THE INDIANA PREVENTION RESOURCE CENTER GIS in Prevention

THE INDIANA PREVENTION RESOURCE CENTER GIS in Prevention Tobacco Series, No. 1 Noble County, Indiana Barbara Seitz de Martinez, Ph. D, MLS, CPP The Indiana Prevention Resource Center at Indiana University is funded, in part, by a contract with the Indiana Family and Social Services Administration, Division of Mental Health and Addiction, financially supported through HHS/Substance Abuse Mental Health Services Administration, Center for Substance Abuse Prevention, Substance Abuse Prevention and Treatment Block Grant. The IPRC is operated by the Department of Applied Health Science and The School of Health, Physical Education and Recreation. 2005 1

GIS in Prevention Tobacco Series, No. 1 Noble County, Indiana Barbara Seitz de Martinez, Ph. D, MLS, CPP Project Staff: Solomon Briggs, GIS Technician Parul Kaushik, MPH Jennifer Hoffman Bilesha Perera, MSc, Ph. D Megan Randall, B. A. Nicole Smith Indiana Prevention Resource Center Opinions expressed herein are those of the authors, and not necessarily those of the Trustees of Indiana University or the Division of Mental Health and Addiction. Indiana University accepts full Responsibility for the content of this publication. © 2005 The Trustees of Indiana University. Permission is extended to reproduce this County Profile for non-profit educational purposes. All other rights reserved. GIS in Prevention, Tobacco Series, No. 1

Noble County The maps and tables in this publication were prepared using PCensus 7. 06 for Map. Info and Map. Info Professional 7. 0. GIS in Prevention, Tobacco Series, No. 1

Acknowledgements This edition of the PREV-STAT™ County Profiles is dedicated to the memory of Mr. William J. Bailey, MPH, CPP, past Executive Director of the Indiana Prevention Resource Center, whose vision for the application of GIS to prevention led him to launch PREV-STAT™ in the Spring of 2002. Primary thanks are due to the project staff – Bilesha, Jennifer, Megan, Nicole, Parul, and Solomon – whose hours of work brought this effort to completion. During the course of our year’s work on this project, Bilesha Perera completed his Ph. D and Parul Kaushik completed her MPH in Applied Health Science. Jennifer Hoffman and Nicole Smith progressed to near completion of their MPH degrees. Megan Randall completed her bachelor’s degree in Journalism; and Solomon Briggs, a recent I. U. graduate, completed his A+ Certifications in computer hardware and software. This second edition of the full County Profiles includes information gathered from multiple agencies and sources, including the Alcohol and Tobacco Commission, the Indiana State Excise Police Tobacco Retailer Inspection Program (TRIP), and the Indiana State Police Forensics Laboratory for methamphetamine data, the Family and Social Services Administration, and the Indiana Business Resource Center. Thanks go out to all the agencies that make their rich data available to the public. Special thanks to Major Steve Anderson, State Director of the Indiana Tobacco Retailer Inspection Program (TRIP) and to Dave Heath, Chairman of the Alcohol and Tobacco Commission. Special thanks to Desiree Goetze, Coordinator of TRIP at the Indiana Prevention Resource Center, for her support and advice. Special thanks also to Sergeant Dave Phelps of the Indiana State Police Forensics Laboratory for sharing data on methamphetamine laboratory seizures. GIS in Prevention, Tobacco Series, No. 1

Acknowledgements, cont. Thanks, too, to Steve Turner, who has provided online search engine access to a subset of the data from the full County Profiles, offering access to multiple years and multiple variables for each of several data topics. The new search engine, launched in April, will be a major focus for development during the up-coming year. Serving as Deputy Director of the IPRC while continuing to direct the PREV-STAT™ Service certainly contributed to making this a very memorable year of challenges and opportunities. It has been a year of much personal and professional growth. For this opportunity and for all their assistance and support throughout the year, I thank Dr. Mohammad Torabi, Chair of the Department of Applied Health Science and Interim Executive Director of the IPRC, Joyce F. Arthur, all my co-workers at the IPRC, and Sally Fleck, Office of Mental Health and Addiction, Family and Social Services Administration. Finally, my thanks to my husband, for his love and encouragement. GIS in Prevention, Tobacco Series, No. 1

The Bill Bailey I Remember Bill knew poverty. In conversations at work he recounted memories from his childhood that troubled him still, and that moved him to select the field of public health. He worried about the children who wore their house key on a string and had no one to care for them after school. Bill cared about the elderly. He worried about the old folks who lacked access to medical care. He recounted memories of elderly women in his home town, who ate dog food and suffered malnutrition because they could not afford both food and medicines. Bill loved children. His life was about improving their chances for health and happiness. The assets approach to prevention appealed tremendously to him, because it celebrated the beauty of childhood and what is right and wholesome: parents bonding with their children; children bonding with their school and other mentoring adults; and the community of neighbors, the community of faith embracing the children and providing them with healthful activities and strong values, attitudes and beliefs. Bill believed in Everyman. He believed in the power of the people to solve their own problems. At the same time, he believed in the responsibility of government to provide a safety net for the disadvantaged, young and old. Bill was about finding solutions. He was a master at identifying simple solutions to complex problems. Bill studied a situation in all its complexity and reduced it to its simplest basic components, positive and negative. He drew attention to those key elements. Then he found ways to attack the negatives at their point of greatest vulnerability, and to celebrate the positives to multiply their impact. He strived for efficiency and economy of means, calling this “Precision Targeting in Prevention. ” He targeted youth 10 -14 because those are the “critical years. ” He targeted the gateway drugs, and he targeted the after school hours from 3 -6 p. m. because they are the “critical hours. ” He launched a campaign for sciencebased prevention strategies and programs before “science-based” became a national mandate. GIS in Prevention, Tobacco Series, No. 1

The Bill Bailey I Remember He envisioned a State where children would have healthy alternative activities in the after school hours. He invested hundreds of hours in grant-seeking and won the largest prevention grant in the history of the state, establishing after school programs in cities across the state. By doing so he demonstrated the value of this innovative approach and positioned Indiana as a leader in the nation. Bill was a visionary. He foresaw the monumental educational force of the internet and concentrated his energies and resources in the early and mid 1990 s into building the first major drug information portal of any state prevention resource center. Only the federal National Clearinghouse of Drug Information was bigger. Bill was work personified. The hours he poured into the building, maintenance and expansion of the IPRC web site consumed his evenings and weekends. His scholarly articles and his students continue to influence the future of prevention and public health. Bill was a visionary and an innovator. He foresaw the power of desktop publishing to reach the most people with the greatest efficiency and for the least cost. He foresaw the power of mapping to inform prevention planning and decision-making. He called it “creating a statistical picture of your community” and he squeezed the power of that software at a time when it was in its infancy and its potential had not yet evolved. He labored for hundreds of hours to produce maps, which today would take minutes. But by doing so he demonstrated the value of this innovation and justified major investment in it, positioning Indiana again as the leader in the nation in this approach to prevention. Bill loved to talk and share stories, and had a fantastic sense of humor. Those who worked with him will always remember his vigor and enthusiasm for story-telling. The stories were about real people, real issues, and demonstrated how much he cared and how much he wanted to make a difference. Bill did make a difference at many levels and in many lives: at the personal level for those who knew him, and in the history of prevention for decades to come for those touched by the programs he helped to put in place. He will be sorely missed. GIS in Prevention, Tobacco Series, No. 1

Background This is the second edition of The PREV-STAT™ GIS in Prevention County Profiles Series, which includes one volume for each of Indiana’s 92 counties. This edition will join last year’s on the IPRC web site. Microsoft Power. Point was selected as the medium for presentation, because Power. Point (PP) facilitates development of the publication and because PP allows users access to data and maps that is not possible with other formats (e. g. , Adobe pdf files). Using proper citation, the user can copy maps and tables from the County Profile PP slides for use in public presentations, documents, and spreadsheets for their prevention needs. For help with such manipulations of the County Profile components, please call the IPRC (800/346 -3077 in Indiana). Following the appearance of last year’s first edition of the full profiles, the PREV-STAT™ GIS in Prevention County Profiles Fact Sheet Series was published, presenting highlights from the full profiles in the form of 92 fact sheets, one per county. These are also available on the IPRC web site. In addition to providing data, this publication serves a training function, both introducing people to the IPRC’s PREV-STAT™ Service and promoting the goals of the Imagine Indiana Together Framework and the Strategic Prevention Framework, promoting infrastructure development and understanding of how data can be applied to prevention. The County Profiles are at once an application and a training tool. They increase both the return for investment of the IPRC PREV-STAT™ staff, databases and hardware, and also the effectiveness and efficiency of prevention efforts across Indiana. In addition to being available via the internet, individual Profiles can also be made available on CD ROM, upon request. This year a major focus will be enhancement of the search engine component of the PREV-STAT™ Service and web site. GIS in Prevention, Tobacco Series, No. 1

Table of Contents 1. 2. 3. 4. 5. 6. PREV-STAT™ Overview Tobacco Retail Inspection Program TRIP Overview Introduction: Raising Smoke-Free Kids Tobacco Sales Outlets per Capita Failed TRIP Inspections and Proximity to Schools w/ Maps Adult Tobacco Behavior Statistics and Maps Adult Cigarette Smoking (Count and Percent) Adult Cigar Smoking (Count and Percent) Money Spent on Tobacco Money Spent on Cigarettes Money Spent on Other Tobacco Products 7. 8. 9. 10. Household Spending on Tobacco Intensity of TRIP Inspections Tobacco Production Indiana Counties Ranked by: Total Population of Youth, Ages 10 -17 Number of Tobacco Outlets per 1, 000 Persons Tobacco Outlets per 1, 000 Youth Intensity of Inspection GIS in Prevention, Tobacco Series, No. 1

Index of Maps MAPS County Map Population of Youths Vulnerable to Tobacco Sales to Minors (IN by County) Schools in Proximity to Tobacco Outlets that Failed TRIP Inspections (County) Close-up of Schools in Proximity to Tobacco Outlets that Failed TRIP Inspections and Schools (Indiana by County) Adult Cigarette Smoking, Percent (County by Block Group) Adult Cigarette Smoking, Percent (Indiana by County) GIS in Prevention, Tobacco Series, No. 1

Index of Tables TABLES 1. Tobacco Sales Outlets 2. Household Spending on Tobacco 3. Adult Tobacco Behavior 4. Adult Smoking Behaviors Adult Cigarette Smoking (Count) Adult Cigarette Smoking (Percent) Adult Cigar Smoking (Count) Adult Cigar Smoking (Percent) Money Spent on Tobacco Money Spent on Cigarettes Money Spent on Other Tobacco Products 5. Intensity of TRIP Inspections 6. Tobacco Production 7. Indiana Counties Ranked by Total Population Population of Youth, Ages 10 -17 Number of Tobacco Outlets Tobacco Outlets per 1, 000 Persons Tobacco Outlets per 1, 000 Youth Intensity of Inspection GIS in Prevention, Tobacco Series, No. 1

