Bob Bailey, assistant dean of the MU School of Law and chairman of the Health Report Card project, said issues were identified from many data sources, including the 1995 Boone County Community Health Assessment survey and the 1995 Community Needs Assessment. Funding for the health survey and needs assessment came from the Boone County Commission and the Missouri Department of Health. Technical support was provided by the state Department of Health and University of Missouri Outreach and Extension.

Areas of particular concern include Boone County's high school dropout rate of 8.9 percent, which is higher than the state average of 7.4 percent, the high number of young children who are not fully immunized against childhood diseases and an increasing number of births to teenage mothers.

According to the survey of county residents, lack of insurance and the cost of health care are significant issues for many Boone Countians, particularly the 16.6 percent who live at or below the poverty level and the additional 17.7 percent with incomes less than 200 percent of the poverty level. Almost 20 percent of these individuals indicated they had not received medical care when needed during the previous year because they could not afford it. Other local health issues highlighted by the survey and health assessment included inaccessibility of dental and mental health care, domestic violence, underemployment, child abuse, tobacco and substance abuse, transportation issues for senior citizens and respite for individuals caring for an ailing partner or housemate.

Because the project is just getting started, a report card was not generated this year. That will be done next year and every year thereafter, to monitor Boone County's progress on these health issues.

Bernard Ewigman, medical director of the Family Health Center at Parkade and chairman of the data assessment team, noted that additional issues may come to light as the project gets under way.