DiabetesRiskFactors CommunityProfile GreaterFlintArea Shiawassee‐Genesee‐LapeerCounties March2013 Prepared By: The Directors of Health Promotion and Education TableofContents TargetPopulation....................................................................................................................................................................1 LocationofPeoplewithDiabetesRiskFactors...............................................................................................................................4 Marketing....................................................................................................................................................................................6 GreaterFlintAreaMaps...........................................................................................................................................................7 DemographicandSocioeconomicStatusAssociatedwithHigherRiskofDiabetes..........................................8 BehaviorsAssociatedwithHigherRiskofDiabetes....................................................................................................14 UnderstandingtheEnvironment......................................................................................................................................................18 LargeEmployers.....................................................................................................................................................................19 Appendix1:ProjectandTechnicalNotes......................................................................................................................................20 Appendix2:EnhancedDemographics........................................................................................................AppendixtooLarge SeeExcelWorkBook“Appendix2Demographics” Appendix3:SupportingDocumentationforMap2andtheMediaProfiles..................................................................21 Appendix4:MediamarkResearchDefinitionofMediaQuintiles........................................................................................27 Appendix5:SelectDemographicsbyZipCode.........................................................................................AppendixtooLarge SeeExcelWorkBook“Appendix5DemographicsbyZipCode” Appendix6:BehaviorsAssociatedwithHigherRiskofDiabetes.....................................................AppendixtooLarge SeeExcelWorkBook“Appendix6BehaviorsAssociatedwithHigherRiskofDiabetes” Appendix7:ListofSelectBusinesses...........................................................................................................AppendixtooLarge SeeExcelWorkBook“Appendix7Businesses” Appendix8:ListofLargeBusinesses..................................................................................................AppendixtooLarge SeeExcelWorkBook“Appendix8LargeBusinesses” Greater Flint Area Shiawassee, Genesee, and Lapeer Counties TheNationalAssociationofChronicDiseaseDirectors(NACDD)hascontractedwiththeDirectors ofHealthPromotionandEducation(DHPE)toprovidethefollowingdataandrecommendationsto beusedtoidentify: targetaudiencesfortheDiabetesPreventionPrograms(DPP) howtoreachthetargetaudience healthcarefacilitiesintheareathatcanrefertoDPPs. locationsofselectbusinessthatmaybeusefulinpromotingDPPs ThisreportusesPRIZMsegmentdescriptionstodeterminewherepeopleatriskfordiabetesmay belocated.Thereare66PRIZMsegmentsthateachhasuniquedemographicdescriptionsbasedon income,lifestage,agerange,presenceofchildreninthehousehold,homeownership,employment, education,andraceandethnicity.Basedonthesegmentprofilesthefollowingquestionscanbe examined: Whereisthetargetpopulationlocated? Howwouldyoureachthem? Whatelseisinthearea? TargetPopulation Approximately144,0001prediabeticadults21yearsoldandolderliveShiawassee,Genesee,and LapeerCountieswhichwillbereferredtoastheGreaterFlintAreathroughouttheremainderofthe report.Approximately50%ofadults65andolderareestimatedtohaveprediabetes.1Peoplewith prediabeteshaveanincreasedriskofdevelopingtype2diabetes,heartdisease,andstroke.Studies haveshownthatpeoplewithprediabeteswholoseweightandincreasetheirphysicalactivitycan preventordelaytype2diabetesandinsomecasesreturntheirbloodglucoselevelstonormal. Ifthemodifiableriskfactorsfortype2diabetes(beingoverweightorobeseandphysicalinactive) continuetoincrease,sowilltheprevalenceoftype2diabetes.Theadultobesityprevalencein Michiganhasincreasedfrom18.2to31.7percentbetween1995and2010.2 IndividualsatgreatestriskofdevelopingdiabetesinMichiganare: AfricanAmericans Individualswithnocollegeeducation Householdsthatearnlessthan$25,000peryear 1 Estimate is based on multiplying the population for those 21 years old and older by 35%.The estimated number of persons with prediabetes was calculated by applying the national estimate of prediabetes from NHANES III to the 2013 population estimate for adults aged 21 years and older in the geography of interest. This is the same methodology as was used in the Centersfor DiseaseControlandPrevention.Nationaldiabetesfactsheet:nationalestimatesandgeneralinformationondiabetesand prediabetesintheUnitedStates,2011.Atlanta,GA:U.S.DepartmentofHealthandHumanServices,CentersforDisease ControlandPrevention,2011.Availableat:http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf. 2 MichiganBehavioralRiskFactorSurveillanceSystem,1995‐2010.Availableathttp://apps.nccd.cdc.gov/BRFSS. 1 | P a g e Table1providesasummaryofsomeofthedemographicfactorsassociatedwithahigherriskof developingdiabetes.Appendix2containsadetailedreportofdemographicsandhousehold characteristicsfortheareaofinterest. Table1.Demographics Genesee GreaterFlintArea Michigan Shiawassee‐Genesee‐ County LapeerCounties TotalPopulation 417,447 574,046 9,862,679 Age <21yearsold 21‐44 45‐64 65‐84 85+ 28.7% 29.3% 27.4% 12.7% 1.9% Race White BlackorAfricanAmerican AmericanIndianandAlaskaNative Asian NativeHawaiianandOtherPacificIslander SomeOtherRace TwoorMoreRaces 28.3% 28.7% 28.3% 12.9% 1.8% 27.7% 29.7% 27.9% 12.7% 2.0% 74.4% 20.7% 0.5% 0.9% 0.0% 0.8% 2.7% 80.3% 15.2% 0.5% 0.8% 0.0% 0.8% 2.4% 78.6% 14.2% 0.6% 2.6% 0.0% 1.6% 2.4% Ethnicity Hispanic NotHispanic 3.2% 96.8% HouseholdIncome Average Median Population25andolderwithlessthana 4‐yearcollegedegree 3.3% 96.7% 4.7% 95.3% $43,375 $33,574 $46,585 $36,549 81.0% 82.0% $58,514 $43,691 74.9% DPP=DiabetesPreventionProgram DataSource:2013TheNielsenCompanyEnhancedDemographicReport Over25%ofthepopulationisbetween45and64yearsold.Thisagegroupisanidealtargetgroup astheprevalenceofdiabetesgoesupdramaticallyinthepopulation65andolder.3TheGreater FlintAreahasalowermedianhouseholdincomecomparedtothestateasawhole.GeneseeCounty hasanevenlowermedianhouseholdincome.Thepercentofthepopulation25yearsoldandolder withlessthana4‐yearcollegedegreeishigherintheGreaterFlintAreaandGeneseeCounty comparedtothestateasawhole,suggestingthatthisareamaybeatgreaterriskofdeveloping diabetesasindividualswithlowerincomeandlessthana4‐yearcollegedegreehaveahigher prevalenceofdiabetes.4 Map1showsthelocationoftheGreaterFlintAreathatmuchoftheanalysisinthisreportisbased on. 3 4 MichiganBehavioralRiskFactorSurveillanceSystem,1995‐2010.Availableathttp://apps.nccd.cdc.gov/BRFSS. CentersforDiseaseControlandPrevention.Nationaldiabetesfactsheet:nationalestimatesandgeneralinformationon diabetesandprediabetesintheUnitedStates,2011.Atlanta,GA:U.S.DepartmentofHealthandHumanServices,Centers forDiseaseControlandPrevention,2011.Availableat:http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf. 2 | P a g e 3 | P a g e LocationofPeoplewithDiabetesRiskFactors Peoplewithriskfactorsfordiabetesareconsideredthetargetpopulation.Thetargetpopulation wasdeterminedusingthedemographicdescriptionandlifestylepreferencesofeachPRIZM segmentfoundintheGreaterFlintArea.Segmentswithdemographiccharacteristicsassociated withahigherprevalenceofdiabeteswerecombinedtoformaprofile.Thedemographicand socioeconomiccharacteristicsthatwereincludewhere: EducationAttainment:whereeducationwaslessthanafour‐yearcollegedegree HouseholdIncome:averaged$50,000orlessperyear Age:segmentagerangesthatoverlappedorcontainedtheagegroupof45to84yearolds BasedonthesethreecharacteristicsthefollowingPRIZMsegmentswerefoundtobeathighriskof developingdiabetes:38,39,40,41,42,43,44,45,46,48,49,52,53,54,55,56,57,58,59,60,61,64,65,66. Thereare66PRIZMsegments.Ingeneral,asthesegmentnumberincreases,thesocioeconomic statusdecreases.Asmentionedpreviouslyeachsegmenthasauniquedemographicand socioeconomicdescriptionsbasedonseveralindicatorsincluding:income,lifestage,agerange, presenceofkidsinthehousehold,homeownership,employment,education,andraceandethnicity. Foradetaileddescriptionofeachsegment,visit http://www.claritas.com/MyBestSegments/Default.jsp?ID=30&id1=1027&id2=&webid=1 Toverifythatthesesegmentsalsohadhighrisklifestylebehaviorsthatcouldleadtodiabetes analyseswereconductedtoexaminetheirlikelihoodofbeingphysicallyactive,consumingfruits andvegetables,andwatchingover20hoursoftelevisionperweek.Itwasfoundthatthese segmentswereamongtheleastlikelytobephysicallyactiveandtoconsumefruitsandvegetables, andamongthemostlikelytowatchmorethan20hoursoftelevisionperweek. ThezipcodeswithintheGreaterFlintAreawhere50%ormoreofthepopulationfitsthisprofile are:48458, 48476, 48532, 48519, 48463, 48727, 48817, 48457, 48464, 48506, 48509, 48420, 48505, 48507, 48429, and48423. Map2showstheconcentrationofthetargetsegmentswithineachzipcode.Thedarkertheorange colorthehighertheconcentrationofthetargetsegment.Table2providesalistofallthezipcodes intheGreaterFlintAreaandthenumberofhouseholdsthatareconsideredathighriskof developingdiabetes.ThistablecanbefoundinAppendix3. 4 | P a g e 5 | P a g e Marketing5 Belowarewaystoreachthetargetaudience.Therearedescriptionsofhowoftenandthetypesof print,radio,andtelevisionstationstheyread,listento,andwatch.Forradioandtelevision,the timesanddaysoftheweektheaudiencesismostlikelytolistentoorwatcharealsolisted. SeeAppendix2fordetailedtablesandinformationforthesourceinformationthedescriptions belowarebasedon. PrintMediaProfile: Approximatelythesamenumberofusersper100householdsreadsthenewspaperfrequently(16+ timesformalesand13+timesforfemalesina28dayperiod)asreadthenewspaperinfrequently (0‐15timesformalesand0‐12timesforfemalesina28dayperiod).Over70usersper100 householdsinthetargetPRIZMsegmentsreadtheSundayNewspaper.Over50usersper100 householdsinthePRIZMsegmentsreadwomen’smagazines,generaleditorialmagazines,thedaily newspaper,homeservicemagazines,andnewsweeklymagazines.Thenumberofusersper100 householdsisapproximatelythesameforquintiles3,4,and5formagazinesandquintiles1,2,4, and5fornewspapers,indicatingthatthetargetsegmentsareaslikelytobemoderatetoinfrequent readersofmagazinesandheavytoinfrequentreadersofnewspapers.Althoughthetargetsegments are13%lesslikelytoreadtheSundaynewspapercomparedtoallsegmentsnationally,73users per100householdsinthetargetpopulationdoreadtheSundaypaper.Ifusingprintmediafor marketing,theSundaynewspaperhasthemostreach. RadioMediaProfile: Thetargetsegmentsaremorelikelytolistentotheradio0to2hoursperweekcomparedtoall segments.Theredoesn’tappeartobeaspecifictimeframethatmostusersinthetargetsegments listentotheradio;theyafairlyevenlydistributedacrossthethreetimeperiodsexamined6am‐ 10am,10am‐3pm,and3pm‐7pm.Countryradiostationshavethehighestusersperhouseholdin thetargetsegments.Ifusingradioasamarketingvenue,thebesttypeofstationtoadvertiseonis countyradio.Itappearsthatasmanyusersper100householdslistentotheradiofrequentlyasdo infrequently.Ifusingradioasavenueformarketing,thebeststationstoadvertiseonarecountry radiostations.Therearenoparticulartimesofdaysthatappeartobebetterthanothers. TelevisionMediaProfile: Thetargetsegmentsaremorelikelytowatch24hoursoftelevisionperweekcomparedtoall segments.Theyarealsomuchmorelikelytowatch45ormorehoursoftelevisionperweek comparedtoallsegments.Between7and8pmwhenmostusersperhouseholdarewatching televisioninthetargetsegmentandthosewatchingtelevisionduringthistimeareslightlymore likelytobeinthetargetsegmentgroup.Thetargetsegmentisalsomorelikelytowatchdaytime television.Over50usersper100householdsinthetargetsegmentwatchNFLMonday/Thursday nightfootball,theweatherchannel,historychannel,andFOXNews.Ifusingtelevisionfor advertising,thebesttimeofdayisbetween6pm‐8pmontheweatherchannel,historychannel,or FoxNews;notenoncableandnetworkstationsarenotcapturedinthisanalysis. 5 Marketing Profile is based on the PRIZM segments that are least likely to report exercising: segments 26, 31, 38-40, 42-49, 52-66. There are 66 PRIZM segments the higher the number the lower the social-economic status. The segments are defined based on a combination of household characteristics (e.g., presence of kids), demographic characteristics, and economic characteristics. Nielsen’s segmentation system has been tested and verified in various settings and geographic locations. The selected marketing avenues were selected based both on a high Market Potential Index as well as the number of people that could be reached. 6 | P a g e InternetMediaProfile: Thetargetsegmentsaremorelikelytousetheinternet0to17timespermonthcomparedtoall segments.Theyarealsomuchmorelikelytonothaveusedtheinternetatallinaonemonthperiod. Approximately60%ofhouseholdsinthetargetsegmentownacomputerand52%haveinternet accessathome.Ifusinginternetasawaytoadvertise,onlyabouthalfofthetargetsegmenthas accesstotheinternet.Internetuseformostusersinthetargetsegmentsislow. AttitudeTowardMedia: Over60usersper100householdsinthetargetpopulationfeelmagazines,newspapers,radio,and televisionadsgiveusefulinformation;howevertheyarelesslikelytofeelthiswaycomparedtoall segments.Thetargetsegmentsaremorelikelytoagreethattelevisionisthemosttrustedmedia. GroceryShoppingHabits Over95usersper100householdsinthetargetsegmentsgroceryshopatWalmart.Approximately 40usersper100householdsgroceryshopatastore1to5milesfromtheirhome.Ifusinggrocery storesasanavenueforadvertising,choosethoselocatedwithin5milesofthetargetpopulation. RetailerandShoppingHabits: Over110usersper100householdsinthetargetsegmentsshopatWalmart.Approximately35 usersper100householdshaveshoppedatTarget,JCPenney,andKmartinthelastthreemonths.If usingstoresasavenueforadvertising,thebeststorestoadvertiseatareWalmart,Kmart,and Target. Restaurants: McDonaldsandBurgerKingarethetwofastfoodrestaurantswherethehighestnumberofusers perhouseholdfrequent.Howeverthetargetsegmentsarelesslikelytofrequenttheserestaurants comparedtoallsegments. GreaterFlintAreaMaps DatafromNielsenCompanycanalsobeusedtocreatemapsofattributesthroughouttheGreater FlintArea.Thefollowingmapsmaybeusefulinprogramplanningeffortstoidentifypotential targetareas.Maps3through8highlightgeographicareaswithdemographicandsocioeconomic statusdatathatareassociatedwithahigherriskofdevelopingdiabetes.Maps9through12 highlightsgeographicareaswherehealthbehaviorsareexhibitedthatareassociatedwithhigher riskofdevelopingdiabetes.Appendix5containsthedemographicandsocioeconomicstatusdata providedinMaps3through8.Appendix6containsthehealthbehaviordataprovidedinMaps9 through12. 7 | P a g e DemographicandSocioeconomicStatusAssociatedwithHigherRiskofDiabetes Map3showsthepercentof familiesbelowpovertybyzip code.Thezipcodesinredhave thehighestpercentoffamilies belowpoverty;between33.5% and43.7%. ThezipcodesnearFlinthavethe highestpercentoffamiliesbelow poverty. Atleast20%ofthefamiliesinthe followingzipcodesarebelow poverty:48505,48502,48503, 48504,48506,48458,48507,and 48529 8 | P a g e Map4showstheaverage annualhouseholdincome andadults25andolder whohaslessthana4‐year collegedegreebyzipcode. Thedarkerthecolor,the lowertheaverage householdincome.The darkerthelines,thehigher thepercentofadultswho donothavea4‐year collegedegree. ThezipcodesnearestFlint haveboththelowest averagehouseholdincome andthehighestpercentof adults25yearsoldand olderwhodonothavea4‐ yeardegree. Thefollowingzipcodes hadaveragehousehold incomelessthan$45,000 peryear:48502,48505, 48503,48504,48506, 48458,48529,48507,and 48519 Atleast90%ofadults25 yearsoldandolderhave lessthanafour‐year collegedegreeinthefollowingzipcodes:48505, 48727,48458,48529,48506,48463,and48457. 9 | P a g e Map5showsthepercentofthe populationthatisHispanicbyzip code.Asthebluecolordarkens thepercentofthepopulationthat isHispanicincreases.Thezip codeintheeasternpartofLapeer Countyhasthehighestpercentof Hispanics. Atleast7%ofthepopulationis Hispanicinthefollowingzip codes:48444and48506. NationallyHispanicshavea higherriskofdeveloping diabetes.Thepopulationof HispanicsinMichiganislessthan 5%ofthetotalpopulation makingitdifficulttoestimatethe riskforHispanicsinMichiganbut itislikelytoresemblethe nationalrisk. 10 | P a g e Map6showsthepercentofthe populationthatisAfrican Americanbyzipcode.Asthered colordarkensthepercentofthe populationthatisAfrican Americanincreases.Thezip codesnearestFlinthavethe highestpercentofAfrican Americans. Atleast20%ofthepopulationis AfricanAmericaninthefollowing zipcodes:48505,48504,48502, 48503,48532,48458,and48507. 11 | P a g e Map7showsthepercentofthe populationages45through64 yearsoldbyzipcode.Asthe orangecolordarkens,the percentofthepopulationthatis between45and64yearsold increases. Atleast30%ofthepopulationis 45to64yearsoldinthe followingzipcodes:48455, 48428,48463,48841,48421, 48848,48438,48414,48412, 48464,48436,48003,48509, 48460,48418,48446,48461, and48430 12 | P a g e Map8showsthepercentofthe population65yearsoldand olderbyzipcode.Astheorange colordarkens,thepercentof thepopulationthatisbetween 45and64yearsoldincreases. Atleast15%ofthepopulation is65yearsoldandolderinthe following:48433,48532, 48473,48460,48476,48519, 48509,48817,48420,48841, 48449,48463,48429,48455, 48867,48446,48412,48423, 48727,and48464. 13 | P a g e BehaviorsAssociatedwithHigherRiskofDiabetes Map9showsthelikelihoodadultshealth insurancebyzipcodecomparedtothe averageuseracrossthethreecounties.The darkerthebluethelesslikelytheyareto reporthavinghealthinsurance. MarketPotentialIndex(MPI)iscalculated basedonthenumberofusersper100 householdsineachzipcodedividedby numberofusersper100householdsinthe geographicareaofinteresttimes100.It indicatesthelikelihoodthathouseholdsina zipcodearetodisplaythebehaviorofinterest comparedtotheaverageforthegeographyof interest.AnMPIoflessthan100indicates theyarelesslikelytodisplaythebehaviorof interest.AnMPIgreaterthan100indicates theyaremorelikelytodisplaythebehaviorof interest.AnMPIof100indicatesthattheyare aslikelytodisplaythebehaviorofinterestas theaveragehouseholdinthegeographyof interest. ThebehaviorofinterestinMap9ishaving healthinsuranceandthegeographyof interestisShiawassee‐Genesee‐LapeerCounties(GreaterFlintArea).Theareasofdarkestblueare21%lesslikelytohaveinsuranceas comparedtotheaveragefortheGreaterFlintAreaandtheareaswiththelightestblueshadingare9%morelikelytohaveinsuranceas comparedtotheaveragefortheGreaterFlintArea. 14 | P a g e Map10showsthelikelihoodhouseholds consumemoreorlesspoundsoffresh fruitsandvegetablespermonthbyzip codeascomparedtotheaverageuse acrossthethreecounties.Thedarkerthe greenthelesslikelythehouseholdsareto consumeasmuchfreshfruitsand vegetablesastheaveragehouseholdinthe GreaterFlintArea. MarketDemandIndex(MDI)iscalculated basedontheaverageconsumptionper householdineachzipcodecomparedto theaverageconsumptioninthegeography ofinterest.Itindicatesthelikelihoodthat householdsinazipcodehaveahigheror lowerdemand(orrateofconsumption)for aparticularproductcomparedtothe averageforthegeographyofinterest.An MDIoflessthan100indicateshouseholds arelesslikelytoconsumetheproductof interest.AnMDIgreaterthan100indicates householdsaremorelikelytoconsumethe productofinterest.AMDIof100indicates thattheyareaslikelytoconsumethe productofinterestastheaverage householdinthegeographyofinterest. TheproductofinterestinMap10ispoundsoffreshfruitsandvegetablesconsumedpermonthperhouseholdandthegeographyof interestisShiawassee‐Genesee‐LapeerCounties(GreaterFlintArea).Theareasofdarkestgreenare14%lesslikelytoconsumefresh fruitsandvegetablesascomparedtotheaveragefortheGreaterFlintAreaandtheareaswiththelightestyellow‐greenshadingare6% morelikelytoconsumefreshfruitsandvegetablesascomparedtotheaveragefortheGreaterFlintArea. 15 | P a g e Map11showsthelikelihoodadultsin exercise2ormoretimesperweekby zipcodecomparedtotheaveragefor theGreaterFlintArea.Thedarkerthe purplethelesslikelytheyaretoreport exercising2ormoretimesperweek. MarketPotentialIndex(MPI)is calculatedbasedonthenumberof usersper100householdsineachzip codedividedbynumberofusersper 100householdsinthegeographicarea ofinteresttimes100.Itindicatesthe likelihoodthathouseholdsinazipcode aretodisplaythebehaviorofinterest comparedtotheaverageforthe geographyofinterest.AnMPIofless than100indicatestheyarelesslikelyto displaythebehaviorofinterest.AnMPI greaterthan100indicatestheyare morelikelytodisplaythebehaviorof interest.AnMPIof100indicatesthat theyareaslikelytodisplaythe behaviorofinterestastheaverage householdinthegeographyofinterest. ThebehaviorofinterestinMap11isexercising2moretimesperweekandthegeographyofinterestisShiawassee‐Genesee‐Lapeer Counties(GreaterFlintArea).Theareasofdarkestpurpleare26%lesslikelytoexercise2ormoretimesperweekascomparedtothe averagefortheGreaterFlintAreaandtheareaswiththelightestpurpleshadingare16%morelikelytoexercise2ormoretimesper weekascomparedtotheaveragefortheGreaterFlintArea. 16 | P a g e Map12showsthelikelihoodadultswatch45 ormorehoursoftelevisionperweekbyzip codecomparedtotheaveragefortheGreater FlintArea.Thedarkpurpleareasaremore likelytoreportwatching45ormorehoursof televisionperweek. MarketPotentialIndex(MPI)iscalculated basedonthenumberofusersper100 householdsineachzipcodedividedby numberofusersper100householdsinthe geographicareaofinteresttimes100.It indicatesthelikelihoodthathouseholdsina zipcodearetodisplaythebehaviorofinterest comparedtotheaverageforthegeographyof interest.AnMPIoflessthan100indicates theyarelesslikelytodisplaythebehaviorof interest.AnMPIgreaterthan100indicates theyaremorelikelytodisplaythebehaviorof interest.AnMPIof100indicatesthattheyare aslikelytodisplaythebehaviorofinterestas theaveragehouseholdinthegeographyof interest. ThebehaviorofinterestinMap12is watching45ormorehoursoftelevisionper weekandthegeographyofinterestis Shiawassee‐Genesee‐LapeerCounties(Greater FlintArea).Thedarkpurpleareasare26%morelikelytowatch45ormorehoursoftelevisionperweekascomparedtotheaveragefor theGreaterFlintAreaandtheareasinyelloware9%lesslikelytowatch45ormorehoursoftelevisionperweekascomparedtothe averagefortheGreaterFlintArea. 17 | P a g e UnderstandingtheBuiltEnvironment Table2belowprovidesalistofthenumberofcertaintypesofbusinesseslocatedintheGreater FlintArea.BusinesseswereidentifiedbasedonNorthAmericanIndustryClassificationSystem (NAICS)codes.Businesseswereidentifiedusingthefollowingcodes: 621111 MedicalOffices(exceptMentalHealthSpecialist) 445120 Conveniencefoodstores 447110 Gasolinestationswithconveniencestores 445110 Grocerystores 813110 Churches 722511‐722515 Restaurants 722515 Coffeeshops 812112‐812113 BeautySalons 611110 ElementaryandSecondarySchools 713940 FitnessCenters Appendix7providesalistofeachofthesetypesofbusinessesthatareintheGreaterFlintArea. Table2.NumberofSelectTypesofBusinesseswithintheGreaterFlintArea NumberofBusinesses MedicalOffices(exceptMentalHealth 584 Specialist)* 12 FederallyQualifiedHealthCentersǂ ConvenienceStores GasolineStationswithConvenienceStores GroceryStores 128 154 168 Churches 851 Restaurants CoffeeShops 908 18 BeautySalons ElementaryandSecondarySchools 576 459 FitnessCenters 104 *Thisincludesdermatologists,cardiologist,andotherspecialtyofficesinadditiontoprimarycareoffices. Duetochangesincoding,itisnoteasytoseparatethetypeofmedicalofficebasedontheNAICScodes. Also medical offices are listed multiple times because each provider can register themselves as a business.Attemptsweremadetode‐duplicatethenumberbasedonthestreetaddress.However,all listingsareprovidedinAppendix7. ǂHealthResourceandServiceAdministrationDataWarehouse http://datawarehouse.hrsa.gov/Download_HCC_LookALikes.aspx.AccessedMarch8,2013 18 | P a g e LargeEmployers Table3belowprovidesalistofbusinessthathave500ormoreemployeeswithinLexingtonYMCA servicearea.Businesseswithmultiplelocationsmayhaveregisteredthenumberofemployeesfor eachlocationORthenumberforalllocations.(e.g.,McDonald'smightsayithas10,000employees becausealllocationscombinedhave10,000).Appendix8providesalistofallbusinesses,large employers,andbusinesswithmultiplelocations.Thebusinesslistsmaycontainthesamebusiness multipletimesforseveralreasons1)theyhavemultiplelocations2)differentspellingsofthesame businesswereregisteredwiththesameaddress3)thebusinessisregisteredundermorethanone NASICcodeand4)itwasregisterwiththesamenamemorethanonceorwithadifferentemployee size. Table3.LargeEmployerswithinGreaterFlintArea Company Name Address HURLEYMEDICALCTR MCLARENREGIONALMEDICALCTR GMCUSTOMERCARE&AFTERSALES GENESYSHEALTHSYSTEM MEMORIALHEALTHCARECTR VLASICPICKLES MEIJER USPOSTOFFICE CITIZENSBANK SOCIALSERVICEDEPT CHILDREN'SPROTECTIVESVC UNIVERSITYOFMICHIGAN‐FLINT CHARLESSTEWARTMOTTCOLLEGE LAPEERREGIONALMEDICALCTR PENDACORP WALMARTSUPERCENTER MEIJER 5THAVE&GRANDTRAVERSE 401SBALLENGERHWY 6200GRANDPOINTEDR 1GENESYSPKWY 826WKINGST 415SBLACKSCORNERSRD 4333WPIERSONRD#G 250EBOULEVARDDR 328SSAGINAWST 125EUNIONST 125EUNIONST 303EKEARSLEYST 1401ECOURTST 1375NMAINST 2101NLAPEERRD 6170SSAGINAWRD 2474WHILLRD City/State Flint,MI Flint,MI GrandBlanc,MI GrandBlanc,MI Owosso,MI ImlayCity,MI Flint,MI Flint,MI Flint,MI Flint,MI Flint,MI Flint,MI Flint,MI Lapeer,MI Lapeer,MI GrandBlanc,MI Flint,MI Zip Code 48503 48532 48439 48439 48867 48444 48504 48502 48502 48502 48502 48502 48503 48446 48446 48439 48507 19 | P a g e Appendix1:ProjectandTechnicalNotes: BehavioralRiskFactorSurveillanceSystem(BRFSS)isaprimarysourceofdiabetesdataatthe countyandstatelevelforlocalhealthdepartmentsandotheragencies.Throughagrantaward, fromNACDDtheDirectorsofHealthPromotionandEducation(DHPE)areabletoofferdataand analysisatsmallerunitsofgeographythroughadatabasemaintainedbytheNielsenCompany. TechnicalBackground Nielsenisaglobalmarketingandadvertisingresearchcompanythatofferssoftwaretobusinesses andgovernmentagenciesthroughtwosoftwareprograms:ConsumerPointandPrimeLocation. Nielsenisoneoftheworld’sleadingsuppliersofmarketinginformation,mediainformationandTV ratings,onlineintelligence,andmobilemeasurement. NielsenPRIZMSegments Communitypopulationsarecategorizedinto66segmentsbasedonsocioeconomicrank,lifestage, andurbanization.The66segmentseachhaveuniquedemographicdescriptionsbasedonincome, ageclass,agerange,presenceofkidsinthehousehold,homeownership,employment,education, andraceandethnicity.Eachsegmentalsohasspecificlifestylepreferencesthataretypicalforthe segmentsuchasmediapreferences,shoppingpreferences,andtypicalbehaviors.More informationmaybeaccessedatthefollowingsite: http://www.claritas.com/MyBestSegments/Default.jsp?ID=30&SubID=&pageName=Segment%2BL ook‐up Appendix2:EnhancedDemographics Duetothelengthofthisappendixitisinaseparateaccompanyingdocument.Thisappendix containsdetaileddemographicsandsocioeconomiccharacteristicsbeyondthoseprovidedin Table1. 20 | P a g e Appendix3:SupportingDocumentationforMap2andtheMediaProfiles MediaprofileswereconductedforthetargetareaofinterestusingPRIZMhouseholdsegmentsthat havecharacteristicsassociatedwithahigherriskofdevelopingprediabetesanddiabetesasthe targetpopulation.Forthisreport,thegeographyofinteresttheGreaterFlintAreaconsistingof Shiawassee,Genesee,andLapeerCounties. Thereareapproximately226,410householdsintheGreaterFlintArea.Oftheseapproximately 101,225households(or45%ofhouseholds)haveoneormorememberswhoareathighriskof developingprediabetes. Belowisabriefdescriptionofhowtointerpretthetablesinthisappendix.Appendix4provides someadditionalinformationonthedefinitionsofthemediaquintiles. TotalHouseholdsreferstoallhouseholdsinthegeographyofinterest. TargetHouseholdsreferstothehouseholdswithinthePRIZMsegmentsthatareathighestriskof developingprediabetesanddiabetes.ThePRIZMsegmentsthataremostlikelytodevelop prediabetesanddiabetesbasedonage,householdincome,andeducationattainmentare: 38,39,40,41,42,43,44,45,46,48,49,52,53,54,55,56,57,58,59,60,61,64,65,66.Fulldescriptionsofeach ofthesesegmentscanbefoundat: http://www.claritas.com/MyBestSegments/Default.jsp?ID=30&id1=1027&id2=&webid=1.These segmentswereidentifiedashighriskbecausetheiragerangewasbetweenoroverlappedthe45to 84agegroup,theiraveragemedianhouseholdincomeperyearwas$50,000orless,andthehighest levelofeducationattainmentwaslessthanafour‐yearcollegedegree.Thesegmentsidentifiedas highriskforprediabetesanddiabeteshavealsobeenshowntobelessphysicallyactiveandless likelytoconsumefruitsandvegetablesandmorelikelytowatch20ormorehoursoftelevisionper weekascomparedtoothersegments. Countreferstothetotalestimatednumberofhouseholdsthatfittheprofilewithintheareaof interestandhouseholdsegmentsofinterest.ForTotalHouseholds,countisthenumberof householdsintheareaofinterestthatfittheprofile.ForTargetHouseholds¸countreferstothe numberofhouseholdsthatareathighriskofdevelopingprediabetesordiabetesintheareaof interestthatfittheprofile. Users/100HHreferstotherateofadultsthatfittheprofileandarelocatedintheareaofinterest forevery100households.Thisiscalculatedbydividingthehouseholdbasecountbythetarget populationcount.Someoftheprofilesorindicatorsarebasedonhouseholdresponsesothersare basedonindividualadultresponses.Profilesorindicatorsbasedonhouseholdresponsesare indicatedby(H).Thosethatarebasedonindividualadultresponsesareindicatedby(A). Indexreferstothelikelihoodamemberofthetargethouseholdfitstheprofilebasedonabaseline of100.Forexample,iftheindexisover100,itismorelikelythatthetargetpopulationengagesin theactivityorconsumesproductlistedinthefirstcolumnofthetablecomparedtothetotal population.Thisiscalculatedbydividingtheusersperhouseholdsforthetotalpopulationbythe usersperhouseholdforthetargetpopulation. Profilereferstoeachoftheitemslistedinthefirstcolumnofthetables.Thesearethe“profiles”or indicatorsthatarebeingassessedtodeterminetheextenttowhichthetargethouseholdsarelikely toengageintheactivityorconsumeaproductlisted. 21 | P a g e Table4belowprovidesalistofzipcodesintheGreaterFlintAreaalongwiththenumberof householdsineachzipcodeandthenumberofhouseholdsthefitthetargetsegmentprofiles.This istheinformationusedinMap2toidentifywherethetargetpopulationlives. Table4.LocationofTargetPopulationbyZipCode ZipCode 48458 48476 48532 48519 48463 48727 48817 48457 48464 48506 48509 48420 48505 48507 48429 48423 48444 48446 48433 48449 48867 48461 48841 48439 48502 48421 48414 48430 48857 48412 48003 48460 48451 48872 48418 48436 48848 48455 48428 48438 City/Town Mount Morris Vernon Flint Burton Otisville Clifford Corunna Montrose Otter Lake Flint Burton Clio Flint Flint Durand Davison Imlay City Lapeer Flushing Lennon Owosso North Branch Henderson Grand Blanc Flint Columbiaville Bancroft Fenton Morrice Attica Almont New Lothrop Linden Perry Byron Gaines Laingsburg Metamora Dryden Goodrich TotalHouseholds Count 8,140 94 8,178 3,247 1,780 456 2,578 2,976 796 10,928 3,640 8,516 9,165 12,983 3,614 13,490 3,393 11,629 10,464 1,075 11,199 2,906 275 19,672 273 2,525 880 14,566 957 2,195 2,221 858 5,607 2,839 1,531 1,334 2,922 3,065 1,869 2,351 TargetHouseholds Count Percentof Households 6,208 67 4,903 1,935 964 246 1,387 1,563 418 5,720 1,897 4,403 4,727 6,687 1,841 6,745 1,549 5,277 4,701 445 4,414 1,135 103 7,361 91 826 271 4,469 274 586 556 188 1,218 555 298 195 424 378 177 65 76.3 71.9 60.0 59.6 54.2 54.0 53.8 52.5 52.5 52.3 52.1 51.7 51.6 51.5 50.9 50.0 45.7 45.4 44.9 41.4 39.4 39.1 37.5 37.4 33.3 32.7 30.8 30.7 28.6 26.7 25.0 21.9 21.7 19.6 19.5 14.6 14.5 12.3 9.5 2.8 22 | P a g e ZipCode TotalHouseholds Count City/Town 48444 Imlay City 48446 Lapeer 48433 Flushing HouseholdBaseCount TargetHouseholds