1. Introduction: Raising Smoke-Free Kids When a child is born, parents, grandparents and other relatives and friends, in whose home the child will spend time, prepare or “childproof” to create a safe and wholesome environment. When the child reaches school age, most parents entrust their child to the school, confident that teachers and school personnel will provide a safe and wholesome environment where the child will continue to thrive. Proactive parents become involved in the school to help guarantee this happens. From birth and throughout life, the child, then adolescent, then young adult experiences more and varied contexts and gains skills needed to appraise and respond appropriately to people, circumstances and events. Through role modeling and many other methods, parents and others help the child and adolescent to master these skills. At the same time, parents and others attempt to protect the child and adolescent from negative influences and from stressors (people, circumstances and events) inappropriate to their age and maturity. This process continues into young adulthood and to an extent throughout life. But inevitably, parents and other caregivers gradually release control over their offspring’s interactions; and gradually the child assumes responsibility for her or his own life. The child passes increasingly into the hands of society, that is, the communities (school, town, neighborhood, workplace, social group, etc. ) in which he or she lives. It is therefore important to be concerned with the larger environment beyond the home for its many influences upon child development. Communities can be defined variously, including geographically and socially. How we define community will depend on the question being asked or objective being sought. Sometimes the geographic and social communities overlap, even coincide; but many times they do not. Geographically the communities in which people live include the global, national and state levels down to the smaller county, block group, neighborhood and household level. Socially people belong to groups that cross all geographic boundaries and that can be described from broad political, socioeconomic, religious, linguistic, ethnic and lifestyle categories, down to the individual school, program, club, religious congregation, neighborhood and nuclear family. GIS in Prevention, Tobacco Series, No. 1

1. Introduction: Raising Smoke-Free Kids, cont. In fact, society has its hands on the child from the beginning, since an individual’s eyes, ears, and mind are constantly being filled with images and sounds produced or supplied by our unique environments. In nearly every corner of the earth and for nearly every child, this includes the electronic media that enters through our televisions, computers, and music players. Although the notion of child-proofing the world is more than overwhelming, there is much that a parent, neighborhood and community can do to positively influence child development and thus adult behaviors. Ideally, the world should be a safe place for everyone, where everyone could thrive. Those concerned about children need to be concerned with their total environment. Though it is very difficult for a single person or a few individuals to effect large scale change, individual actions and organized efforts by community coalitions and advocacy groups can influence policies, laws and community norms, thus reaching the broader environment and society. In addition to the ways parents can influence their children’s risk for smoking in the home (e. g. , an authoritative child-raising style, communicating disapproval of smoking, and parental non-smoking), a significant factor in adolescent smoking is friends’ smoking behavior. Mewse, et al (2004: 64 -65) found that the “association between parental smoking and adolescent smoking is mediated by friends’ smoking behavior. ” Adolescents’ friends are a powerful influence, as are their parents. The question then becomes: “How can parents influence the smoking behavior of their children’s friends? ” GIS in Prevention, Tobacco Series, No. 1

1. Introduction: Raising Smoke-Free Kids, cont. An answer is “By influencing community norms. ” Actually, there are numerous ways to influence the smoking behavior of the child’s or adolescent’s friends. One way is to try to influence the child’s choice of friends. But this is not enough, because as the child ages, the parent’s ability to control or influence becomes more limited. Another method for influencing youth tobacco behaviors is reducing the availability of tobacco to youth. Since millions of youth in the U. S. purchase cigarettes personally (NHSDA 2002: 2), enforcement of laws prohibiting the sale of tobacco to youth is imperative. But this is not enough, because, rather than make a direct purchase, over 60% of youth will ask a friend or relative to buy cigarettes for them. (NHSDA 2002: 1 -2) In order to discourage this enabling behavior, strategies such as penalties, education and cessation should be put in place to target those who might purchase for youth, i. e. , parents, siblings and others of legal age. (CSAP 2000: 4) The task of confronting the availability of drugs in the community involves identifying the locations where drugs are sold and/or produced, as well as reducing the demand. Research finds that although users of drugs are relatively evenly distributed across most communities, the sources of drugs are not. (Saxe 2001: 19871994) Advocacy for the establishment and enforcement of policies and laws is another method. Goals of this effort would include: increasing state and local taxes on cigarettes; restricting indoor smoking; regulating and enforcing youth access laws; and state laws regulating purchase, possession and use. GIS in Prevention, Tobacco Series, No. 1

1. Introduction: Raising Smoke-Free Kids, cont. Supporting the appropriate use of the tobacco settlement moneys and state excise taxes for tobacco control efforts is another important strategy. Research shows that if the states and District of Columbia had followed even the minimum recommendation of the Centers for Disease Control and Prevention (CDC) for the amount of money to be spent on tobacco control, the prevalence of youth smoking would have fallen from between 3. 3 to 13. 5% more than it has. (Tauras 2005: 341). Other strategies involve education, including normative education. According to the CDC, education strategies, when carried out together with community and media activities, have the potential to “postpone or prevent smoking onset in 20 to 40 percent of adolescents. ” (CDC 2000: 2) The character, timing and duration of school-based programs are all significant. Normative education is important, because it creates awareness of true community norms, countering misperceptions that “everyone is doing it. ” Nationally, 75% of 12 th graders, 84% of 10 th graders, and 91% of 8 th graders are not current (past 30 -days) smokers. (Monitoring the Future 2004: 53). In order to reduce tobacco use, it is important to understand all the factors that contribute to smoking. For example, poverty and stress have been associated with negative health outcomes, including tobacco use. Bennet, et al (2005), found a positive connection between perceived experiences of racial/ethnic harassment and smoking. Likelihood of smoking was two times higher for African American college students during the 30 days following a perceived incident of racial/ethnic harassment, suggesting tobacco use to cope with psychosocial stress. (Bennet 2005: 239) GIS in Prevention, Tobacco Series, No. 1

1. Introduction: Raising Smoke-Free Kids, cont. Appropriate targeting of tobacco prevention efforts requires addressing health disparities. For example, adolescents residing in rural areas are 19% more likely to smoke than their suburban peers. (Eberhardt and Pamuk 2004: 1684) The Chartbook confirms “that the reduction and elimination of health disparities among rural populations will require a population approach that is sensitive to local variations in physical and cultural realities. ” (Hartley 2004: 1677) In addition, it is necessary to consider the subgroups in the community, as well as multiple variables. A study by Subramanian, et al, found that a negative health outcome association with poverty was tied not only to neighborhood of residence, but also to race/ethnicity. In the neighborhoods studied, the health of Blacks was more severely affected by poverty than was the health of Whites, suggesting that “the consequences of neighborhood deprivation may be particularly exacerbated for Blacks, compared with Whites. ” (Subramanian 2005: 262 -263) Clearly, the answer to the challenge of reducing youth tobacco use requires a multi-faceted approach, involving multiple strategies – policies, practices and programs – components of a comprehensive plan. This approach offers far-reaching impact and benefits over time and space. Prevention happens in communities, and every community is distinct. In order to successfully reduce youth smoking, it is essential to understand the local environment. (NIH 1998: iii) To be most effective, prevention programs and strategies need to be appropriate to the characteristics of the community where they are implemented. The selection of strategies and programs for a particular community should be based on a thorough assessment, including data describing risk and protective levels, which highlight the problems and resources of the community. Based on this data, the greatest risks and weakest protective factors can be targeted, using the community’s resources and building on the strongest protective factors that characterize that community. (Hawkins, et al, 2004: 213) In addition, within the local community, it is also necessary to distinguish between subgroups, because generalized data may be misleading with regard to the reality of subgroups within the community. The PREV-STAT Service is one way to seek a revealing picture of the various groups making up a community. GIS in Prevention, Tobacco Series, No. 1

1. Introduction: Raising Smoke-Free Kids, cont. Community mobilization and awareness policies should target social sources as well as tobacco retailers. Education about underage use and health consequences of smoking can influence social norms, namely, the perceived acceptability of youth smoking and of supplying them with cigarettes. Seeing parents and other adults attempting to quit smoking may also influence youth to not start smoking, as well as reduce the availability of cigarettes from those who have quit smoking. (CSAP 2000: 5) The potential negative impact of friends’ smoking, the fact that many retailers sell to youth and the fact that youth obtain cigarettes through multiple means, should motivate parents and other concerned citizens to become involved in efforts to influence smoking norms in their community. Influencing norms involves more than monitoring your child’s activities and trying to influence her or his choice of friends. It also involves reducing the sources of drugs by enforcing laws prohibiting sales of tobacco products to minors. It involves taking the parental authority and parental disapproval of smoking to a community level. It includes community-wide actions to communicate repeatedly the message that “Our community disapproves of youth smoking and our community will not tolerate the sale of tobacco products to youth. ” One of the most effective ways to address tobacco availability and its use by minors is through comprehensive tobacco control programs, which include adequate training for employees, an adequate number and distribution of inspections in the community, an adequate structure of penalties and fines, plus public awareness about the program (Goetze 2004: 2) Indiana is lucky to have such a program, namely, the Tobacco Retail Inspection Program (TRIP) of the Alcohol and Tobacco Commission (ATC) in conjunction with the Indiana Prevention Resource Center (IPRC). This program, described in more detail elsewhere in this publication, has contributed to reductions in availability of tobacco to youth and to an overall reduction in youth smoking in Indiana. (The same principle holds true for influencing underage alcohol use through compliance checks of alcohol retail outlets. ) GIS in Prevention, Tobacco Series, No. 1

1. Introduction: Raising Smoke-Free Kids, cont. Research shows that if an individual does not begin smoking before the age of 18, she or he is unlikely to become a regular user of tobacco. Using data from TRIP, the IPRC’s PREV-STAT™ Service has calculated the number of tobacco outlets per 1, 000 youth ages 10 -17 for each county and for the state (7. 2 per thousand). This ratio provides some insight into the density of tobacco’s presence among the population of youth most vulnerable to initiating use and becoming regular users of tobacco. One way to illustrate how this number is useful for communicating relative risk and also the need for citizen support is to describe the rate of outlets per thousand youth in concrete images and familiar terms. Imagine a hypothetical community where the rate of outlets is 8 per thousand youth ages 10 -17. There are 2, 000 students in the town’s high school. Eight outlets per 1, 000 youth equates to 16 outlets per 2, 000 youth. If the 16 tobacco outlets were located within the walls of the school or on its campus, parents and school personnel would be acutely aware of the outlets’ proximity to the students. And if it were discovered that even one of those outlets was selling cigarettes to minors, the reaction surely would be swift and clear. Undoubtedly, violators would be penalized and vigilance maintained. Since we know that high school students move freely about a city, why would parents, educators and others not be equally concerned about outlets located throughout the entire community? Residents should support frequent and emphatic communications to all tobacco retailers, reminding them that the sale of tobacco to youth is not tolerated in their community. And they should support the use of penalties for non-compliance to give weight to this mandate. The IPRC PREV-STAT™ service has also used TRIP data to create a calculation for the intensity of inspection (ratio of number of inspections to number of retail tobacco outlets). This number gives limited insight into the amount of energy being expended in each county. This number, combined with data on the non-compliance rate and trends over time, gives a fuller picture of progress with regard to community norms and efforts currently being undertaken to change them. GIS in Prevention, Tobacco Series, No. 1

1. Introduction: Raising Smoke-Free Kids, cont. Ideally, all sectors of the community would participate in prevention efforts, including law enforcement, medical, education, business, religious, government, neighborhood and other professionals, practitioners and volunteers. The hope is that the benefits of a comprehensive, multi-strategy combination of evidence-based programs, policies and practices will generally influence community norms towards a non-smoking lifestyle. The hope is that the benefits will ripple across the community, reducing all forms of drug abuse and improving quality of health and quality of life for all its residents now and for future generations. Bibliography Department of Health and Human Services (2000). U. S. Public Health Service. Reducing Tobacco Use: A Report of the Surgeon General -- Executive Summary. Atlanta: US DHHS, CDC, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Eberhardt, M. S. and E. R. Pamul (2004). “The importance of place of residence: Examining health in rural and nonrural areas, ” American Journal of Public Health 94/10, 1682 -1686. Goetze, Desiree (2004). “Effectiveness of compliance programs, ” Prevention Newsline 4/4, 1 -7. Hartley, David (2004). “Rural health disparities, population health, and rural culture, ” American Journal of Public Health 94/10, 1675 -1678. GIS in Prevention, Tobacco Series, No. 1

1. Introduction: Raising Smoke-Free Kids, cont. Hawkins, J. David, M. Lee Van Horn, and Michael W. Arthur. (2004) “Community variation in risk and protective factors and substance use outcomes. ” Prevention Science 5/4, 213 -220 Johnston, Lloyd D. , Patrick M. O’Malley, Jerald G. Bachman, and John E. Schulenberg (2005). Monitoring the future: National results on adolescent drug use. Bethesda: NIH. SAMHSA (2002). “How youths get cigarettes, ” The NHSDA Report (November 22). SAMHSA. CSAP (2000). Social Sources of Cigarettes for Youth: The Problem and Potential Solutions. Rockville, CSAP. Mewse, Avril, J. J. , Richard Eiser, Alan M. Slater, and Stephen E. G. Lea (2004), “The smoking behaviors of adolescents and their friends: Do parents matter? ” Parenting Science 4/1, 51 -72. Saxe, Leonard, et al (2001), “The visibility of illicit drugs: Implications for community-based drug control strategies, ” American Journal of Public Health 91/12, 1987 -1994. Subramanian, Jarvis, T. Chen, David H Rehkopf, Pamela D. Waterman, and Nancy Krieger (2005). “Racial disparities in context: A multilevel analysis of neighborhood variations in poverty and excess mortality among black populations in Massachusetts, ” American Journal of Public Health 95/2, 260 -265. GIS in Prevention, Tobacco Series, No. 1

2. PREV-STAT™: Overview Increasingly, the value of data to decision-making is shaping how people work. Collection and analyses of relevant data facilitates improved quality in all phases of prevention. Better needs assessment enables better planning, better capacity building, better processes, programs, outcomes, evaluations, and grant-writing. Advances in technology have made the use of data extremely cost effective. In 2002 the Indiana Prevention Resource Center launched a new, free service called PREV-STAT™ for people working in prevention in Indiana. This system uses geographic information system software to analyze demographics and alcohol, tobacco and other drug risk and protective factors down to the neighborhood level. Using GIS software and data from a variety of sources, IPRC staff create county profiles and customized project reports, including maps and tables. Users of this service include such prevention professionals and practitioners as state level officials, agency heads, teachers, community coalition members and program leaders. PREV-STAT™ enables the user to understand the characteristics of a place, to locate a group of people with particular attributes, or to study a subset of the population of a given locale. Analysis can be done at any level from the state to the county, block group, zip code, neighborhood, or based on any arbitrary selected boundaries. Alternately, a radius can be drawn around a site (e. g. , a school, place of worship or prevention program) to be studied. The greatest power of PREV-STAT™ is its ability to zoom in on the very small geographic area! GIS empowers the prevention landscape by attaching threads to statistics and tying them to precise locations on earth. These locations can be potentially very small, like your neighborhood or the mile radius around your school or prevention program site. GIS gives faces to the statistics by allowing you to study specific groups of people. You can ask either GIS in Prevention, Tobacco Series, No. 1

2. PREV-STAT™: Overview, cont. “Who lives here? ” or “Where do they live? ” Ask “Who lives here? ” to learn about people in a specific area (e. g. , your county, neighborhood or school district). Ask “Where do they live? ” to find out about a target audience you seek to serve, (e. g. , single female-headed families with incomes below $30, 000). GIS in prevention helps make statistics more meaningful and persuasive. Purchased databases (e. g. , from the U. S. Census Bureau, Applied Geographic Solutions-AGS, Claritas, Health Data Science) provide rich data at the community and neighborhood levels. In addition, asset information is continuously being collected to reflect local resources in the form of prevention programs and other community and youth serving agencies, organization and institutions (e. g. , libraries, YMCAs, and religious institutions). Other environmental risk and protective factors represented in PREV-STAT™ include schools, alcohol outlets and locations of tobacco retailers that were found to have sold to minors, and gambling casinos. ) These County Profiles offer statistics at the county level with comparisons to the State of Indiana and U. S. In addition, for many variables there are tables listing statistics by block groups (neighborhoods) for the entire county demonstrate the wide diversity that exists within each county and identifies where in the county there assets or strengths (e. g. , literacy and vehicles for transportation) and challenges or risks (e. g. , child poverty). In addition, 32 maps accompany and illustrate demographics, risk and protective factors. The contents of this volume are intended to advance prevention by providing statistical information for use in the various phases of the prevention process, including community readiness, needs assessment, grant-seeking, program planning, and eventually program evaluation. This series is full of information about the citizens of Indiana, living in her 92 counties: their ages; occupations; incomes; households and families; education; behaviors with regard to alcohol, GIS in Prevention, Tobacco Series, No. 1

