Health & Wellness

It is important to note that the Youth Risk Behavior Survey changed methodology to be administered online in 2019.  Previously done as a paper survey, this change could impact the makeup of the groups responding to the survey (see Notes on Indicators pages, e.g., 4.10 Youth Suicide-Related Behavior).  Restraint should be used when making comparisons between years, which are marked below with an asterisk (*).

Infant Health
The Fox Cities region sees a lower percentage of births paid for by Medicaid or BadgerCare than the state Medicaid average and a higher percentage of births with prenatal care in the first trimester. Beyond the biological risk of low birthweight that is connected with the age of the mother, there are several socioeconomic risks with teen pregnancy, including lower education levels, higher rates of poverty, and poorer quality of life for children of teenage mothers. The percentage of births paid for by Medicaid or BadgerCare Plus is another indicator of socioeconomic risk. Where the percentage of babies born with a low birth weight decreased in Outagamie County, Calumet and Winnebago saw an increase from 2016 to 2018.

Youth Suicide
The percent of Fox Cities high schoolers who considered (14.8%) or attempted (6.0%) suicide in 2019 is just under the Wisconsin average but are similar for each.  This represents a substantial decrease in the percent of Fox Cities youth who attempted suicide in 2015 (12%)*. Across race/ethnic categories in Fox Cities, a higher percent of youth of color attempted suicide (except for Asian youth), particularly American Indian/Alaska Native and youth with multiple race identities, compared to white youth. The percent of black/African American youth and youth with multiple race identities who considered suicide was greater compared to those same groups in Wisconsin, while the percent of white and Asian youth were somewhat lower than those groups in Wisconsin.

Across Fox Cities, sexual minorities are far more likely to report considering suicide, and to attempt suicide than heterosexual youth.  Bisexual youth are at the highest risk, almost half of whom have considered suicide in the past year (42.6%), and almost one in five attempted suicide in the past year (18.6%).  Gay or lesbian youth are at the next highest risk for considering suicide (37.1%) and attempted suicide (11.8%), while heterosexual-identified youth are at the lowest risk (11.7% considered suicide, 4.5% attempted).  While high, and alarming, these represent lower risks from these same groups in Wisconsin, and nationally. This may highlight a need for more targeted intervention programs and supportive services for all youth, and especially for students who may be at higher risk.  

Health Access and Outcomes
In the Fox Cities region, there has been an increase in the percentage of adults without health insurance and a stable percentage of the population receiving Medicaid from 2015 to 2018. Encouragingly, the percentage of adults having blood pressure and cholesterol checks has increased across the Fox Cities region since 2011.  The percent of children without health insurance almost doubled from 2016 to 2018, compared to a relatively flat Wisconsin trend. The overall health outcome ranking in Fox Cities increased between 2015 and 2019, with Calumet consistently being in the top 5.

Diabetes and Obesity 
Both Calumet and Outagamie saw an increase in adult obesity between 2007 and 2018(1), as the prevalence of type 1 and 2 diabetes also increased in 2018. Alongside this, the three-year average mortality rate for diabetes-related deaths significantly decreased between 2015 and 2018 in Calumet County, remained stable for Outagamie, and increased in Winnebago. An estimated 27.8% of people living with diabetes in the United States are currently undiagnosed(2). It may be that increased coverage will improve access to preventive health screening, earlier diagnosis and ultimately better health outcomes for diseases like diabetes. 

Cigarette, Alcohol, and Drug Use
Adult smoking in Outagamie County is half of either Wisconsin or the country and has decreased by almost half between 2015 and 2019.  In contrast, rates of adult smoking in Winnebago County have increased slightly and are just higher than the state and country.  Youth smoking in the Fox Cities has declined from 21% in 2009 to 5% in 2019*. This represents a slightly lower youth smoking rate than Wisconsin, but less than one-third the national percentage.  For the years of data available, the higher rates of vaping appear to coincide with lower rates of smoking, but it is not known whether youth have moved into vaping rather than quitting the habit or have a stronger preference for vaping and never smoked.  The percent of youth engaging in vaping in the Fox Cities area is similar to that in the rest of the state, but slightly lower.  Of note is that the combination of youth smoking and vaping for 2019 (22.6%) outpaces the highest smoking rate (2009 – 21.0%)*.

Adult casual drinking in all three Fox Cities counties is higher than the state (63%) or national (54%) average and is highest in Calumet County (77%).   Rates of adult binge drinking in Calumet (29%) and Winnebago (28%) are higher than Wisconsin (24%) and the nation (16%), while binge drinking in Outagamie County (23%) is just below the state average.  Binge drinking in all three counties has slightly increased since 2013, but still represents a decline since 2011.  Youth in Fox Cities drink at lower rates (25.2%) than the state (29.8%) or country (29.8%), representing a continued decrease since both 2009 and 2015.*  In 2019, binge drinking among youth in Fox Cities (9.1%) is also lower than both the state (12.7%) and the country (13.5%) and has plummeted by more than half since 2009 (23%).*

Youth marijuana use (21.7%) in Fox Cities has slightly declined since 2015 (24.6%)—while almost twice the Wisconsin average (11.9%), it is still substantially lower than the national average (35.6%).*  The use of methamphetamine (1.7%) has fallen by half since 2015 (3.1%), and is lower than both the state (1.9%) and country (2.5%).*

(1) 2007 adult obesity data not available for Winnebago 
(2) 2012 CDC estimate, see here for full report: