 100,000 population in Shelby County[1] .³⁰ In 2020, there were 236 new HIV cases in Shelby County, among which 77% were men, 58% were adults aged 20 - 34 years old, 82% were Black, and 42% were men who have sex with men (MSM).³⁰ Among metropolitan areas in the United States, Memphis-Shelby County ranks third with an estimated rate of new HIV infections of 20.7 per 100,000 population. This is in comparison to Nashville, TN which is ranked thirty-eight with a rate of 10.7 per 100,000 population. Regarding new AIDs diagnosis among Metropolitan areas in the United States, Memphis-Shelby County ranks first with a rate of 14.8 per 100,000 population. In comparison Nashville ranks seventy-two with a rate of 3.6 per 100,000 population.

For Shelby County in 2020, there were 8,976 chlamydia cases, among which 69% were females and 91% were adults aged 15 - 34 years old. There were 4,456 gonorrhea cases in 2020, among which 53% were males and 85% were adults aged 15 - 34 years old. Lastly, Shelby County had 1,052 cases of syphilis (all stages) in 2020, among which 72% were males and 65% were adults aged 15 - 34 years old.³¹ Race data for sexually transmitted infections (STIs) were limited, but based on 2019 data, non-Hispanic Blacks experienced higher cases and rates of chlamydia, gonorrhea, and syphilis.³²

[2] [RR3] Recent 5-year data trends for the Memphis Metropolitan Statistical Area (MSA) have seen increases in STI incidence rates. The Memphis MSA continuously experiences higher incidence rates compared to the U.S. MSA total. This trend can be observed for chlamydia, gonorrhea, and syphilis as seen in the table.³³

[1] [RR2] Recent 5-year data trends for the Memphis Metropolitan Statistical Area (MSA) have seen increases in STI incidence rates. The Memphis MSA continuously experiences higher incidence rates compared to the U.S. MSA total. This trend can be observed for chlamydia, gonorrhea, and syphilis as seen in the table.³³

Specifically for Shelby County, the incidence rate for chlamydia in 2019 was 1096 per 100,000 population. In 2020, the chlamydia incidence rate was 958 per 100,000 population. Incidence rate for gonorrhea in 2019 was 455 per 100,000 population, and in 2020, that rate was 476 per 100,000 population. As for syphilis (all stages), the incidence rate in 2019 was 99 per 100,000 population. In 2020, the incidence rate was 112 per 100,000 population. Besides the rate decrease in chlamydia, even with COVID-19 restrictions and lock down in 2020, gonorrhea and syphilis (all stages) saw incidence rate increases in Shelby County^.32,1

VIOLENCE

The rate of death by assault in Shelby County in 2020 was 34.9 per 100,000 population, almost 5 times the national rate of 7.5 per 100,000.^4,19,48 The rate varies considerably between the districts from a low of 10.4 to a high of 73.8[1] [KJ2] [KJ3] . More men died from homicide than women in Shelby County with 88.7% of the deaths due to assault being to men in 2020. Blacks are more likely to die from assault compared to any other race. In Shelby County, the black death rate due to assault was almost 10 times the white rate.⁴

Death By Assault

INFANT MORTALITY

For 2015-2020 combined, the infant mortality rate was 8.9 per 1,000 live births compared to the national rate of 4.8 per 100,000 live births. Substantial racial disparities exist with black/African Americans having over twice the rate of infant deaths as non-Hispanic whites.⁴ Although they remain too high, infant mortality rates have been on a steady downward trend, declining by about 26% over the past decade. The leading causes of infant death in Shelby County are Sudden Unexpected Infant Deaths (SUID) (23%), prematurity or low birth weight (18%), and congenital defects (17%).⁴ Sleep-related infant deaths are a substantial contributor to SUID.⁴ [4] [5] [6] [RR7]

Infant mortality

[8] [RR9] [10] [RR11] [RR12]