2. PREV-STAT™: Overview, cont. tobacco, other drugs, and gambling; their assets and their hardships; their resources and their needs. Even so, the information contained in these volumes is incomplete without the insider knowledge that the residents of the counties bring to it. It is hoped that users of this volume will seek to complement this county-level information by requesting custom reports for their neighborhoods and communities from the IPRC PREV-STAT™ Service. Data will never replace people, who remain the key to success. We talk about data-driven prevention, but people actually remain very much in the driver’s seat. People as individuals and agencies need to collaborate and develop protocols for data collection and data sharing. People at the grassroots need to add their common sense, insider-knowledge to the process to check for missing variables, wrong assumptions, cultural oversights or insensitivities. People select what data will be collected and how. They collect it, analyze it, check its accuracy, use their findings to develop reasonable strategies, practices and programs. They use data in decision-making related to planning, marketing, testing, and implementing. At each step of the way, people use data, including data generated by the prevention activities themselves, to evaluate performance, both in terms of processes and outcomes. Process evaluation uses data to measure such things as the fidelity of program delivery and efficiency in maximizing human and financial capital. Outcome evaluation uses such data tools as pre- and post- tests, surveys and data trends to assess the effectiveness of prevention efforts. The PREV-STAT™ Service is here to meet your needs. You do not need to have a precise question in mind. We will help you discover how PREV-STAT™ can help you. Just call and ask to speak to someone about PREV-STAT™. GIS in Prevention, Tobacco Series, No. 1

2. PREV-STAT™: Overview, cont. Instructions for How to Access PREV-STAT™: PREV-STAT™, the IPRC GIS-in-prevention service, is available at no cost to prevention professionals and practitioners affiliated with non-profit or governmental organizations or agencies, including schools and religious institutions. The IPRC is continuously working to obtain more data and to use it to produce maps, tables, slides, publications and soon searchable databases to meet your prevention needs. Access PREV-STAT™ through the IPRC home page: http: //www. drugs. indiana. edu/ Click on Resources, then on PREV-STAT™. You will then be on the following page http: //www. drugs. indiana. edu/resources/prev-stat/index. html/ From this page you can access: The new search engine of PREV-STAT™ County Statistics (with select statistics from 2002 -2005) GIS in Prevention, County Profiles Series, Nos. 1 -2. 92 volumes published in 2004 and 2005 GIS in Prevention, County Profiles Fact Sheet Series, No. 1 -- short version (No. 2 up-coming) GIS in Prevention, Tobacco Series, No. 1 (92 volumes, up-coming) Resources for County- and Local-Level Data for Prevention Planning You can obtain copies of Indiana’s 92 County Profiles in these ways: 1. View and print entire files or selected pages from the IPRC web site 2. Download files from the IPRC web site 3. Call or e-mail your request that a file be sent to you on CD ROM You can obtain a custom report: 1. Call or e-mail the IPRC to discuss your request 2. Be very patient. Custom reports are done as time permits 3. You can only request one report at a time 4. Demand may limit custom reports by any individual per year Points of access to the PREV-STAT™ Service: 1. www. drugs. indiana. edu 2. 1 -812 -855 -1237, or, in Indiana toll free at 1 -800 -346 -3077 GIS in Prevention, Tobacco Series, No. 1

Noble County Archival Indicators of Risk Community Risk Factor: Availability of Drugs Tobacco Sales Outlets Per Capita The Center for Substance Abuse Prevention (CSAP) defines this indicator as the number of tobacco sales outlets in relation to the total population. The following table shows the number of outlets in the county compared to the State. It also reveals the density of outlets per capita for the county by stating the number of outlets for every 1, 000 residents and for every 1, 000 youth in the county. Tobacco Retail Sales Outlets Per 1, 000, 2003 Number of Outlets Total Population Outlets Per 1000 Persons Total Population, 10 -17 Outlets per 1000 Youth GIS in Prevention, Tobacco Series, No. 1 Noble Indiana 43 5, 095 47, 622 6, 193, 993 0. 9 0. 8 5, 970 710, 759 7. 2 Table 1: Tobacco Sales Outlets, 2003 (ATC, 2004)

Population of Youths Vulnerable to Tobacco Sales to Minors Indiana Prevention Resource Center Source: AGS Consumer Behavior, 2003 (2004) Youth Ages 10 -17 (2003) GIS in Prevention, Tobacco Series, No. 1

