We are of this place, not just from it.
COMMUNITY HEALTH NEEDS ASSESSMENT FY 2020-2022 Essentia Health-Sandstone Table of Contents
Acknowledgements 2 Executive Summary 3 Introduction 4 Essentia Health at a Glance 5 Hospital Service Area 6 Demographics & Socioeconomic Factors 7 Evaluation of 2016-2019 Implementation Plan 8-9 2020 – 2022 CHNA Process & Timeline 10 Assess & Prioritize 11 Community Input 12 Key Findings 13-15 Design & Conclusion 16 Implementation Plan 17-20
Appendix A – Data Presentation PowerPoint Appendix B – Health Priority Survey Monkey Appendix C – Health Priority Survey Monkey Results Appendix D – Hanlon Criteria Matrix Appendix E – Hanlon Matrix Results
Lead Parties on the Assessment
Martina Mellang - Community Health Specialist, Essentia Health Tanya Christopherson - Clinical Dietitian, Nutrition Services Supervisor, Essentia Health-Sandstone
Acknowledgements
This report is based on a collaborative process with the following community members and organizations. Essentia Health would like to express our gratitude to the many steering committee members and community members for their contribution to planning, development, and analysis of community health needs. Additional thanks to the community members who shared their expertise and helped us include the voices of diverse sectors of our community.
• Pine County Public Health • Pine County Health and Human Services
• Sandstone Lion's • Family Pathway’s Food Bank • East Central Schools • Meshakwad Community Center • FirstLight Health Systems • Pine City Board • Hinckley-Finlayson School District • North Pine Area Hospital District Board • Pine County Veterans Services
• Grand Casino Hinckley • MDH Center for Public Health Practice • Jewish Faith Community Rabbi • Community Connection Allies • Council on Aging • Gateway Family Health Clinic • First Lutheran Church
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Executive Summary
Essentia Health-Sandstone is part of Essentia Health, a nonprofit, Essentia Health is integrated health system caring for patients in Minnesota, Wisconsin, called to make a North Dakota and Idaho. Essentia Health is called to make a healthy difference in people’s lives. To fulfill that mission, we seek opportunities healthy difference in to both enhance the care we provide and improve the health of our people’s lives communities.
Every three years, each Essentia Health hospital conducts a Community Health Needs Assessment (CHNA) to systematically identify, analyze and prioritize community health needs. The process is conducted in collaboration with many community partners including other health care systems, local public health departments, and organizations or individuals that represent broad interests in the community, including members of medically underserved, low-income, and populations at higher health risk.
Once priority health needs are identified, Essentia Health-Sandston designed an implementation strategy to address the needs with internal stakeholders and community partners. The plan is designed to leverage existing community strengths and resources available to improve health.
From July 2018-April 2019, Essentia Health-Sandstone analyzed data, convened community partners, sought input from community members, and led a process to identify the following priority areas for the 2020 – 2022 Community Health Needs Assessment:
1. Mental health 2. Obesity
3. Substance abuse
The 2020-2022 Implementation Plan outlines the multiple objectives, activities and strategies to address each priority area.
Mental health goal: All youth and adults in Pine County experiencing positive mental well- being and resilience.
Obesity goal: The community has access to healthy eating and active living opportunities.
Substance abuse goal: Youth and adults in Pine County are substance-free.
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Introduction
Essentia Health is called to make a healthy difference in people’s lives. To fulfill that mission, we seek opportunities to both enhance the care we provide and improve the health of our communities. In conducting the Community Health Needs Assessment, Essentia Health has collaborated with community partners to embrace these guiding principles:
ra it½ r.iealtti a@d W.ell liless a We are called to make a healthy Essentia Hl ealtta is difference in people's lives.
Achieve health and vitality with our community.
Mental Nutrition & Substance Wellness Physical Activity Use
Prioritize sustainable evidence based efforts around the greatnt 4 GUIDING PRINCIPLES community good.
Essentia Health, in a collaborative effort and through workin g together with other commu nity partners w ill:
14 COMMUNITIES • Douglas County (Superior. W I) • Becker County {D etroit Lakes. MN) • Pine County (Sandstone. MN) • B ig Stone County (Graceville. MN) •St. Louis County \DuluthNirginia/Aurora. MN) • Norman County (Ada MN) • Itasca County (Deer River. MN) • Cass and Clay Counties (Fargo. ND) • Crow Wing County (Brainerd. MN) • Idaho County (Cottonwood, ID) • Polk County (Fosston. MN) • Clearwater County (Orofino. ID)
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Essentia Health at a Glance t,, , Essentia Health together as one r--- • .A-. for the needs of al l \ Montana North Dakota .I'• Minnesota ...... ~ • ...... i\. 14,400 total employees •" •Ir • 74 clinics ~ ·. ,, -~ 15 hosp itals ,------.., . ) 6 long-term care facilities ,V.ho "-',_,....,/:\,------' • 5 ambulance services
ld• ___1 2 assist ed living facilities I "-~;-:_J 4 independent living facilities 1 research & education institute
Headquartered in Duluth, Minnesota, Essentia Health combines the strengths and talents of 14,400 employees, who serve our patients and communities through the mission of being called to make a healthy difference in people’s lives.
Essentia Health-Sandstone is part of Essentia Health. The nine-bed Critical Access hospital opened in May 2017. It serves Sandstone and surrounding areas, including Hinckley, Finlayson, and Askov. Essentia Health-Sandstone is a Level IV Trauma Center and Acute Stroke Ready Hospital. It offers emergency care 24 hours a day, seven days a week and has an urgent care unit. It offers inpatient and outpatient hospital services ranging from cancer rehabilitation to physical therapy.
Essentia Health-Sandstone is a part of the Pine Healthcare Campus. This medical community
improves the health of rural areas by providing basic and life-saving health care close to home. Other facilities on the grounds includes the Gateway Family Health Clinic, Thrifty White Pharmacy and the Golden Horizons Senior Living and Memory Care.
Caring for our Community: Our commitment to our community’s health and wellness goes well beyond the work of the Community Health Needs Assessment. Through contributions of over $1 million annually to numerous community organizations we’re working together with our communities to improve the health and vitality of our neighborhoods. In addition, we’re proud to say our employees donated more than 22,000 hours of their time and talents to a variety of programs and outreach efforts. Our community investments are designed to promote better health, help lessen inequities in our communities, improve access to health care and strengthen the fabric of our communities.
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Hospital Service Area
Essentia Health-Sandstone is a part of the Pine Healthcare Campus. For the purposes of this assessment, community is defined as the Essentia Health-Sandstone planning area combined with the ZIP codes where 80 percent of inpatients resided for fiscal year 2019. This includes the ZIP codes of 55072 (Sandstone), 55037 (Hinckley), 55735 Finlayson, and 55704 (Askov). The community was defined based on the hospital’s ability to have the greatest impact with the available resources. The hospital is committed to building and sustaining partnerships with area organizations in order to extend its reach to all areas within this region.
Other facilities on the Pine County Healthcare Campus include the Gateway Family Health Clinic, Thrifty White Pharmacy and the Golden Horizons Senior Living and Memory Care. Moose Lake has Mercy Hospital, about 25 miles north of Sandstone. Cloquet has Community Memorial Hospital, about 50 miles north of Sandstone. First Light Health System has a hospital in Mora, about 30 miles south of Sandstone.
Due to the region’s rural nature, data for populations smaller than county level are frequently unavailable or of limited value. Therefore, in the following assessment, data are presented at the county and state level to ensure stability of the estimates. When available, ZIP code or census tract level data will supplement the county level information to provide a deeper understanding of the health needs of the community.
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Demographics & Socioeconomic Factors
Table A. Overall demographics (2016) Total Population Pine Sandstone Minnesota County Population 29,067 2,741 5,450,868 Population age 65 and over (%) 18.30% 10.40% 14.29% Poverty Median household income $45,379 $42,292 $63,217 People of all ages living in poverty (%) 13.70% 19.90% 10.80% People under 18 years living in poverty (%) 17.50% 30.90% 13.69% Unemployment rate 3.70% 2.00% 3.40% Educational Attainment High school graduate or higher, person’s age 25 years+ (%) 89.40% 80.40% 92.80% Population ages 25+ with bachelor’s degree or higher 13.80% 10.60% 34.30% Housing Percent of owner-occupied homes (%) 77.80% 48.70% 71.40% Population spending more than 30% of income on rent (%) 48.60% 37.70% 47.30% Transportation Households with no motor vehicle available (%) 5.40% 7.60% 7.00% Source: U.S. Census Bureau 2016, American Community Survey
Table B. Race/Ethnicity Distribution (2016) Race Distribution – Sandstone, MN Race 2016 Percent 2015 Percent % Change Total Population 2,741 100.00% 2,780 100.00% -1.40% One Race 2,654 96.80% 2,716 97.70% -2.28% White 2,026 73.90% 2,099 75.50% -3.48% Black or African American 376 13.70% 362 13.00% 3.87% American Indian and Alaska Native 133 4.90% 134 4.80% -0.75% Asian 12 0.40% 0 0.00% 0.00% Native Hawaiian/Pacific Islander 13 0.50% 11 0.40% 18.18% Other Race 94 3.40% 110 4.00% -14.55% Two or More Races 87 3.20% 64 2.30% 35.94% Hispanic or Latino 334 12.20% 387 13.90% -13.70% Source: U.S. Census Bureau 2014-2016, American Community Survey
Pine County residents are increasingly older, have lower incomes and higher rates of poverty compared to the state. The region’s rural nature makes transportation and isolation two barriers to accessing care. Poverty, education, age and race are all factors contributing to inequitable health outcomes. Poverty is not evenly distributed across racial/ethnic groups, ages or educational levels.
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Evaluation of 2016–2019 Implementation Plan
During 2016–2019, Essentia Health-Sandstone addressed significant needs identified in the 2016 assessment: mental health and healthy lifestyle choices. Some activities were led by the hospital, while others were part of larger collaborative efforts with local partners. The following describes significant accomplishments and outcomes.
Priority Area #1: Mental Health
Essentia Health-Sandstone is taking an active role in community-based coalitions related to the priorities addressed in the Community Health Needs Assessment.
In 2017, Essentia Health-Sandstone partnered with Grand Casino Hinckley to host the Community Mental Health Forum inspired by and as a follow-up event to an Opioid Forum. Representative Rick Nolan and Interim Chair of the Pine County Chemical Health Coalition Becky Foss requested this forum. More than 250 people attended.
Essentia Health participated in the Region 7E Community Conversation Series that took place from October-December 2018 to discuss ways to remove stigma, increase mental health education, and identify programs for mental health. The Community Conversations were a sequential, progressive four- part series supporting adult mental health in the region.
Priority Area #2: Healthy Lifestyle Choices
Essentia Health-Sandstone partnered with East Central Schools to provide education and awareness on a variety of health topics. In the fall of 2018, Kristine Crowley, Essentia’s tobacco treatment specialist, completed tobacco education at East Central for 8th- 12th graders. Tanya Christopherson, Essentia’s dietitian, educated 8th and 10th graders on healthy eating, physical activity and ways to make healthy lifestyle changes.
In October 2018, Essentia-Health Sandstone partnered with the Lions Family Health Expo. The expo offered free lab tests for cholesterol, A1C, Vitamin D, mammograms, glucose, and flu shots funded by Essentia Health-Sandstone. Free screenings for vision, hearing, blood pressures, BMI, memory, sleep, and depression were also offered.
Essentia Health-Sandstone is a partner with the Pine County Chemical Health Coalition as an executive committee member. One accomplishment was the Sticker Event which involved six liquor establishments. The Prevention Campaign was created to talk about responsible beverage server
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training and prevent underage drinking. The coalition will support the 2019 post-prom event to prevent high school students from using alcohol and other substances.
SNAP Rx, a food insecurity screening program, was piloted in the Emergency Department. Essentia Health-Sandstone partnered with Lake and Pines. In this screening, patients were asked three questions to assess food insecurity. If a patient agreed to the SNAP Rx program, they are referred to Lakes and Pines to be connected with resources around food insecurity.
Essentia Health-Sandstone hosts the National Diabetes Prevention Program. A trained lifestyle coach facilitates one class each year. This free lifestyle change program has been offered since 2014 for a total of five completed classes.
In 2017, the respiratory therapist at Essentia Health-Sandstone completed tobacco treatment specialist training to help individuals quit smoking and educate youth on the health dangers from tobacco and vaping devices.
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2020-2022 CHNA Process and Timeline
Essentia Health’s Community Health Advisory Committee developed a shared plan for the 15 hospitals within the system. The plan was based on best practices from the Catholic Hospital Association and lessons learned from the 2016-2019 CHNA process. The process was designed to:
• Incorporate input from persons representing broad interests of the community • Collaborate with local public health and other health care providers • Utilize multiple sources of public health data to make data-driven decisions
Each individual hospital worked with community partners to carry out the plan in their service area. Aspects of the plan were adapted to meet the unique needs of each location. Hospital leadership teams and local hospital boards received and approved each implementation plan, followed by final approval by the Essentia Health Board of Directors. The following visual describes the assessment steps and timeline.
Timeline
Analyze Data & ASSESS Service Area Select Health Status Define Service Area Inventory available Demographics Indicators (July -Sept. 2018) resources
Justify needs that PRIORITIZE Choose will not be Gather Community Prioritization Prioritize Issues addressed and Input on Priority (Sept. - Jan.2018) Process provide reasoning Issues why
DESIGN Identify the "team" Identify Develop Goals and Choose Strategies and resources for Performance (January- April Measurable and Tactics Objectives each strategy Indicators 2019)
Share results and Prepare reports, Post to website, FINALIZE action plans with and review with Present to Hospital and share plan key stakeholders (May - June key stakeholders Board for Approval with the broader and leaders for final feedback community 2019) systemwide
Adoption of implementation strategy:
The Community Health Needs Assessment and Implementation Strategy were approved by the Essentia Health Sandstone Pine Medical Center Board approved on April 16, 2019 and the Essentia Health East Region Board of Directors approved on
May 2, 2019.
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Assess
Secondary data was collected and analyzed by the Pine County Public Health. The Pine County Public Health Advisory Committee discussed Pine County health data and watched a YouTube clip called “A Tale of Two Zip Codes” to discuss health equity and the social determinants of health. Themes that stuck out from the data presentation included aging, average household income, housing, smoking-related cancers, mental health and chronic stress. Due to the rural nature of the community, data for populations smaller than county level were frequently unavailable or of limited value. In the assessment, data was presented at the county and state level, and when available, ZIP code or census tract. The Minnesota Department of
Health Vital Statistics and Minnesota County Health Tables were the source for demographic and socioeconomic trends. Data on the Pine County chronic conditions, adult substance use and adult mental health came from the Minnesota East Central Regional Community Health Survey. The Minnesota Student Survey showed data trends for student substance use and mental health. Please see Appendix A for the Data Presentation PowerPoint.
Data was reviewed and discussed with the Pine County Public Health Advisory Committee representing the broad interests of the community. Agencies represented at the presentations included: FirstLight Health Systems, Pine County Commissioner, Pine County Veterans Services Officer, Family Pathways, North Pine Area Hospital District Board, Pine County Public Health, Jewish Faith Community Rabbi and a student from East Central High School.
Prioritize To narrow down the list of 23 health indicators from the data assessment, the Pine County Public Health Advisory Committee completed a survey to identify the top eight health indicators. This list of eight health indicators was then put through a formal prioritization process known as the Hanlon method, which takes health priorities based on the criteria. Each member of the committee individual scored the health indicators on the level of influence, seriousness of the problem, size of the problem, interventions that are proven to be effective and unfair health differences. The three health issues with the highest score were then identified as the three focus areas for the 2020-2022 Community Health Needs Assessment. Mental health had the highest score, obesity and substance abuse tied for second, and tobacco came in third. The committee agreed to pair substance abuse and tobacco together. Through this process, three priorities were identified for action.
1. Mental health 2. Obesity 3. Substance abuse See Appendix B for the survey used to determine the top eight health priorities and Appendix C for the results of the health priorities. See Appendix D and E for the Hanlon Criteria Matrix and Results.
Significant needs not addressed in the CHNA: Other issues identified through the process but not included among the top three priorities included maternal health, access to health care, and older adults and aging. Additionally, Essentia Health already collaborates with local partners to address these specific issues in the communities. 11
Community Input After priority issues were identified through reviewing data and the formal prioritization process, Essentia Health-Sandstone solicited broad feedback from the community on the priorities chosen and how to address the needs.
Community input was primarily gathered through focus groups and key informant interviews. Over the course of two months, more than 50 community members provided input on the priority issues in their community. Essentia Health-Sandstone lead focus groups at the schools, Meshakwad Community Center, the Sandstone Food Shelf, and the Sandstone Lion’s Health Event. Four key questions were asked to discern community strengths, health issues and barriers.
1. Do you confirm the top three priorities? 2. What are the strengths and weaknesses in this community related to those priorities? 3. What partners should be involved to help address the priorities? 4. What are some solutions?
The focus groups used a Results Based Accountability format to get feedback from the community on the strengths and barriers of each of the three priority areas. Each focus group was presented with an indicator or data set to clearly understand the current conditions and where improvements needed to be. This approach helped identify root causes, partners who could be involved and solutions to the three health priority areas. Focus groups were limited to an hour and promoted a safe space to have an open dialogue. Participants in focus groups or key informant interviews came from the following areas:
• Pine County Health and Human Services • Sandstone Lions • Family Pathway’s Food Bank • East Central Schools • Meshakwad Community Center • Hinckley-Finlayson School District • North Pine Area Hospital District Board • Community Connection Allies • Council on Aging • Gateway Family Health Clinic • First Lutheran Church
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Key Findings
Priority #1 Mental Health Supporting Data:
• Pine County’s median household income is $46,332 compared to the state of Minnesota at $63,459. (Vital Statistics Report, 2016) • 8.4% of Pine County adults felt sad, blue or depressed for 10-19 days a month and 1.6% felt sad, blue or depressed all 30 days (Minnesota East Central Regional Community Health Survey, 2015). • 23% of females in 8th, 9th, and 11th grade in 2016 reported having long-term mental health, behavioral or emotional problems compared to 14% in 2013 (Minnesota Student Survey, 2016 and 2013). • 15% of males in 8th, 9th, and 11th grade in 2016 reported having long-term mental health, behavioral or emotional problems compared to 10% in 2013 (Minnesota Student Survey, 2016 and 2013).
Community Input:
Some limiting factors that contribute to poor mental health include the lack of mental health providers in Sandstone. Transportation is also an issue to access the needed therapy. The community noted a need for more mental health awareness and stigma prevention efforts. Suggestions to improve social isolation were made to provide more church dinners, community center get-togethers, activities for seniors. Seniors would also benefit from financial aid and lower cost programing. There is a need for more jobs in the area and more career counseling. Students reported fear of mandated reporters and a need for more trusted adults.
Community Strengths and Resources Available:
The Meshakwad Community Center in Hinckley is now open to the public with plans to expand programming and events as well as classes in the fitness center. Many community members reported on the variety of outdoor recreation opportunities to engage in and the local parks to visit. The East Central
Minnesota Pride is an annual event supporting the growing LGBTQ community that started in 2005 supporting the rural area that lies between the Twin Cities and Duluth. The 7 County Senior Federation was noted as a benefit to the community serving the aging population. Wellness in the Woods advocates on behalf of individuals experiencing mental health challenges in rural Minnesota by offering training and education opportunities such as Wellness Recovery Action Plan and Mental Health First Aid. Schools in Pine County are working to become trauma-informed. Students noted the benefit of having music and shop classes along with after-school programs. The schools also offer peer-to-peer groups.
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Priority #2 Obesity
Supporting Data:
• 51% of Pine County adults were obese in 2015 compared to 24% of adults in 2005 (Bridge to Health Survey, 2015). • 16% of 8th, 9th, and 11th graders in Pine County were overweight and obese (Minnesota Student Survey, 2016). • Almost 9% of Pine County adults report being told by a health care professional that they have diabetes (Minnesota East Central Regional Community Health Survey, 2015). • Almost 11% of Pine County adults report being told by a health care professional that they have pre-diabetes (Minnesota East Central Regional Community Health Survey, 2015).
Community Input:
Information from the community focus groups found many common themes. The community reported a lack of physical ability to get to food shelves, grocery stores, or medical appointments with a need for more accessible transportation. Some community members reported that there is a lack of motivation to be physically active and live a healthy lifestyle. Along with the barriers of transportation, there is limited access to healthy foods that are affordable. Students reported a need for healthier school lunch options with more varieties of fresh fruit and vegetables.
Community Strengths and Resources Available:
Community conversations highlighted the assets in the county that are readily available. Essentia Health-
Sandstone offers the National Diabetes Prevention Program to help those with prediabetes live a healthier lifestyle. Students reported the many opportunities to stay active through sports and the pool at East Central High School. To help ease the burden of food insecurity, the schools offer the Backpack Program. Pine County also is rich in natural habitat and outdoor recreation for people to enjoy year-round.
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Priority #3 Substance Abuse
Supporting Data:
• 31% of 9th graders in Pine County used alcohol one or more times in the last 12 months compared to 21% of 9th graders in the state of Minnesota (Minnesota Student Survey, 2016). • 8% of 9th graders in Pine County smoked cigarettes on one or more days in the last 30 days (Minnesota Student Survey, 2016). • 25% of Pine County adults reported smoking cigarettes compared to 29% in 1995 (Bridging Health North, 2015). • In the past 30 days, almost 33% of Pine County adults reported binge drinking (Minnesota East Central Regional Community Health Survey, 2015).
Community Input:
The community felt that when it comes to substance abuse in Pine County, there are many root causes for both youths and adults. It was noted that in general, it is difficult to change habits and stay motivated to choose healthy activities with the pressure of social norms and the stress life brings. Isolation that individuals experience creates mental health issues and may cause more people to abuse substances. There is a perception of substance use among students in Pine County. Students in Pine County also show a low perception of risks in drinking alcohol. There is a lack of safe places for students to go when they feel they are in an unsafe situation. Historical trauma also influences the current substance abuse in Pine County.
Community Strengths and Resources Available:
Essentia Health-Sandstone has a certified tobacco treatment specialist on site to educate and reduce tobacco use among youth and adults. There is a Pine County Chemical Health Coalition and Planning and Implementation grant that drives the Positive Community Norms Campaign through media messages and billboards. The Sticker Shock Project is one of the ways to message underage drinking prevention. Another resource the coalition provides is the community dinner which focuses on youth trends around alcohol use.
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Design
Essentia Health worked with internal stakeholders as well as community partners to design a strategy to address each of the priority needs identified in the CHNA process. The plan outlines actions that will be taken to respond to the identified community needs including goals and measurable objectives, strategies, tactics, and performance indicators.
The implementation plan is a three-year plan to address priority needs. The implementation plan will be reviewed annually, with progress shared with hospital leadership and the Board of Directors on an annual basis.
Additionally, the following three priorities were determined by the Community Health Advisory Committee (CHAC) at a retreat in January 2019. The retreat included input from Community Health staff from across the Essentia Health system. Prioritization was based on common themes from the 15 Community Health Needs Assessments.
• Mental health and wellness • Substance abuse • Nutrition and physical activity
During the FY2020-FY2022 assessment cycle, some activities will be led by the individual hospitals/markets, while others will be coordinated across the health system. This will help Essentia Health make the greatest impact with available resources
No written comments were received from the 2013 CHNA. Any comments would have been taken into consideration in this report.
Conclusion
As a nonprofit health system, Essentia Health is called to make a healthy difference in people’s lives. This needs assessment illustrates the importance of collaboration between our hospitals and community partners. By working collaboratively, we can have a positive impact on the identified health needs in our community in FY 2020-2022.
For questions or comments about the community health needs assessment, please contact: [email protected]
Copies of this plan can be downloaded from our website: https://www.essentiahealth.org/about/chna/
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CHNA 2020-2022 Implementation Plan
Sandstone CHNA Advisory Committee
Our Mission: Support a healthier community for all
Sandstone CHNA Advisory Committee will work together to address each aspect of this implementation plan with mutually reinforcing activities. The community stakeholders work together to carry out this implementation plan utilizing a multi-sector coalition-based approach. This approach will support and leverage each other’s efforts, discourage duplication and distribute activities based on areas of expertise. The Essentia Health system has outlined an allocation of resources available to each hospital as a percentage of net revenue to address the priorities set forth in the Community Health
Needs Assessments. Progress on goals will be monitored and reported to hospital leaders routinely.
Our Results
The community has access to All youth and adults in Pine Youth in Pine County are healthy eating and active living County experienc e positive menta l substance-free opportunities well-being and resilience
Our Indicators
• Adults who are obese in Pine • Adults who felt sad, blue or • Pine County tobacco use in 9th County depressed in the last 30 days grade
• Pine County 8th, 9th, and 11th • Pine County 8th, 9th, and 11th graders who are overweight graders who report having any • Pine County alcohol use in 9th and obese mental health, behavioral or grade emotional problems
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CHNA 2020-2022 Implementation Plan
Obesity: The community has access to healthy eating and active living opportunities Indicators Partners who can help Chris's grocery, SHIP, Food Shelf, Farmer's Market, School Administration/Food Adults who are Obese Pine County 8th, 9th, 11th Service Managers, Food Suppliers/ Local Farmers , Student Council/NHS, graders weight status accoriding Sandstone Garden Club, Essentia Health-Sandstone, Fitness Centers/gyms, City 60 51.1 to BMI-overweight and obese Government-Parks and Rec, City Council, County Government, Sheriff's 50 40% Department, Tribal government, Civic organizations-Lion's Club, VFW, American 40 Legions, DAV, Senior Centers, Faith Community, Meals on Wheels- Community 30% 30 24 22.3 Connection Allies, Arrowhead Transit, DNR, Grand Casino, Stephanie Heim-MN 15% 15% 16% 16% 20 20% Farm to School, University of Minnesota-Extension, Minnesota Dept of Health, 10 10% Council on Aging
0 0% I I I I 2005 2010 2015 2013 2016
- Pine County ■ Over weight ■ Obese
Source: Bridge to Health Survey, 2015 Source: Minnesota Student Survey, 2016 Story Behind the Data What we are going to do Factors that have contributed to improvements: Strategy #1: Increase healthy and local food choices • National Diabetes Prevention Program available Action Steps: • Indoor gym at Baptist church in Askov (unknown if open to community) A) Partner with 4-H and other youth leadership groups (i.e. National Honor • High school sports Society) to explore farm-to-school and community garden initiatives • Pool at East Central High School B) Expand options for healthy food choices (E.g. Farm to School, healthy snacks in • School healthy snack policy classrooms, school gardens) • Parks, nature, trails C) Explore grants to aid schools with healthy snacks and expanding healthy food • School backpack program choices. • Food pantry in high school Strategy #2: Offer group educational, social, or physical activities that promote Limiting factors: social interactions, regular attendance, and community involvement among older adults. • Lack of motivation to eat healthy (ex- fruit/vegetables, eliminate soda) Action Steps: • Lack of motivation to be physically active A) Provide Matter of Balance classes/ identify a volunteer program leader • Transportation B) Partner with Community Education to promote social activities • Access to healthy, affordable food C) Develop a social norms campaign around physical activity, eating well and the • Lack of physical ability to get to food shelves, grocery stores, and medical Diabetes Prevention Program appointments • Not enough funding for healthy school lunch options • School lunch food has limied variety of fresh fruits and veggies
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CHNA 2020-2022 Implementation Plan
Mental Health: All youth and adults in Pine County experience positive mental wellbeing and resilience. Indicators Partners who can help Adult Mental Health Pine County 8th, 9th, 11th graders who Da ys fe l t sa d / b lu e/ d ep re sse d report having any long-term mental health, Local advisory councils, AA, Recovering Hope, NAMI, TSA, Adult mental health in th e la s t 3 0 d a ys behavioral or emotional problems providers, Faith community, Central MN Council on Aging, Briana, Schools, ACE’s p in e co u n ty a d u lt s, 2 0 1 5 trainers, Mental Health First Aid trainers, Law enforcement, emergency 0 days 10-19 days All 30 days ■ ■ ■ 25% 23% response, WINDOW, Dementia friends-through ACT on Alzheimer’s, Adult day program-Lakes and Pines, Senior Centers 20% 48.0% 14% 15% 15% Youth Mental Health 10% Schools, Churches, Students, Boy scouts, girl scouts, FFA, 4H, Tribe, Casino, 10% Businesses, Government, Mental Health providers, NAAMI, Civic organizations, non-profits, WINDOW-domestic abuse issues, Essentia, First Light, Fairview, Law 5% Enforcement, Pregnancy Resource Centers, Parents, families in general
0% males females 8.4% 2013 2016
1.6% 1.6% Source: Source: Minnesota East Central Regional Community Health Survey 2015 P■ I NE - Source: Minnesota Student Survey, 2016
Story Behind the Data What we are going to do Factors that have contributed to improvements: Strategy #1: Increase access to mental health services and training opportunities. • Peer to peer friend groups, school teachers trying to help Action Steps: • Music and shop classes in schools, after school opportunities A) Explore opportunities with the tele-health committee and Gateway Clinic • Education efforts to reduce stigma B) Research Community Health worker model at Ely Clinic ‘ • Trauma informed school planning and implementation grant Strategy #2: Coordinate and implement training—for first responders, peer helpers, and • Community Center at Mille Lacs Band: Meshakwad others—on effective suicide grief support and stress management. • Parks/outdoor opportunities Action Steps: • Wellness in the Woods (peer support line, warm line), Text 4 Life, Drop in center A) Identify specific needs of first responders for training • 7 County Senior Federation B) Identify funding and training program • LGBTQ-Pride Parade (East Central MN Pride) C) Create ongoing training to offer continued support Strategy #3: Establish a program that builds relationships between an older adult and an Limiting factors: at-risk child or adolescent; programs are often based in schools, community centers, or faith-based organizations • No mental health providers in Sandstone or access/transportation to therapists when Action Steps: needed A) Research social-emotional learning skills and programs for youth and adults • Lack of awareness surrounding mental wellbeing B) Utilize current city spaces and buildings to have more opportunities for organized • Need for more church dinners, community center get-togethers, activities for seniors on events limited budgets, financial help for seniors C) Research and identify local programs to establish relationships and potentially partner • Lack of employment opportunities and job training • Students don’t necessarily feel comfortable talking to school therapists and teachers • Mandated reporters: fear of getting into trouble.
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CHNA 2020-2022 Implementation Plan
Substance Abuse: Youth in Pine County are substance free. Indicators Partners who can help Adult Substance Abuse Smoked cigarettes in the last 30 Alcohol use in the last 30 days Clinics (All), Law enforcement (Sheriff's dept, police dept), Probation, Courts, days 50% 44% School Admin, Briana-Trauma Informed Care, Essentia-grief support groups, Faith community, Tribal community, AA, NA, County-Tribal Coalition, 30% 26% 40% 34% Pharmacies, Sober squad, Meshakwad Community Center, 30% 25% 29% 17% 17% 30% 20% Youth Substance Abuse 15% 10% 17% Substance Use Prevention Coalition, Vape shops, Convenience stores, Tobacco 8% 20% 10% cessation counselors-Essentia, City council/county board/tribal govt, 5% 10% Bars/restaurants, Casino, Schools-administrators, health teachers, Athletic directors, Students, Faith community, AA, NA, American Lung Association 0% 0% 2004 2007 2010 2013 2016 2004 2007 2010 2013 2016
9th Grade 9th Grade
Source: Minnesota Student Survey, 2016 Story Behind the Data What we are going to do Factors that have contributed to improvements: Strategy #1: Increase the age to purchase tobacco to 21 in Pine County (T21). • Tobacco Cessation Counselor in Sandstone Action Steps: • Sticker Shock Project A) Educate local government on youth tobacco use B) Present to County Board of Commissioners to revise Pine County’s tobacco ordinance • Positive Community Norms Campaign- media messages/billboards regulating the possession, sale and consumption of tobacco (and devices) • Alcohol education class for DWI offenders-discounted rates for bringing minors C) Partner with Pine County Health Administrator and the Chemical Health Coalition to • P&I grant/Community Coalition educate the community on the importance of supporting T21 • Alcohol compliance checks are happening Strategy #2: Work with Pine County schools to start smoking education younger based on • Post Prom implemented to reduce alcohol use survey results that show when most youth first start smoking. Action Steps: Limiting factors: A) Develop tobacco prevention education program B) Support the creation of a short film on vaping geared towards youth • Difficulty in changing habits, lack of awareness/motivation C) Recognize and create a tobacco prevention student lead group • Providing people with therapy and transportation to therapy/treatments D) Research eCHECKUP TO GO, QR codes for students: apps Project EX, Text to quit • No safe place for kids to go to if in an unsafe situation Strategy #3: Adopt trauma specific interventions and educate the community about • Lack of ways to engage or connect with low community events Adverse Childhood Experiences Action Steps: • Pine County schools/students have the reputation of using drugs/alcohol A) Provide Historical Trauma and Cultural Healing education (Briana) • Students have a low perception of the risks in drinking in moderation B) Research trauma informed schools to support Hinkley Finlayson High School • Historical trauma C) Support Pine County in becoming a trauma informed community
20
Appendix A
PINE COUNTY HEALTH INDICATOR DATA
Public Health P revent . Promote. Protect . Appendix A
Demographics Appendix A
Total Population 29,300
29,218 29,200
29,104 29,095 29,100 29,069
29,000
28,900 28,874
28,800
28,700 Pine County
■ 2012 ■ 2013 ■ 2014 ■ 2015 ■ 2016
Source: Vital Statistics Trend Report 2016 Appendix A State & County Population Estimates by Age and Sex, 2016
Age Group
State, Sex 0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+ Total County
Minnesota F 348,080 351,164 357,497 366,445 328,404 390,152 317,958 176,707 135,915 2,772,322
M 363,883 365,774 374,830 376,507 335,232 386,721 306,201 153,936 84,546 2,747,630
1,445 1,589 1,211 1,498 1,551 2,195 1,952 1,281 740 13,462 Pine F
M 1,532 1,801 1,722 2,101 1,944 2,469 2,096 1,165 582 15,412
Source: Minnesota County Health Tables - MDH Appendix A
Selected Minnesota Population Statistics by State & County, 2016
Number Percent Number Percent Females State/County < 5 years < 5 years 0-19 years 0-19 years Ages 15-44
State of 352,504 6.4 1,428,901 25.9 1,054,708 Minnesota
Pine County 1,367 4.7 6,367 22.1 4,181
Source: Minnesota County Health Tables - MDH Appendix A
Number and Percent of People 65 Years and Older, State and County, 2016
State/County Number Percent
State of Minnesota 832,228 15.1
Pine County 5,579 19.3
Source: Minnesota County Health Tables - MDH Appendix A
Population by race/ethnicity year 2016 30,000 26,444
25,000
20,000
15,000
10,000
5,000
1,038 833 644 179 0 Pine County
■ White ■ African American ■ Amerian Indian ■ Asian ■ Latino*
Source: Vital Statistics Trend Report 2016 Appendix A
Population per Square Mile 2016 1,600
1,411 1,400
1,200
1,000
800
600
400
200 21 0 Pine County
■ Land Area in Square Miles ■ Population per Square Mile
Source: Minnesota County Health Tables, Demographics Appendix A
Estimated Number of Households
11,350 11,344 11,340 11,336
11,330 11,328
11,320
11,310
11,300 11,295
11,290 11,281 11,280
11,270
11,260
11,250
11,240 Pine County
■ 2012 ■ 2013 ■ 2014 ■ 2015 ■ 2016
Source: Vital Statistics Trend Report 2016 Appendix A
Total Enrollment PreK-12
3,880 3,866 3,860 3,840
3,820 3,808 3,800 3,778 3,780 3,760 3,741 3,740 3,720 3,700 3,680 3,660 Pine County
■ 2013-14 ■ 2014-15 ■ 2015-16 ■ 2016-17
Source: Vital Statistics Trend Report 2016 Appendix A
Pre-Kindergarten to 12th Grade Enrollment by Race/Ethnicity 2016-2017 School Year, October 1, 2016
African American State/County White Asian Hispanic Total American Indian
State of 600,739 103,750 21,049 63,880 74,836 859,885 Minnesota
Pine County 3,282 84 275 38 99 3,778
Source: Minnesota County Health Tables - MDH Appendix A
Students Eligible for Free or Reduced Meals - Percent, School Year 60
49.9 50.3 50 48 47
40 38.5 38.3 38.1 37.6
30
20
10
0 State of Minnesota Pine County
■ 2013-14 ■ 2014-15 ■ 2015-16 ■ 2016-17
Source: Vital Statistics Trend Report 2016 Appendix A
Students Receiving Special Education - Percent, School Year 15.5 15.1 15 14.9 14.9
14.5 14.5 14.1 13.9 14 13.8
13.5 13.1 13
12.5
12 State of Minnesota Pine County
■ 2013-14 ■ 2014-15 ■ 2015-16 ■ 2016-17
Source: Vital Statistics Trend Report 2016 Appendix A
Socioeconomics Appendix A
Unemployed (Annual Average) Percent 9 8.1 8 7.5
7
6 5.9 6 5.6 5.5 5.1 5 4.1 4 3.7 3.8
3
2
1
0 State of Minnesota Pine County
■ 2012 ■ 2013 ■ 2014 ■ 2015 ■ 2016
Source: Vital Statistics Trend Report 2016 Appendix A
FOOD STAMP UTILIZATION AVG. MONTHLY HOUSEHOLD
■ 2012 ■ 2013 ■ 2014 ■ 2015 ■ 2016 1865 1792 1724 1724 1539 1532 1501 1475 1386 1311 1290 1263 1255 1232 1174 1045 941 919 877 847 837
PINE COUNTY ISANTI COUNTY KANABEC COUNTY MILLE LACS COUNTY
Source: Vital Statistics Trend Report 2016 Appendix A
Per Capita Income - Adjusted to 2016 Dollars 60,000
51,848 52,038 49,348 49,875 50,000 48,614
40,000 33,520 34,379 31,368 31,474 32,510 30,000
20,000
10,000
0 State of Minnesota Pine County
■ 2012 ■ 2013 ■ 2014 ■ 2015 ■ 2016
Source: Vital Statistics Trend Report 2016 Appendix A
Median Household Income - Adjusted to 2016 Dollars
70,000 63,459 61,441 62,317 59,519 60,523 60,000
50,000 47,267 46,332 44,366 43,577 42,736 40,000
30,000
20,000
10,000
0 State of Minnesota Pine County
2012 2013 2014 2015 2016 Source: Vital Statistics Trend Report 2016 ■ ■ ■ ■ ■ Appendix A
Percent of All Ages Living in Poverty 20
18 17.5 15.7 16 13.9 14 13.4 12.2 12 11.4 11.2 11.4 10.2 9.9 10
8
6
4
2
0 State of Minnesota Pine County
■ 2012 ■ 2013 ■ 2014 ■ 2015 ■ 2016
Source: Vital Statistics Trend Report 2016 Appendix A
Percent of People Under 18 Years Living in Poverty 30
25.1 25 23.2 20.8 20 18.6 17.1 14.6 14.8 15 14 13.1 12.5
10
5
0 State of Minnesota Pine County
■ 2012 ■ 2013 ■ 2014 ■ 2015 ■ 2016
Source: Vital Statistics Trend Report 2016 Appendix A
Selected Minnesota Socioeconomic Statistics by State and County 2012-2016 American Community Survey (Census)
Percent of:
Population 25+ years People of all ages Children < 18 living in with <= high school Housing occupied by Housing unites built living at or below single parent headed State/County education or owner before 1980 200% of poverty households equivalent State of 33.1% 25.9% 74.6% 26.2% 56.7% Minnesota
Pine County 52.2% 36.6% 80.7% 28.7% 45.3%
Source: Minnesota County Health Tables - MDH Appendix A
Elderly (age 65+) Dependency Ratio per 100 people aged 15-64 35
30 30 28.5 29 27.1 27.8
25 23 21.6 22.3 20.3 21 20
15
10
5
0 State of Minnesota Pine County
■ 2012 ■ 2013 ■ 2014 ■ 2015 ■ 2016
Source: Vital Statistics Trend Report 2016 Appendix A
Child Dependency Ratio Under 15 31
30 29.6 29.6 29.6 29.6 29.7
29
28 27.4
27 26.5 26.1 25.9 26 25.3 25
24
23 State of Minnesota Pine County
■ 2012 ■ 2013 ■ 2014 ■ 2015 ■ 2016
Source: Vital Statistics Trend Report 2016 Appendix A
Total Dependency Ratio 56 55.3 55 55 54.5 54.4 54.3 54
53 52.7 51.9 52 51.2 51 50.6 49.9 50
49
48
47 State of Minnesota Pine County
■ 2012 ■ 2013 ■ 2014 ■ 2015 ■ 2016
Source: Vital Statistics Trend Report 2016 Appendix A
Maternal Health & Natality Appendix A
Number of Births 1,700
1,650 1,636 1,594 1,600
1,550
1,500 1,468 1,450
1,400 1,390
1,350
1,300
1,250 Pine County
■ 1997-2001 ■ 2002-2006 ■ 2007-2011 ■ 2012-2016
Source: Vital Statistics Trend Report 2016 Appendix A
Birth Rate per, 1,000 Population 20
18 17.3
16 14.6 13.7 14 13.4 12.7 11.7 12 11.1
10 9.6
8
6
4
2
0 State of Minnesota Pine County
■ 1997-2001 ■ 2002-2006 ■ 2007-2011 ■ 2012-2016
Source: Vital Statistics Trend Report 2016 Appendix A
Births to Unmarried Women - Percent 60
50 47.7 44.2 40.1 40 36.9 33.1 32.5 29.1 30 25.6
20
10
0 State of Minnesota Pine County
■ 1997-2001 ■ 2002-2006 ■ 2007-2011 ■ 2012-2016
Source: Vital Statistics Trend Report 2016 Appendix A
Number of Infant Deaths by Birth Year 14 13
12 11 10 10
8 7
6
4
2
0 Pine County
■ 1996-2000 ■ 2001-2005 ■ 2006-2010 ■ 2011-2015
Source: Vital Statistics Trend Report 2016 Appendix A Mothers who Smoked during Pregnancy – Percent 35
30.8 30 27.5 27.5 26.2 25
20
15 13 11.9 10.1 10.6 10
5
0 State of Minnesota Pine County
■ 1997-2001 ■ 2002-2006 ■ 2007-2011 ■ 2012-2016
Source: Vital Statistics Trend Report 2016 Appendix A
rchildhood lead exposure Indicator Notes Tp·me Minnesota Year(s) Cohort method, under 3 7 4 63/i 2012 Children tested for lead years • o 80.7% Cohort method, 5+ Children with elevated blood lead levels mcg/dl 0.0¾ t 1.0% 2012 Annual method, under Children tested for lead (annually) 6years 17.0% 20.4% 2015 Annual method, 5+ 2015 Children with elevated blood lead levels (annually) mcg/dl 0.3% t 0.9% Children in poverty Under 5 years 22.9% 17.2% 2010-2014
Pre-1950 housing l 19.3% 22.2% 2010-2014
Source: Minnesota Public Health Data Access Appendix A
2016 Child Subjects of Maltreatment Reports
Total Family Assessment
Child Unique Rate per Medical Mental Physical Sexual State/County Population Neglect Child 1000s Neglect Injury Abuse Abuse Ages 0-17
State of 1,284,387 39,736 30.9 379 952 24,185 16,109 4,966 Minnesota
Pine County 5,972 519 86.9 0 8 394 201 62
Source: Minnesota County Health Tables - MDH Appendix A
Children in Out-of-Home Care per 1,000 in the Child Population (0-17 years old), 2016
Child Population Total Children Children < 18 State/County Age 0-17 < 18 Per 1,000
State of Minnesota 1,284,387 14,492 11.3
Pine County 5,972 112 18.8
Source: Minnesota County Health Tables - MDH Appendix A
Eating Habits, Physical Activity & Chronic Conditions Appendix A TOTAL FRUIT AND VEGETABLE SERVINGS YESTERDAY PICKM ADULTS, 2015
■ 0 servings ■ 1-2 servings ■ 3-4 servings ■ 5 or more servings 38.70% 38.70% 37.80% 37.80% 37.60% 37.60% 36.90% 36.90% 36.60% 36.60% 36.50% 36.50% 36.40% 36.40% 34.90% 34.90% 34.80% 34.80% 30.50% 30.50% 28.50% 28.50% 23.20% 23.20% 21.50% 21.40% 21.40% 20.20% 20.20% 6.20% 6.20% 5.40% 5.40% 4.50% 4.50% 4.40% 4.40% 4.10% 4.10% I I I I I PINE ISANTI CHISAGO KANABEC MILLE LACS
Source: Minnesota East Central Regional Community Health Survey 2015 Appendix A WEIGHT STATUS ACCORDING TO BODY MASS INDEX PICKM ADULTS, 2015
■ Not overweight ■ Overweight but not obese ■ Obese 38.70% 38.70% 37.50% 37.50% 37.20% 37.20% 36.50% 36.50% 36.40% 36.40% 35.70% 35.70% 34.90% 34.90% 34.70% 34.70% 34.40% 34.40% 34.20% 34.20% 30.80% 30.80% 29.40% 29.40% 28.30% 26.30% 26.30% 24.90% 24.90%
PINE ISANTI CHISAGO KANABEC MILLE LACS
Source: Minnesota East Central Regional Community Health Survey 2015 Appendix A 30+ MINUTES MODERATE ACTIVITY – DAYS PER WEEK PICKM ADULTS, 2015
■ 0 days ■ 1-4 days ■ 5 or more days 62.40% 62.40% 61.20% 61.20% 59.00% 59.00% 58.70% 58.70% 58.20% 58.20% 30.80% 30.80% 28.70% 28.70% 27.60% 27.60% 26.10% 26.10% 25.10% 25.10% 14.90% 14.90% 13.70% 13.70% 12.50% 12.50% 11.00% 11.00% 10.10% 10.10%
PINE ISANTI CHISAGO KANABEC MILLE LACS
Source: Minnesota East Central Regional Community Health Survey 2015 Appendix A 20+ MINUTES VIGOROUS ACTIVITY – DAYS PER WEEK PICKM ADULTS, 2015 ■ 0 days ■ 1-2 days ■ 3 or more days 46.90% 46.90% 41.10% 41.10% 38.40% 38.40% 38% 35.70% 35.70% 34.70% 34.70% 33.60% 33.60% 32.50% 32.50% 31.70% 31.70% 30.80% 30.80% 29.10% 29.10% 28.70% 28.70% 28.10% 28.10% 26.30% 26.30% 24.40% 24.40%
PINE ISANTI CHISAGO KANABEC MILLE LACS
Source: Minnesota East Central Regional Community Health Survey 2015 Appendix A Have you ever been told by a health care professional that you had any of the following health conditions? PICKM adults, 2015
Chronic Lung Disease 5.80% Other Mental Health Issues 6.50% Stroke/Stroke-Related Health Problems 6.80% Diabetes 9.90% Asthma 10.40% Cancer 11.40% Pre-Diabetes 12.20% Pre-Hypertension 12.20% Heart Trouble or Angina 13.50% Obesity 15.40% High Triglycerides 18.90% Anxiety or Panic Attacks 19.00% Depression 20.90% Arthritis 23.40% Hypertension 27.40% High Cholesterol 29.40% Overweight 37.20% 0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 40.00%
■ Series 1
Source: Minnesota East Central Regional Community Health Survey 2015 Appendix A EVER TOLD YOU HAD DIABETES OR PRE-DIABETES PICKM ADULTS, 2015
■ Diabetes ■ Pre-diabetes 13.60% 13.60% 13.10% 13.10% 12.40% 12.40% 11.00% 11.00% 10.90% 10.90% 10.80% 10.80% 10.30% 10.30% 10.00% 10.00% 8.90% 8.90% 7.80% 7.80%
PINE ISANTI CHISAGO KANABEC MILLE LACS
Source: Minnesota East Central Regional Community Health Survey 2015 Appendix A EVER TOLD YOU HAD HYPERTENSION OR PRE-HYPERTENSION PICKM ADULTS, 2015
■ Hypertension ■ Pre-hypertension 32.90% 32.90% 32.50% 32.50% 28.20% 28.20% 25.10% 25.10% 24.20% 24.20% 13.80% 13.80% 13.60% 13.60% 11.10% 11.10% 10.40% 10.40% 9.60% 9.60%
PINE ISANTI CHISAGO KANABEC MILLE LACS
Source: Minnesota East Central Regional Community Health Survey 2015 Appendix A EVER TOLD YOU HAD HIGH CHOLESTEROL OR TRIGLYCERIDES PICKM ADULTS, 2015
■ High cholesterol ■ High triglycerides 34.10% 34.10% 31.10% 31.10% 29.20% 29.20% 26.60% 26.60% 26.00% 26.00% 22.40% 22.40% 20.10% 20.10% 19.80% 19.80% 17.50% 17.50% 16.70% 16.70%
PINE ISANTI CHISAGO KANABEC MILLE LACS
Source: Minnesota East Central Regional Community Health Survey 2015 Appendix A EVER TOLD YOU HAD HEART TROUBLE OR ANGINA, OR STROKE OR STROKE-RELATED HEALTH ISSUES PICKM ADULTS, 2015
■ Heart trouble or angina ■ Stroke or stroke-related health problems 15.70% 15.70% 14.80% 14.80% 13.30% 13.30% 12.10% 12.10% 11.60% 11.60% 11.30% 11.30% 8.40% 8.40% 5.80% 5.80% 4.80% 4.80% 4.40% 4.40%
PINE ISANTI CHISAGO KANABEC MILLE LACS
Source: Minnesota East Central Regional Community Health Survey 2015 Appendix A
Youth Substance Use Appendix A 9th Grade Students: Percent who used alcohol one or more times in the last 12 months 70%
59% 60% 54%
50% 47% 43% 43%
40% 38%
32% 31% 30% 24% 21% 20%
10%
0% State of Minnesota Pine County
■ 2004 ■ 2007 ■ 2010 ■ 2013 ■ 2016
Source: Minnesota Student Survey – Selected Single Year Results MDH Appendix A 9th Grade Students: Percent who used alcohol on one or more days in the last 30 days 50%
45% 44%
40%
35% 34% 30% 29% 30% 28%
25% 24%
20% 19% 17% 15% 15% 11% 10%
5%
0% State of Minnesota Pine County
■ 2004 ■ 2007 ■ 2010 ■ 2013 ■ 2016
Source: Minnesota Student Survey – Selected Single Year Results MDH Appendix A 9th Grade Students: Percent who drove a motor vehicle after using alcohol or other drugs one or more times in the last 12 months 16% 15%
14%
12%
10%
8% 8%
6% 6% 5% 4% 4% 4% 4%
2% 2% 2% 1%
0% State of Minnesota - Pine County ■ 2004 ■ 2007 ■ 2010 ■ 2013 ■ 2016
Source: Minnesota Student Survey – Selected Single Year Results MDH Appendix A 9th Grade Students: Percent who smoke cigarettes on one or more days in the last 30 days 30%
26% 25%
20% 17% 17% 15% 15% 12% 10% 10% 10% 8% 7%
5% 4%
0% State of Minnesota Pine County
■ 2004 ■ 2007 ■ 2010 ■ 2013 ■ 2016
Source: Minnesota Student Survey – Selected Single Year Results MDH Appendix A 9th Grade Students: Percent who used chewing tobacco, snuff or dip on one or more days in the last 30 days 0.14 13% 12% 0.12
0.1
0.08
6% 0.06 5% 5% 5% 4% 0.04
2% 0.02
0 0 0 State of Minnesota Pine County
■ 2004 ■ 2007 ■ 2010 ■ 2013 ■ 2016
Source: Minnesota Student Survey – Selected Single Year Results MDH Appendix A 9th Grade Students: Percent who used marijuana one or more times in the last 12 months 30%
25% 24%
21% 21% 20% 19% 17% 15% 15% 15% 15% 14%
10% 10%
5%
0% State of Minnesota Pine County
■ 2004 ■ 2007 ■ 2010 ■ 2013 ■ 2016
Source: Minnesota Student Survey – Selected Single Year Results MDH Appendix A 9th Grade Students: Percent who used marijuana on one or more days in the last 30 days 20% 18% 18%
16%
14% 12% 12% 12% 12% 10% 10% 10% 10% 9% 9%
8% 7%
6%
4%
2%
0% State of Minnesota Pine County
■ 2004 ■ 2007 ■ 2010 ■ 2013 ■ 2016
Source: Minnesota Student Survey – Selected Single Year Results MDH Appendix A
Adult Substance Use Appendix A CURRENT TOBACCO USE PICKM ADULTS, 2015
■ Cigarettes ■ Cigars ■ Pipes ■ Smokeless tobacco ■ E-cigarettes ■ Other tobacco products 20.20% 20.20% 15.70% 15.70% 14.60% 14.60% 14.10% 14.10% 13.50% 13.50% 10.60% 10.60% 10.20% 9.40% 9.40% 9.20% 9.20% 7.90% 7.90% 7.00% 7.00% 6.90% 6.90% 6.30% 6.30% 6.00% 6.00% 5.90% 5.90% 5.30% 5.30% 4.80% 4.80% 4.60% 4.60% 4.50% 4.50% 4.30% 4.30% 4.00% 4.00% 3.30% 3.30% 2.90% 2.90% 2.60% 2.60% 1.70% 1.70% 1.70% 1.70% 1.30% 1.30% 0.50% 0.50% 11 11. .11 . I _ 0.30% I I PINE ISANTI CHISAGO KANABEC MILLE LACS
Source: Minnesota East Central Regional Community Health Survey 2015 Appendix A HEAVY ALCOHOL USE IN THE PAST 30 DAYS PICKM ADULTS, 2015
■ No drinking ■ Drinking, not heavy ■ Heavy drinking 57.20% 57.20% 55.30% 55.30% 54.30% 54.30% 53.70% 53.70% 51.10% 51.10% 39.20% 37.20% 37.20% 34.00% 34.00% 32.70% 32.70% 29.30% 29.30% 15.40% 15.40% 13.00% 13.00% 12.30% 12.30% 9.70% 9.70% 5.60% 5.60%
PINE ISANTI CHISAGO KANABEC MILLE LACS
Source: Minnesota East Central Regional Community Health Survey 2015 Appendix A BINGE DRINKING IN THE PAST 30 DAYS PICKM ADULTS, 2015
■ No drinking or no binge drinking ■ Any binge drinking 79.60% 79.60% 77.30% 77.30% 75.60% 75.60% 73.30% 73.30% 67.40% 67.40% 32.60% 32.60% 26.70% 26.70% 24.40% 24.40% 22.70% 22.70% 20.40% 20.40%
PINE ISANTI CHISAGO KANABEC MILLE LACS
Source: Minnesota East Central Regional Community Health Survey 2015 Appendix A
Total Substance Use Treatment Program Admission Percentages by Age 40.00%
35.20% 35.00% 34.00%
30.00%
25.00% 24.20% 21.10% 20.00% 19.00% 17.60%
14.00% 15.00% 13.00%
10.00% 7.80% 5.60% 5.00% 4.30% 4.10%
0.00% State of Minnesota Pine County
■ Under 18 ■ 18-24 ■ 25-34 ■ 35-44 ■ 45-54 ■ 55+
Source: 2017 Drug and Alcohol Abuse Normative Evaluation System Report Appendix A Total Substance Use Treatment Program Admission Percentages by Race/Ethnicity 80.00% 75.20%
70.00% 67.90%
60.00%
50.00%
40.00%
30.00%
20.00% 16.50% 11.80% 9.90% 10.00% 5.60% 3.40% 2.60% 1.70% 3.20% 1.40% 0 0.00% State of Minnesota- - - -Pine County - ■ White ■ African American ■ Hispanic ■ Native American ■ Asian ■ Other
Source: 2017 Drug and Alcohol Abuse Normative Evaluation System Report Appendix A Primary Substance of Abuse 45.00% 41.90%
40.00% 35.80% 35.00%
30.00% 26.10% 24.60% 25.00%
20.00%
15.00% 13.60% 14.20% 12.40% 11.70% 10.00% 5.60% 6.40% 5.00%
0.00% State of Minnesota Pine County
■ Alcohol ■ Marijuana/Hashish ■ Heroin ■ Opiates/Synthetics ■ Methamphetamine
Source: 2017 Drug and Alcohol Abuse Normative Evaluation System Report Appendix A Number 1 Treatment Barrier 50.00% 44.80% 45.00%
40.00%
35.00%
30.00%
25.00%
20.00%
15.00%
10.00%
5.00%
0.00% Pine County
■ Mental Illness
Source: 2017 Drug and Alcohol Abuse Normative Evaluation System Report Appendix A
Mental Health Appendix A EVER TOLD YOU HAD DEPRESSION, ANXIETY OR PANIC ATTACKS, OR OTHER MENTAL HEALTH ISSUES PICKM ADULTS, 2015
■ Depression ■ Anxiety or Panic Attacks ■ Other Mental Health 24.30% 24.30% 23.20% 23.20% 21.50% 21.50% 21.30% 21.30% 20.70% 20.70% 20.00% 20.00% 20.00% 18.10% 18.10% 17.00% 17.00% 16.10% 11.80% 11.80% 6.10% 6.10% 4.20% 4.20% 3.90% 3.90% 3.70% 3.70% I PINE ISANTI CHISAGO KANABEC MILLE LACS
Source: Minnesota East Central Regional Community Health Survey 2015 Appendix A DAYS FELT SAD/BLUE/DEPRESSED IN THE LAST 30 DAYS PICKM ADULTS, 2015
■ 0 days ■ 1-9 days ■ 10-19 days ■ 20-29 days ■ All 30 days 60.30% 60.30% 53.10% 53.10% 48.10% 48.10% 48.00% 48.00% 45.70% 45.70% 39.20% 39.20% 39.00% 39.00% 33.90% 33.90% 33.30% 33.30% 26.70% 26.70% 10.50% 10.50% 9.30% 9.30% 9.30% 9.30% 8.40% 8.40% 7.00% 7.00% 6.40% 6.40% 4.20% 4.20% 4.00% 4.00% 3.00% 3.00% 2.80% 2.80% 2.60% 2.60% 1.60% 1.60% 1.30% 1.30% 1.10% 1.10% I.. 11_ 1.00% . I._ 1 11 I•. PINE ISANTI CHISAGO KANABEC MILLE LACS
Source: Minnesota East Central Regional Community Health Survey 2015 Appendix A LIMITED BECAUSE OF MENTAL OR EMOTIONAL HEALTH ISSUE PICKM ADULTS, 2015
■ Need help doing routine things ■ Difficulty doing errands alone ■ Difficulty doing social activites ■ Column1 16.90% 16.90% 16.90% 16.90% 15.80% 15.80% 14.10% 14.10% 12.70% 12.70% 12.30% 12.30% 11.50% 11.50% 10.90% 10.90% 10.30% 10.30% 8.00% 8.00% 6.90% 6.90% 6.70% 6.70% 5.50% 5.50% 4.60% 4.60% 4.30% 4.30% 4.20% 4.20% 3.70% 3.70% 3.60% 3.60% 3.40% 3.40% 2.60% 2.60%
PINE ISANTI CHISAGO KANABEC MILLE LACS
Source: Minnesota East Central Regional Community Health Survey 2015 Appendix A Pine County Grade 8th 9th 11th Male Female Male Female Male Female % % % % % % During the last 12 0 times 87% 72% 83% 78% 83% 64% months, how many times did you do 1 or 2 times 5% 11% 11% 10% 6% 14% something to purposely hurt or 3 to 5 times 4% 9% 3% 2% 1% 11% injure yourself without 6 to 9 times wanting to die, such 0% 2% 2% 3% 7% 2% as cutting, burning, or 10 to 19 times bruising yourself on 2% 2% 2% 2% 1% 0% purpose? 20 or more times 2% 3% 0% 5% 1% 8%
Have you ever No 88% 69% 80% 70% 66% 54% seriously considered attempting suicide? Yes, during the last (Mark all that apply) year 8% 20% 11% 15% 20% 25% Yes, more than a year ago 8% 13% 14% 23% 20% 35% Have you ever actually No 92% 94% 92% 90% 86% 80% attempted suicide? (Mark all that apply) Yes, during the last year 3% 2% 2% 7% 5% 10% Yes, more than a year ago 6% 4% 6% 6% 11% 16%
* 5th grade survey did not ask these questions.
Source: Minnesota Student Survey 2016 Appendix A 2016 Minnesota Student Survey
TABLE 27A EMOTIONAL WELL-BEING AND DISTRESS*" Pine County Grade 8th 9th 11th Male Female Male Female Male Female % % % % % % Over the last 2 weeks, how Not at all 52% 40% 46% 46% 42% 25% often have you been bothered by little interest Several days 26% 40% 33% 35% 36% 46% or pleasure in doing things? More than half the days 9% 14% 10% 12% 17% 23%
Nearly every day 13% 6% 11 % 6% 5% 6%
Over the last 2 weeks, how Not at all 66% 36% 64 % 46% 51 % 28% often have you been bothered by feeling down, Several days 21 % 34% 18% 32% 22% 46% depressed or hopeless? More than half the days 8% 10% 8% 9% 15% 10%
Nearly every day 6% 20% 11 % 14% 13% 17%
* 5th grade survey did not ask these questions. " Both questions on this table were new in 2016.
Source: Minnesota Student Survey 2016 Appendix A Pine County Grade 5th Thinking back the last 30 days, how much do you agree or disagree Male Female with the following statements? % % I worry a lot Strongly agree 8% 19%
Agree 25% 34%
Neither agree nor disagree 34% 33%
Disagree 20% 7%
Strongly disagree 13% 6%
I sometimes feel bad without Strongly agree 19% 20% knowing why Agree 33% 42%
Neither agree nor disagree 20% 20%
Disagree 17% 12%
Strongly disagree 11% 6%
* Only 5th grade survey asked these questions.
Source: Minnesota Student Survey 2016 Appendix A
Causes of Death Appendix A
Number of Deaths 1,600 1,419 1,400 1,246 1,217 1,200 1,165
1,000
800
600
400
200
0 Pine County
■ 1997-2001 ■ 2002-2006 ■ 2007-2011 ■ 2012-2016
Source: Vital Statistics Trend Report 2016 Appendix A
Crude Death Rate per 100,000 Population 1200 1,108.90
1000 976.2 918.3 926.7 844.1 778.7 762.8 800 729
600
400
200
0 State of Minnesota Pine County
■ 1997-2001 ■ 2002-2006 ■ 2007-2011 ■ 2012-2016
Source: Vital Statistics Trend Report 2016 Appendix A
Age Adjusted Death Rate per 100,000 Population 900 810.8 800 772.1 753.2 729.4 699.9 687.1 700 661 648.5
600
500
400
300
200
100
0 State of Minnesota Pine County
■ 1997-2001 ■ 2002-2006 ■ 2007-2011 ■ 2012-2016
Source: Vital Statistics Trend Report 2016 Appendix A
Age Adjusted Death Rate - Females 680
660 653.8 644.5 640 622.7 620 610.8
600 593.3
580 558 560.6 560 556.3
540
520
500 State of Minnesota Pine County
■ 1997-2001 ■ 2002-2006 ■ 2007-2011 ■ 2012-2016
Source: Vital Statistics Trend Report 2016 Appendix A
Age Adjusted Death Rate - Males 1200
981.5 1000 944.7 900.2 838.4 840.4 863.2 797.4 800 760.3
600
400
200
0 State of Minnesota Pine County
■ 1997-2001 ■ 2002-2006 ■ 2007-2011 ■ 2012-2016
Source: Vital Statistics Trend Report 2016 Appendix A
Cancer, Age Adjusted Death Rate 250
213.9 211.7 200 189.3 183.4 176.1 167.3 167.7 152.8 150
100
50
0 State of Minnesota Pine County
■ 1997-2001 ■ 2002-2006 ■ 2007-2011 ■ 2012-2016
Source: Vital Statistics Trend Report 2016 Appendix A Cancer in cidence (per 100 000J Indicator Notes Pine Minnesota YearlsJ Age-adjusted rate per 2009-2013 All cancer types combined 100,_00Q 460.2 458.6 A8e-ad6usted rate per Bladder 1 0 00 21 .3 22.2 2009-2013 Age-adjusted rate per Brain and other nervous system 100,000 5.3 (UR) 6.8 2009-2013 Age-adjusted rate per Breast 100J)00 128.3 130.2 2009-2013 Age-adjusted rate per Chronic ly mphocytic leu kemia 100,000 7.1 6.5 2009-2013 Age-adjusted rate per Colorecta I 100,_000 41.3 39.6 2009-2013 Age-adjusted rate per 2009-2013 Esophagu s 100,000 4.1 (UR) 4.8 Age-adjusted rate per Kidney 100,000 15.3 15.5 2009-2013 Age-adjusted rate per La rynx 100 000 4.9 2.9 2009-2013 Age-adjusted rate per 2009-2013 Leu kemia 100 000 15.4 16.1 Age-adjusted rate per Liver and bile duct 100,000 6.7 5.4 2009-2013 Age-adjusted rate per Lung and bronchus 100.000 66.8 55.5 2009-2013 Age-adjusted rate per Melanoma 100,_000 19.6 27.7 2009-2013 Age-adjusted rate per Mesothel ioma 100 000 2.1 (UR) 1.3 2009-2013 Age-adjusted rate per 2009-2013 Non-Hodg kin lymphoma 100J)00 16.3 22.5 Age-adjusted rate per 2009-2013 Oral and p haryngeal 100,QQQ_ 18.5 11.9 Age-adjusted rate per Pancreas 100,000 13.5 11.3 2009-2013 Age-adjusted rate per 2009-2013 Thyroid 100,000 18.4 12.6
Source: Minnesota Public Health Data Access Appendix A
Heart Disease, Age Adjusted Death Rate 250 221.9
197.4 200 190.1
146.9 150 141.7 123.4 124.4 116.6
100
50
0 State of Minnesota Pine County
■ 1997-2001 ■ 2002-2006 ■ 2007-2011 ■ 2012-2016
Source: Vital Statistics Trend Report 2016 Appendix A Stroke, Age Adjusted Death Rate 70
60 57.4
50.4 50 45 41.4 39.9 40 35.4 34.4 32.7 30
20
10
0 State of Minnesota Pine County
■ 1997-2001 ■ 2002-2006 ■ 2007-2011 ■ 2012-2016
Source: Vital Statistics Trend Report 2016 Appendix A Top 10 Leading Causes of Death 2012-2016
State of Minnesota Pine County
Mortality Table 5: Minnesota Premature Deaths (Under age 75) Mortality Table 5: Minnesota Premature Deaths (Under age 75) compared to All Deaths by Number and Age Adjusted Death Rates compared to All Deaths by Number and Age Adjusted Death Rates by State and County, 2012-2016 by State and County, 2012-2016
A ll Deaths All Deaths Cause Rank Number Rate Cause Rank Number Rate Cancer 1 380 183.. 4 Cancer 1 48,386 152.8 Cirrhosis 10 2 1 10.5 Cirrhosis 10 2,644 8.4 Chronic Lower Respiratory Disease 4 98 48.2 Chronic Lower Respiratory Disease 4 11 ,378 36.0 Diabetes 6 5 1 24.6 Diabetes 6 5,998 18.8 Heart Disease 2 251 124.4 Heart Disease 2 38,335 11 6.6 Neohritis 9 22 11.5 Nephritis 9 3,220 9.9 Pneumonia and Influenza 8 24 12.5 Pneumonia and Influenza 8 3,314 10.0 Stroke 5 69 34.4 Stroke 5 10,712 32.7 Suicide 7 28 19.2 Suicide 7 3,497 12.5 Unintentional Injury 3 90 55.7 Unintentional lniurv 3 12.566 4 1.5 Source: Minnesota Department of Health, Center for Health Statistics Source: Minnesota Department of Health, Cente r for Health Statistics
Source: Minnesota County Health Tables - MDH Appendix A Top 15 Leading Causes of Death: Pine County - 2016
All Ages
Cause Ranlc Number Alzhe ime r's disease 7 9 Be nign Neoplasms 15 1 Cance r 1 80 Chronic lowe r respiratory dis 3 22 Cirrhosis 9 5 Diabetes 6 10 Heart disease 2 61 Hypertension 9 5 Nephritis 11 4 Parkinsons 11 4 Pne umonia and influe nza 13 3 Septicemia 14 2 Stroke 5 1 1 Suicide 7 9 Uninte tional injury 4 15 Source: Minnesota Department of Healt , Ce nte r or He a Ith Statistics Minnesota County Health Tables – Mortality Appendix A
Hospitalizations
Indicator Notes Pine Minnesota -- Year(s) Per 10,000, age- 2012-2014 Asthma emergency department vi sits adjusted 51.1 40.6 Per 10,000, age- 2012-2014 Asthma hospitalizat ions adj usted 8.4 6.1 Per 10,000, ages 25+, COPD hospitalizatio ns age-adjusted 20.8 15.8 2012-2014 Carbon monoxide p oisoning emergency department visits Per 100,000, age- 11.9 (UR) 5.1 2012-2014 adjus!ed - Per 100,000, age- 2012-2014 Carbon monoxide p oisoning hospitalizations adj usted 0.0 (UR) 0.4 Per 10,000 ages 35+, Heart attack hospita lizations age-adjusted 31.7 26.7 2011-2013 Heat-illness emerge ncy department visits Per 100,000, Age- 19.2 16.9 2010-2014 Agjusted - Heat-illness hospita lizations Per 100,000, Age- 1.9 (UR) 1.5 2005-2014 Adjusted -
Source: Minnesota Public Health Data Access Appendix A
Infectious Disease Appendix A Pine County Infectious Disease 2014-2016 45
40 39
35
30 26 25 22 20 18
15 12 10 10 7 4 5 5 4 5 2 2 3 0 0 0 1 1 0 0 0 - ■ 11 1■ 1 -
■ 2014 ■ 2015 ■ 2016
Source: MDH Epidemiology Dept. Disease Report 2014-2016 Appendix A
Vaccine Preventable Diseases Appendix A Pine County Vaccine Preventable Disease Indicators 2014-2016 3.5
3 3
2.5
2
1.5
1 1
0.5
0 0 0 0 0 0 0 0 0 0 0 Mumps Pertusis Hepatitis A Hepatitis B
■ 2014 ■ 2015 ■ 2016
Source: MDH Epidemiology Dept. Disease Report 2014-2016 Appendix A Childhood Immunizations 2017
Pine County State of Minnesota
Hep A 42.60% 36.70% 75.40% Rotavirus 67.70%
PCV 77.50% 76.10% 80.30% Varicella 82.50%
Hep B 82.40% 79.90% 77.20% Hib 77.70%
MMR 80.30% 79.90% 81.70% Polio 81.00%
DTaP 65.40% 67.90%
Complete Immunization Series 61.30% 60.90%
0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 90.00%
Source: Minnesota Public Health Data Access https://mndatamaps.web.health.state.mn.us/interactive/immunizations.html Appendix A
Steinbach Childhood Immunizations (2017): Percent of children wilh comp/ere childhood immunizarion series @County <30% 30- 59% 60- 79% 80%+- Thunder Bay o ZIP code (Metro Area) <30¾ 30- 59% Gran 60- 79% 80% + Data not shown
Fa t h
Marq u,tte SaL M
Watertown
Green Bay
Fond du Lac Sheboygan
Sioux Fall
Source: Minnesota Public Data Access https://mndatamaps.web.health.state.mn.us/interactive/immunizations.html Appendix A
Sexually Transmitted Diseases Appendix A Pine County Sexually Transmitted Diseases 2014-2016 80 75 70 70 64
60
50
40
30
20 15
10 8 4 2 0 0 0 0 1 0 - Chlamydia -Gonorrhea Syphillis All Stages- HIV (AIDS) ■ 2014 ■ 2015 ■ 2016
Source: MDH Epidemiology Dept. Disease Report 2014-2016 Appendix A
Injuries Appendix A Unintentional Injury, Age Adjusted Death Rate 60 55.7 54
50 48.7 48.3
41.5 40 37.2 35.4 35.6
30
20
10
0 State of Minnesota Pine County
■ 1997-2001 ■ 2002-2006 ■ 2007-2011 ■ 2012-2016
Source: Vital Statistics Trend Report 2016 Appendix A Unintentional Injury, Number 100 90 90
80 76 73 69 70
60
50
40
30
20
10
0 Pine County
■ 1997-2001 ■ 2002-2006 ■ 2007-2011 ■ 2012-2016
Source: Vital Statistics Trend Report 2016 Appendix A All Crashes – Pine County 2011-2015 390
381 380 378
370
361 359 360
350 346
340
330
320 All Crashes
■ 2011 ■ 2012 ■ 2013 ■ 2014 ■ 2015
Source: Minnesota Department of Public Safety, Office of Traffic Safety Appendix A Pine County DWI’s 2011-2015 200 176 180 170
160 140 140 136
120 113
100
80
60
40
20
0 DWI's
■ 2011 ■ 2012 ■ 2013 ■ 2014 ■ 2015
Source: Minnesota Department of Public Safety, Office of Traffic Safety Appendix A Minnesota Crash Statistics - Pine County 16
14 14
12 12
10 9
8 8 7 7
6 6
4 4 4 4 4 3 3 3 3
2 2 2 2 2 2 1 1 1 1 1 1 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 11. I 1111 I I 11 I I All Deaths Alcohol Related Deaths Motor Vehicle Alcohol Related Motor Unbelted Motor Vehicle Alcohol Related Motorcycle Deaths Alcohol Related Occupant Deaths Vehicle Occupant Occupant Deaths Unbelted Motor Vehicle Motorcycle Deaths Deaths Occupant Deaths
■ 2011 ■ 2012 ■ 2013 ■ 2014 ■ 2015
Source: Minnesota Department of Public Safety, Office of Traffic Safety Appendix A
Environmental Appendix A
Radon Indicator Notes Pine Minnesota Year(s) Annual average rate of properties tested Per 10,000 parcels 6.8 16.7 2010-2016
Percent of properties tested 2 pCi/L I 60.8% 73.5% 2010~2016 Percent of (2roperties tested 4 pCi/L l 29.3% 44.1% 2010-2016
Source: Minnesota Public Health Data Access Appendix BB
Pine County Community Advisory: Prioritization
Your participation of this survey will help determine this communities areas of opportunities and challenges. Once the most pressing problems are identified, this team will address them through community action.
1. Full Name
2. Email address
3. Please select the FIVE most important 'health problems' in Pine County. (Those problems that have the greatest impact on overall community health)
Maternal, fetal, and infant health (prenatal care, teen birth Sexual health (STDs/STIs, reproductive health care) □ rate, smoking during pregnancy) □ Injury prevention (drowning, falls, helmet and car seat safety) Child maltreatment, abuse and neglect □ □ Violence prevention (interpersonal violence, intimate partner Cancer □ violence, sexual violence) □ □ Oral health □ Firearm safety □ Heart health (heart disease, stroke, high blood pressure) □ Suicide Diabetes Clean water/environment □ □ □ Obesity □ Access to health care and preventative services □ Substance abuse/illicit drug use □ Active living and healthy eating □ Tobacco □ Older adults and aging □ Mental Health □ Immunization and infectious disease □ Motor vehicle collisions □ Housing □ Other (please specify)
1 Appendix BB
4. What do you think are the FIVE most important factors that define a "Healthy Community" (Those factors that most affect the quality of life in a community) □ Inclusive, equitable and broad community participation □ Equity (lack of disparities) Low crime/Safe neighborhoods □ □ Low levels of child maltreatment, abuse and neglect □ High Quality Schools A strong economy and employment opportunities (lack of □ poverty)
□ Access to health care and preventative services □ A stable, sustainable ecosystem and environment □ High quality public spaces (parks and recreation) □ Access to religious/spiritual support Affordable housing □ □ Strong family support/social connectedness □ Opportunities for healthy behaviors and lifestyles □ Access to transportation □ Arts and cultural events □ Low death and disease rate □ Access to healthy food □ Other (please specify)
2 Appendix C
Q3 Please select the FIVE most important 'health problems' in Pine County. (Those problems that have the greatest impact on overall community health)
Maternal, fetal, and .. .
maltreatment•..
Cancer
Oral health
Heart health (heart dlsea•.• .----
DI abetes - I Obesity
Substance abuse/llllcl .. . .------
Tobacco
Mental Health
Motor vehicle co\llslons
Sexual health (STDs/STls, .••
Inj ury prevention•..
Violence prevention... .------
Fi rearm safety
Suicide
Clean water/envl ro...
Access to health care ..•
Active living and healthy...
Older adults and aging
Immunization and lnfectlo...
Housing
Other (please specify) .....-- 0 % 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Appendix D
Hanlon Criteria Matrix
Control Serious Size Interventions Health Total Rank Equity - - Health Issue 1-10 1-10 1-10 1-10 1-10 EXAMPLE 1 9 7 8 8 41 I I I 1. Mental Health - - 2. Substance Use ,_ - 3. Older adults ,_ - 4. Housing _ ,_ - - 5. Access to health - - 6. Tobacco ' - - 7. Obesity ,_ 8. Maternal health KEY: Scale 1-10 where 1 is poor/low/not serious and 10 is good/high/serious
Control: Having the power to influence or direct behavior. Level of resources available to leverage.
Seriousness: Impact on others, death rate, premature mortality, hospitalizations, disability
Size: What percent of the local population is affected by the particular health problem?
Intervention: Is there a proven strategy? How effective is the given strategy?
Health Equity: Are some groups affected more than others? Inequities are types of unfair health differences closely linked with social, economic or environmental disadvantages that adversely affect groups of people. Appendix E
Hanlon Calculator Individual total scores: 1 2 3 4 5 6 7 8 9 Total Score
Mental Health 34 37 41 24 37 31 35 39 33 311
Substance Use 34 28 39 32 40 34 31 37 34 309
Older adults 35 29 28 21 38 29 42 37 29 288
Housing 30 27 24 22 34 21 32 26 22 238 Access to health 35 31 33 23 30 25 33 33 29 272 Tobacco 32 26 21 36 36 38 41 39 30 299
Obesity 37 30 25 39 37 34 34 38 35 309
Maternal health 25 37 46 30 21 34 28 41 35 297
This is the calculator used at the Pine County Public Health Advisory Committee used to prioritize the top eight health indicators. Everyone scored the health indicators on the level of influence, seriousness of the problem, size of the problem, interventions that are proven to be effective and unfair health differences. Once committee members filled out their individual matrix, this spreadsheet was completed at the meeting to show total scores. There was a total of nine committee members who participated in the prioritization process.
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