Count Percentof Households 3,393 11,629 10,464 1,549 5,277 4,701 45.7 45.4 44.9 231,154 101,206 43.78 Tables4through11showselectmediaprofilewiththehighestnumberofusersper100 householdswithinthetargethouseholdsegmentsintheGreaterFlintArea.Summeryanalysisand recommendationsbasedonthesedataareprovidedinMarketingsectionofthisreport. Table5.PrintMediaUseamongResidentsintheGreaterFlintAreaThatAreLeastLikelyto EngageinHealthyBehaviors PrintMediaProfile ReadMagazines‐LowerHalf(A) ReadNewspaper‐LowerHalf(A) ReadNewspaper‐UpperHalf(A) ReadNewspaper‐DistributedMagazines‐ Net Audience(A) ReadSundayNewspaper(A) ReadMagazines‐UpperHalf(A) ReadWomen'sMagazines‐NetAudience(A) ReadGeneralEditorialMagazines‐NetAudience (A) ReadDailyNewspaper(A) ReadHomeServicesMagazines‐NetAudience (A) ReadNewsWeeklyMagazines‐NetAudience(A) ReadMagazines‐Quintile5(A) ReadMagazines‐Quintile4(A) ReadNewspaper‐Quintile2(A) ReadNewspaper‐Quintile5(A) ReadNewspaper‐Quintile4(A) ReadMagazines‐Quintile3(A) ReadNewspaper‐Quintile1(A) HouseholdBaseCount TotalHouseholds Count Users/ 100HHs 227,062 100 209,227 92 210,384 93 212,807 94 TargetHouseholds Count Users/ Index 100HHs 97,799 97 96 83,563 83 89 81,918 81 87 81,851 81 86 189,592 192,532 167,593 165,052 84 85 74 73 73,856 67,680 63,643 62,536 73 67 63 62 87 79 85 85 158,849 135,681 70 60 61,805 51,814 61 51 87 85 146,464 94,415 90,205 88,089 85,613 82,226 83,970 82,076 226,410 65 42 40 39 38 36 37 36 51,111 45,162 36,353 35,930 35,325 33,656 32,219 31,619 101,225 50 45 36 36 35 33 32 31 78 107 90 91 92 92 86 86 PRIZM2013,AttributeList:MediamarkResearchInc.,2012,Copyright2012,TheNielsenCompany. 23 | P a g e Table6.RadioMediaUseamongResidentsintheGreaterFlintAreaThatAreLeastLikelyto EngageinHealthyBehaviors RadioMediaProfile PlacedinLowerHalfofRadioListening(A) PlacedinUpperHalfofRadioListening(A) ListenM‐F‐Radio‐6am‐10am‐NetAudience(A) ListenS‐S‐Radio‐10am‐3pm‐NetAudience(A) ListenM‐F‐Radio‐10am‐3pm‐NetAudience(A) ListenM‐F‐Radio‐3pm‐7pm‐NetAudience(A) ListenS‐S‐Radio‐6am‐10am‐NetAudience(A) PlacedinRadioQuintile5(A) ListenCountryRadio‐NetAudience(A) PlacedinRadioQuintile1(A) PlacedinRadioQuintile4(A) HouseholdBaseCount TotalHouseholds Count Users/ 100HHs 211,609 93 208,004 92 199,413 88 168,715 75 158,110 70 169,149 75 132,119 58 90,649 40 109,447 48 87,710 39 82,727 37 226,410 TargetHouseholds Count Users/ Index 100HHs 90,908 90 96 74,585 74 80 65,039 64 73 59,391 59 79 58,924 58 83 51,891 51 69 49,563 49 84 46,536 46 115 39,785 39 81 32,813 32 84 32,331 32 87 101,225 PRIZM2013,AttributeList:MediamarkResearchInc.,2012,Copyright2012,TheNielsenCompany. Table7.TelevisionMediaUseamongResidentsintheGreaterFlintAreaThatAreLeast LikelytoEngageinHealthyBehaviors TelevisionMediaProfile TVTotalUpperHalf(A) Avg1/2HrTVAud‐PrmtmWkday8pm‐11pm (E/P)(A) Avg1/2HrTVAud‐Wkdays8pm‐11pm(E/P)(A) Avg1/2HrTVAud‐Wkdays7.30pm‐8pm(E/P)(A) Avg1/2HrTVAud‐Wkdays7pm‐7.30pm(E/P)(A) Avg1/2HrTVAud‐Su7pm‐10pm(E/P)(A) Avg1/2HrTVAud‐Sa8pm‐10pm(E/P)(A) WatchSatellite/CableTVSubscribers(H) TVDaytimeTV‐NetAudience(A) Avg1/2HrTVAud‐Sa7.30pm‐8pm(E/P)(A) Avg1/2HrTVAud‐Wkdays6pm‐7pm(E/P)(A) Avg1/2HrTVAud‐Su6pm‐7pm(E/P)(A) Avg1/2HrTVAud‐Su10pm‐11pm(E/P)(A) WatchTheWeatherChannel‐1wk(A) TVTotalLowerHalf(A) HeavyCableTVViewer‐15+hrs‐1wk(H) Avg1/2HrTVAud‐Wkdays4pm‐7.30pm(E/P)(A) Avg1/2HrTVAud‐Sa6pm‐7.30pm(E/P)(A) Avg1/2HrTVAud‐Su4.30pm‐6pm(E/P)(A) WatchHistoryChannel‐1wk(A) SubscribetoCableTV(H) WatchNFLMonday/ThursdayNightFootball‐ 1wk (A) WatchFoxNewsChannel‐1wk(A) TVTotalQuintile1(A) HouseholdBaseCount TotalHouseholds Count Users/ 100HHs 224,632 99 204,901 91 TargetHouseholds Count Users/ Index 100HHs 102,492 101 102 85,529 84 93 204,901 188,154 180,918 196,570 192,490 186,888 145,738 157,422 150,812 151,308 152,074 163,499 194,969 142,294 124,111 126,262 127,026 145,213 120,169 152,478 91 83 80 87 85 83 64 70 67 67 67 72 86 63 55 56 56 64 53 67 85,529 85,427 83,745 82,227 82,010 79,459 73,056 72,397 72,285 67,195 64,153 64,012 62,981 62,307 60,880 58,944 56,129 53,946 53,912 52,087 84 84 83 81 81 79 72 72 71 66 63 63 62 62 60 58 55 53 53 51 93 102 104 94 95 95 112 103 107 99 94 88 72 98 110 104 99 83 100 76 134,010 97,040 226,410 59 43 51,832 51,766 101,225 51 51 87 119 PRIZM2013,AttributeList:MediamarkResearchInc.,2012,Copyright2012,TheNielsenCompany. 24 | P a g e Table8.InternetUseamongResidentsintheGreaterFlintAreaThatAreLeastLikelyto EngageinHealthyBehaviors InternetUseProfile UseInternet‐Light(A) UseInternet‐1mo(A) UseInternetatHome‐1mo(A) UseInternetforE‐Mail‐1mo(A) OwnPC(H) InternetUseQuintiles:5(A) HasInternetAccessatHomeusingComputer(H) UseInternet‐Heavy(A) InternetUseQuintiles:4(A) HouseholdBaseCount TotalHouseholds Count Users/ 100HHs 240,721 106 298,986 132 259,255 115 254,665 112 167,280 74 104,420 46 149,923 66 178,875 79 96,200 42 226,410 TargetHouseholds Count Users/ Index 100HHs 113,216 112 105 92,867 92 69 76,025 75 66 74,807 74 66 61,874 61 83 56,344 56 121 52,917 52 79 52,249 52 65 45,473 45 106 101,225 PRIZM2013,AttributeList:MediamarkResearchInc.,2012,Copyright2012,TheNielsenCompany. Table9.AttitudeTowardsMediaamongResidentsintheGreaterFlintAreaThatAreLeast LikelytoEngageinHealthyBehaviors AttitudeTowardsMediaProfile NewspaperAdsGiveUsefulInfoonBargains‐ Agree(A) TVAdsGiveGoodInfoonNewProducts/Services‐ Agree(A) NewspaperAdsGiveGoodInfoonNew Products/Services‐Agree(A) MagazineAdsGiveGoodInfoonNew Products/Services‐Agree(A) TVAdsAreAmusing‐Agree(A) TVAdsGiveUsefulInfoonBargains‐Agree(A) WaitforOtherstoTryThingsBeforeIBuy‐ Agree (A) NewspaperAdsGiveGoodInfoonConsumer ProductsUse‐Agree(A) TVAdsGiveGoodInfoonConsumerProdUse‐ Agree(A) OftenSeekAdviceofOthersBeforeBuying‐ Agree (A) MagazineAdsGiveUsefulInformationon Bargains‐Agree(A) MediaTrustedtheMost‐Television(A) HouseholdBaseCount TotalHouseholds Count Users/ 100HHs 262,966 116 TargetHouseholds Count Users/ Index 100HHs 106,900 106 91 238,919 106 95,319 94 89 213,597 94 87,647 87 92 206,513 91 81,970 81 89 197,434 200,359 183,330 87 88 81 80,421 79,887 73,337 79 79 72 91 89 89 173,084 76 73,153 72 95 175,817 78 71,522 71 91 182,275 81 70,694 70 87 168,645 74 69,359 69 92 134,429 226,410 59 66,293 101,225 65 110 PRIZM2013,AttributeList:MediamarkResearchInc.,2012,Copyright2012,TheNielsenCompany. 25 | P a g e Table10.GroceryShoppingHabitsamongResidentsintheGreaterFlintAreaThatAreLeast LikelytoEngageinHealthyBehaviors GroceryShoppingHabitsProfile ShopatWal‐MartSupercenter‐1mo(A) GroceryShop‐1Time‐1wk(A) RedeemCouponsatGroceryStore‐3mo(A) GroceryStore‐Travel3‐5Miles(A) GroceryStore‐Travel1‐2Miles(A) GroceryShop‐2Times‐1wk(A) HouseholdBaseCount TotalHouseholds Count Users/ 100HHs 256,522 113 128,722 57 136,141 60 113,873 50 95,874 42 105,842 47 226,410 TargetHouseholds Count Users/ Index 100HHs 99,241 98 87 51,911 51 90 47,421 47 78 41,605 41 82 39,317 39 92 37,425 37 79 101,225 PRIZM2013,AttributeList:MediamarkResearchInc.,2012,Copyright2012,TheNielsenCompany. Table11.RetailerUseandShoppingHabitsamongResidentsintheGreaterFlintAreaThat AreLeastLikelytoEngageinHealthyBehaviors RetailerandShoppingHabitsProfile ShopatWal‐Mart‐3mo(A) ShopatLowe's‐1yr(A) ShopatHomeDepot‐1yr(A) ShopatWalgreens‐6mo(A) ShopatCVSPharmacy/LongDrugs‐6mo(A) ShopatWal‐MartPharmacy‐6mo(A) ShopatTarget‐3mo(A) ShopatJCPenney‐3mo(A) ShopatKmart‐3mo(A) HouseholdBaseCount TotalHouseholds Count Users/ 100HHs 293,658 130 171,345 76 167,312 74 142,532 63 130,358 58 94,830 42 135,212 60 107,471 47 85,311 38 226,410 TargetHouseholds Count Users/ Index 100HHs 113,039 112 86 57,086 56 75 52,271 52 70 51,817 51 81 46,970 46 81 39,525 39 93 39,178 39 65 38,728 38 81 35,592 35 93 101,225 PRIZM2013,AttributeList:MediamarkResearchInc.,2012,Copyright2012,TheNielsenCompany. Table12.RestaurantUseamongResidentsintheGreaterFlintAreaThatAreLeastLikelyto EngageinHealthyBehaviors RestaurantUseProfile BuyfromAnyFastFoodRestaurant‐1mo(A) BuyfromFastFoodBurgers/HotDogs Restaurant‐1mo(A) BuyfromFamilyRestaurant/Steakhouse‐ 1mo(A) BuyfromMcDonald's‐1mo(A) BuyfromFastFoodPizzaRestaurant‐6mo(A) BuyfromFastFoodSandwichRestaurant‐ 1mo (A) BuyfromFastFoodChickenRestaurant‐1mo(A) BuyfromFamilyRestaurants/SteakHousesfor Supper/Dinner‐1mo(A) BuyfromFastFoodPizza/PastaRestaurant‐ 1mo (A) BuyfromBurgerKing‐1mo(A) HouseholdBaseCount TotalHouseholds Count Users/ 100HHs 350,102 155 300,721 133 TargetHouseholds Count Users/ Index 100HHs 131,153 130 84 112,451 111 84 266,610 210,790 169,358 156,692 118 93 75 69 94,202 75,642 56,216 52,211 93 75 56 52 79 80 74 75 137,362 158,167 61 70 49,854 49,704 49 49 81 70 133,688 59 44,086 44 74 116,703 226,410 52 43,364 101,225 43 83 PRIZM2013,AttributeList:MediamarkResearchInc.,2012,Copyright2012,TheNielsenCompany. 26 | P a g e Appendix4:MediamarkResearchDefinitionofMediaQuintiles Newspapers Numberofnewspapersreadinan average28‐dayperiod. QuintileI QuintileII QuintileIII QuintileIV QuintileV Upperhalf(Heavy) Lowerhalf(Light) Magazines Numberofmagazinesreadinan average28‐dayperiod. QuintileI QuintileII QuintileIII QuintileIV QuintileV Upperhalf(Heavy) Lowerhalf(Light) Radio Numberofhalfhourslistenedtoper week. QuintileI QuintileII QuintileIII QuintileIV QuintileV Upperhalf(Heavy) Lowerhalf(Light) TV‐Total Numberofhalfhoursviewedperweek foralltimeperiods QuintileI QuintileII QuintileIII QuintileIV QuintileV Upperhalf(Heavy) Lowerhalf(Light) Men Women 25+ 21‐24 9‐20 1‐8 0 16+ 0‐15 25+ 20‐24 7‐19 1‐6 0 13+ 0‐12 Men Women 15+ 8‐14 4‐7 1‐3 0 6+ 0‐5 18+ 10‐17 5‐9 2‐4 0‐1 7+ 0‐6 Men Women 60+ 26‐59 14‐25 5‐13 0‐4 20+ 0‐19 42+ 21‐41 12‐20 3‐11 0‐2 15+ 0‐14 Men Women 85+ 57‐84 38‐56 19‐37 0‐18 47+ 0‐46 95+ 60‐94 39‐59 20‐38 0‐19 49+ 0‐48 27 | P a g e Internet Numberoftimesusedinamonth QuintileI QuintileII QuintileIII QuintileIV QuintileV Upperhalf(Heavy) Lowerhalf(Light) Men 56+ 28-55 6-27 1-5 0 18+ 0-17 Women 56+ 19-55 2-18 1 0 18+ 0-17 Appendix5:SelectDemographicsbyZipCode Duetothelengthofthisappendixitisinaseparateaccompanyingdocument.Thisinformationin thisappendixwasusedinthecreationofMaps3through8. Appendix6.BehaviorsAssociatedwithHigherRiskofDiabetes Duetothelengthofthisappendixitisinaseparateaccompanyingdocument.Theinformationin thisappendixwasusedcreateMaps9through12. Appendix7.ListofSelectBusinessesintheGreaterFlintArea Duetothelengthofthisappendixitisinaseparateaccompanyingdocument.Theinformationin thisappendixwasusedtoestimatethenumberofbusinessinTable2. Appendix8.LargeandMultiSiteBusinesses Duetothelengthofthisappendixitisinaseparateaccompanyingdocument.Theinformationin thisappendixwasusedtodevelopthelargeemployerlistinTable3. 28 | P a g e
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