Noble County Archival Indicators of Risk Community Risk Factor: Availability of Drugs to Youth: Failed TRIP Inspections Thanks to the outstanding work of the Tobacco Retailer Inspection Program (TRIP), we have additional data concerning the availability of tobacco products to youth, such as the locations of outlets that sold to youth and the number of total inspections and of failed inspections in each county where inspections were held in 2003. In Noble County, there was insufficient activity in TRIP inspections to be able to make any statistically reliable inferences. The sale of tobacco to youth is a clear indicator of the availability of drugs to youth and of the attitude of at least some members of the community with regard to the seriousness of the issue. Therefore we have included some aspects of the TRIP data here and some aspects under “Community Norms. ” The use of compliance checks has been found to be an effective environmental strategy. (Howard, et al. 2001) CASP names “ready access to tobacco” a factor that increases the likelihood of drug use by youth and “active enforcement of youth access laws using unannounced compliance checks” a prevention strategy shown to successfully reduce such sales. (CSAP 2004: 8 -9) Therefore, CSAP promotes increased levels of enforcement as part of a larger effort to reduce youth smoking. (CSAP 2004: 8 -9) Center for Substance Abuse Prevention 2003 Science-Based Prevention Programs and Principles 2003. Rockville, MD. Howard, K. A. , K. N. Ribisl, B. Howard-Pitney, G. J. Norman, L. A. Rohrback 2001 “What Factors Are Associated with Local Enforcement of Laws Banning Illegal Tobacco Sales to Minors? ” Preventive Medicine 33, 63 -70. GIS in Prevention, Tobacco Series, No. 1

Noble County Archival Indicators of Risk Community Risk Factor: Availability of Drugs Proximity of Failed TRIP Inspections to Schools Where drugs are available in areas heavily trafficked by children, the environmental risk is increased (CSAP 2003: 8). In addition to the above statistics for TRIP, PREV-STAT™ has geocoded the locations of schools and of failed tobacco inspections to facilitate yet another level of analysis by showing, via maps, the proximity to schools of tobacco outlets that failed TRIP inspections. For the counties that did participate in the TRIP Program, this County Profiles series presents maps for the county with some close-ups. These maps are intended to give a very general picture of the situation in the county and to encourage people to pursue obtaining similar information at the neighborhood level. (The power of PREV-STAT™ is greatest for neighborhood analysis!) It should be noted that whereas the scale of a map showing the entire county makes it difficult to see much detail, studies of neighborhoods offer great potential for representing the environmental risks and assets. The greatest power of PREV-STAT™ lies in its ability to give extensive data and insights for the very small geographic area. To have a customized study of your neighborhood, call the IPRC and ask for the PREVSTAT™ service. Center for Substance Abuse Prevention 2003 Science-Based Prevention Programs and Principles 2002. Rockville, MD. GIS in Prevention, Tobacco Series, No. 1

Noble County Insufficient data for 2003 GIS in Prevention, Tobacco Series, No. 1

Failed TRIP Inspections Indiana Prevention Resource Center Source: IN State Excise Police, TRIP GIS in Prevention, Tobacco Series, No. 1 Schools in Proximity to Tobacco Outlets That Failed TRIP Inspections in 2003

PCensus Table 2: Adult Smoking Behaviors, 2003 • • Adult Cigarette Smoking (Count) Adult Cigarette Smoking (Percent) Adult Cigar Smoking (Count) Adult Cigar Smoking (Percent) Money Spent on Tobacco Money Spent on Cigarettes Money Spent on Other Tobacco Products These statistics come from MRI Consumer Behavior Lifestyle (2004). GIS in Prevention, Tobacco Series, No. 1

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Noble County, Indiana Prevention Resource Center Source: AGS Consumer Behavior, 2003 (2004) Adult Cigarette Smoking, 2003 (Percent) GIS in Prevention, Tobacco Series, No. 1

Noble County, Indiana Prevention Resource Center Source: AGS Consumer Behavior, 2003 (2004) Adult Cigar Smoking, 2003 (Percent) GIS in Prevention, Tobacco Series, No. 1

Adult Cigarette Smokers, 2003 Indiana Prevention Resource Center AGS, Core Demographics, 2003 estimates (2004) GIS in Prevention, Tobacco Series, No. 1

Noble County Archival Indicators of Risk Community Risk Factor: Community Laws/Norms Adult Tobacco Behavior The following table shows adult smoking behavior as percentages for Noble County, with comparisons for Indiana and the nation. Adult Smoking Behavior, 2003 est. for Population Age 18+ Smoked Cigarettes in last 12 mos. Smoked Cigars in last 6 mos. GIS in Prevention, Tobacco Series, No. 1 Noble Co. Indiana United States 31. 6 29. 3 5 5. 3 Table 3: Adult Smoking Behaviors (MRI, Consumer Behavior Lifestyle 2003, 2004)

Noble County Archival Indicators of Risk Community Risk Factor: Community Laws/Norms Household Spending on Tobacco, 2003 The following table shows per household spending on tobacco products. To give a better perspective we will compare this figure to household spending on miscellaneous reading materials and on personal insurance. Per Household Spending on Tobacco, 2003, est. Per Household Spending on Tobacco Products Noble Co. Indiana U. S. 414 428 444 Cigarettes 375 Per Household Spending on Misc. Reading 400 39 Other Tobacco Products 387 41 44 235 Newspapers 245 257 105 109 114 Magazines 50 52 54 Books 81 84 88 Per Household Spending on Personal Insurance GIS in Prevention, Tobacco Series, No. 1 504 522 553 Table 4: Per Household Spending on Tobacco Products, Miscellaneous Reading and Personal Insurance (AGS, Consumer Spending, 2003)