SUBSTANCE USE DISORDER AND OPIOIDS

Substance use disorder is a growing problem in Shelby County. In 2020, the overall age-adjusted mortality rate of fatal drug overdose was 50 deaths per 100,000 population.^1,35 This is in comparison to the United States with an age-adjusted mortality rate of 28.2 per 100,000 population and Tennessee with a rate of 45.6 per 100,000.^{49,50, 51}The rate of opioid-related fatal overdoses in Shelby County remained lower than the rate for Tennessee overall from 2016 through 2018, but met and surpassed it in 2019 and 2020.⁵¹ The age-adjusted opioid-related mortality rate in 2020 for Shelby County was 42 deaths per 100,000, compared to 36 deaths per 100,000 in Tennessee.⁵¹ Over the last few years synthetic opioids, primarily Fentanyl have become the greatest concern in Shelby County. Fentanyl can be disguised as other drugs, which allows users to unknowingly ingest more than intended, leading to an overdose. ³⁴ According to the Youth Risk Behavioral Surveillance System (YRBSS) for Shelby County, in 2019 an estimated 18.5% of adolescents aged 12-17 had taken a prescription pain medicine without a doctor’s prescription or differently than how a doctor told them to use it.¹⁴ In Shelby County, 26.5% of high school students reported being offered, sold, or given an illegal drug on school property¹⁴

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Opportunities

Promote healthy eating and active living. Healthy nutrition and moderate physical activity promote heart health and healthy aging.
Support and promote smoking prevention and cessation activities. Smoking is the number one risk factor for heart disease and many cancer types.
Promote public transit and rideshare programs that can help limit the number of drivers and traffic congestion on the roads. Support street designs that can improve safety for pedestrians, cyclists and motorists. Improvements could include increased lighting, more sidewalk coverage, connecting pedestrian walkways, street crossing safety features and traffic calming measures.
Promote physical and social programs for older adults. Provide assistance to caregivers of older adults by providing education and supporting adult day care centers. Support Habitat for Humanity of Greater Memphis’ Aging in Place (AIP) Program, which serves homeowners aged 60 and older in Fayette and Shelby Counties to help older homeowners live in their own homes longer.
Increase access to testing and treatment for sexually transmitted infections and HIV. Provide assistance to parents and guardians on how to talk to their children about sex. Increase birth control access for teens.
Encourage participation in WIC (Women, Infants, and Children) and Family Planning programs. It is estimated that less than half of those who qualify participate in WIC.²⁰ Additionally, support breastfeeding initiatives and educate residents about infant safe sleep practices.
Help reduce overdose fatalities by making Naloxone more accessible to the public and include Naloxone in emergency response kits in all public spaces. Provide Naloxone training and educate the public about Opioid and Substance Use Disorders in order to decrease stigma. Share the Tennessee Redline (1-800-889-9789) with those in need of treatment and resources.
Implement evidence-based public health approaches to reduce injuries, shootings, and deaths. Shelby County was recently awarded a grant to implement ‘Cure Violence’, a program shown to reduce violent crime by as much as 63%.²¹
Maximizing participation in TennCare and improving access to quality health care is important to improving outcomes.
Continue efforts through the Health Disparities team to increase COVID-19 outreach and vaccination for under-vaccinated zip codes and districts throughout Shelby County. Maintain and monitor COVID-19 surveillance systems to track any potential spike in cases and respond as appropriate.
To reduce Monkeypox transmission residents should get vaccinated if at high risk for contracting monkeypox. If they know someone who is sick with monkeypox they should minimize skin to skin contact if the person has any rash. If the resident is sick, they should stay home till they have fully recovered.

COMMISSION DISTRICT 1

Commissioner: Amber Mills

COMMISSION DISTRICT 1

Overview

District 1 is situated on the river with Tipton County bordering on the north side of Shelby County and includes Cordova-Appling, Eads-Fisherville, Raleigh, Shelby Forest-Frayser, and Wolf Forest Farms, among other neighborhoods.

Demographics¹: Based on 2020 data, District 1 has a population of 66,796. Compared to Shelby County overall, the population of District 1 is slightly younger, with a median age of 35.7. In this district, about 26% of the population is less than 18 years old, 61% are 18-64, and 12% are 65 and older. This district has the third highest proportion of youth compared to other districts. The residents of District 1 are 51% White, 42% Black or African American and 7% other races or multiracial. There are an estimated 5.1% of residents who are Hispanic or Latino.

Social Determinants¹: In District 1, the median household income is $64,780, which is 24% higher than Shelby County overall. The percent of population living below the poverty level is 12%. In District 1, 17% of children under 18 are living below the poverty level, one of the lowest in Shelby County overall. Education levels are on the low end when compared to the county overall, with 67% of the district receiving a high school diploma or higher, putting the district 6^th in high school educational attainment or higher for the County. Residents of District 1 report a mean traveling time of 27.7 minutes to work.