Noble County Archival Indicators of Risk Community Risk Factor: Community Laws/Norms Intensity of TRIP Inspections The IPRC is grateful to Sergeant Steve Anderson, State Director of the Indiana Tobacco Retailer Inspection Program (TRIP) of the Alcohol and Tobacco Commission, and to Desiree Goetze, Coordinator of the TRIP program at the IPRC, and to the staff and police officers of TRIP for all the support they have given to this project. The IPRC has studied the TRIP data generously made available by the Indiana State Excise Police and has created two additional statistical measurements: 1) for the intensity of inspections (the number of inspections relative to the total number of outlets); 2) for the number of inspections per capita for the population of youth most likely to seek access to tobacco, (i. e. , youth ages 10 -17). Intensity of inspection can be viewed as one of many possible indicators of the degree of a county’s involvement in activities to create or maintain a community norm that youth access to tobacco is not tolerated. GIS in Prevention, Tobacco Series, No. 1

Noble County Archival Indicators of Risk Community Risk Factor: Community Laws/Norms Intensity of TRIP Inspections TRIP Inspection Data, # Co. (using data from IN State Excise Police), 2003 County Name Noble Indiana 0. 00 1. 28 5, 970 710, 759 43 5, 095 Total Inspections Attempted 6, 645 Total Inspections Completed 6, 533 Failed Inspections 896 Percent, Failed Inspections #DIV/0! 13. 7% Percent, Passed Inspections #DIV/0! 86. 3% Intensity of Inspection No of Inspections per Capita: Population Age, 10 -17 Total No. of Tobacco Retail Outlets GIS in Prevention, Tobacco Series, No. 1 Table 5: Intensity of TRIP Inspections and Related Statistics, Calculations for 2003 Based on Data from the TRIP Program (ATC, Indiana State Excise Police, 2004)

Noble County Archival Indicators of Risk Community Risk Factor: Community Laws/Norms Tobacco Production Noble County Did NOT Have Tobacco Production & Revenue: Source: the Strategic Development Group’s “Alternative Agricultural Strategy” (Bloomington, March 15, 2001) report, which is part of Governor Joseph E. Kernan’s “Recipient Final Reports for Office of the Commissioner of Agriculture Grant Programs” (http: //www. in. gov/oca/grants/valueadd/VAFinal. Reports. html): Table 6: Tobacco Production. Kernan’s “Recipient Final Reports for Office of the Commissioner of Agriculture Grant Programs, ” Strategic Development Group’s “Alternative Agricultural Strategy” (Bloomington, March 15, 2001) GIS in Prevention, Tobacco Series, No. 1

Tobacco Production Source: Tobacco Production. Kernan’s “Recipient Final Reports for Office of the Commissioner of Agriculture Grant Programs, ” Strategic Development Group’s “Alternative Agricultural Strategy” (Bloomington, March 15, 2001), p. 11. GIS in Prevention, Tobacco Series, No. 1

Statistics Related to TRIP • • • Total Population of Youth, Ages 10 -17 Number of Tobacco Outlets per 1000 Persons Tobacco Outlets per 1000 Youth Intensity of Inspection GIS in Prevention, Tobacco Series, No. 1

Indiana Counties by Total Population (AGS 2003, 2004) Top Half by Total Population GIS in Prevention, Tobacco Series, No. 1

Indiana Counties by Total Population (AGS 2003, 2004) Bottom Half by Total Population GIS in Prevention, Tobacco Series, No. 1

Indiana Counties by Population Ages 10 -17 (AGS 2003, 2004) Top Half by Population of Youth Ages 10 -17 GIS in Prevention, Tobacco Series, No. 1

Indiana Counties by Population Ages 10 -17 (AGS 2003, 2004) Bottom Half by Population of Youth Ages 10 -17 GIS in Prevention, Tobacco Series, No. 1

Indiana Counties by No. of Tobacco Outlets (ATC, IN State Excise Police, TRIP, 2004) Top Half by No. of Retail Tobacco Outlets GIS in Prevention, Tobacco Series, No. 1

Indiana Counties by No. of Tobacco Outlets (ATC, IN State Excise Police, TRIP, 2004) Bottom Half by No. of Retail Tobacco Outlets GIS in Prevention, Tobacco Series, No. 1

Indiana Counties by No. of Tobacco Outlets Per 1, 000 Persons (No. of outlets: ATC, IN State Excise Police, TRIP, 2004; Population: AGS 2003, 2004) Top Half by No. of Retail Tobacco Outlets per Capita GIS in Prevention, Tobacco Series, No. 1

Indiana Counties by No. of Tobacco Outlets Per 1, 000 Persons (No. of outlets: ATC, IN State Excise Police, TRIP, 2004; Population: AGS 2003, 2004) Bottom Half by No. of Retail Tobacco Outlets per Capita GIS in Prevention, Tobacco Series, No. 1

Indiana Counties by No. of Tobacco Outlets Per 1, 000 Youths Ages 10 -17 (No. of outlets: ATC, IN State Excise Police, TRIP, 2004; Population: AGS 2003, 2004) Top Half by No. of Retail Tobacco Outlets per Youth GIS in Prevention, Tobacco Series, No. 1

Indiana Counties by No. of Tobacco Outlets Per 1, 000 Youths Ages 10 -17 (No. of outlets: ATC, IN State Excise Police, TRIP, 2004; Population: AGS 2003, 2004) Bottom Half by No. of Retail Tobacco Outlets per Youth GIS in Prevention, Tobacco Series, No. 1

Indiana Counties by Intensity of Inspection (Source for no. of inspections and no. of outlets: ATC, IN State Excise Police, TRIP, 2004) Top Half by Ratio of No. of TRIP Inspections/No. of Outlets GIS in Prevention, Tobacco Series, No. 1

Indiana Counties by Intensity of Inspections (Source for no. of inspections and no. of outlets: ATC, IN State Excise Police, TRIP, 2004) Bottom Half by Ratio of No. of Inspections/No. of Outlets GIS in Prevention, Tobacco Series, No. 1