LEADING CAUSES OF DEATH AND LIFE EXPECTANCY

Health data in this profile are reported based on zip codes. Please note data may overlap districts as some zip codes are included in multiple districts.

ZIP CODES INCLUDED:

38002, 38016, 38053, 38127, 38128, 38133

LEADING CAUSES OF DEATH

The five leading causes of death in District 1 are Heart Disease, Cancer, Unintentional Injuries, Cerebrovascular Disease, and Chronic Lower Respiratory Disease (LRD).²

From 2018-2020, the number of people in District 1 that died from heart disease was 1,272.

1,084 people died from cancer, 400 died from unintentional injuries, 270 died from cerebrovascular disease, and 257 died from chronic LRD during that same time period.⁴

The life expectancy in District 1 is 75 years old, placing it 6^th of all the districts.¹

DISTRICT SPECIFIC ISSUES

COVID-19

As of July 31^st, 2022, District 1 had a total of 63,332 COVID-19 cases and 721 deaths. This places the district 3^rd in the total number of confirmed cases and 5th in the total number of deaths.²⁷ The cumulative case rate for this district is 28,418 per 100,000 population, the 4th highest rate among districts and the cumulative death rate is 1,079 per 100,000 population, the 5^th highest.²⁷ Through July 31^st, 2022, only 58.1% of the district population has received a 1^st dose vaccine compared to 61.8% for Shelby County overall and only 12.1% are up to date on their recommended vaccinations compared to 14.0% for the county overall.³⁶ Much of District 1 sits in more rural parts of Shelby County and this may be a contributing factor in lower vaccination percentages.

OPIOID OVERDOSE

Deaths related to opioids in District 1 are the 8^th highest among districts in the county and the rate is less than the rate of the county overall. In District 1 there were 358 fatal provisional opioid-related overdoses from 2014-2021 with a rate of 20.1 per 100,000 population, compared to 25.3 for the county overall.³⁵

OVERWEIGHT AND OBESITY

In a 2019 Shelby County community survey, 70% of those who responded from District 1 self-identified as overweight, the 4^th highest percent among districts. Further, among live births in District 1 for 2020, 34.6% of mothers reported a pre-pregnancy BMI in the overweight/obese range. This is the 7^th highest percentage in comparison to the other districts.

INFANT MORTALITY

District 1 has relatively high counts for infant mortality. From 2015-2020, there were 171 infant deaths and a rate of. 9.0 per 1000 live births. In relation to other Districts, District 1 ranks 4th out of 13 for number of infant deaths and 7^th for infant mortality rate .⁴

OPPORTUNITIES

Obtain and increase funding for resources and staff to combat the comorbidities that impact health outcomes for those living in Shelby County. Educate the community through public health outreach. Partner with other health providers and community-based organizations to do health risk assessment screening and testing.
Continue efforts through the Health Disparities team to increase COVID-19 outreach and vaccination for under-vaccinated zip codes and districts throughout Shelby County. Maintain and monitor COVID-19 surveillance systems to track any potential spike in cases and respond as appropriate.
Implement evidence-based public health approaches to reduce injuries, shootings, and deaths. Shelby County was awarded a grant to implement ‘Cure Violence.’ The program is actively underway and has been shown to reduce violent crime in communities that already have the program implemented.²¹
Make Naloxone more accessible to the public and include Naloxone in emergency response kits in all public spaces. Provide Naloxone training and educate the public about Opioid and Substance Use Disorders in order to decrease stigma. Share the Tennessee Redline (1-800-889-9789) with those in need of treatment and resources.
Create more safe and friendly built environments that promote physical activities in a green and inviting space. Increasing accessible green spaces particularly in areas of high health risks can contribute to health benefits such as physical and mental health, cardiovascular disease, and respiratory disease.³⁷
Promote the Shelby County Health Department WIC (Women, Infants, and Children) and Family Planning Programs. Advertise the available resources and education the programs provide. Maintain a consistent presence in communities of need to increase awareness on breastfeeding, nutrition, and infant safety to caregivers.

COMMISSION DISTRICT 2

Commissioner: David C. Bradford