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FRANKLIN COUNTY 2019 Maine Shared Community Health Needs Assessment Report

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FRANKLIN COUNTY 2019 Maine Shared Community Health Needs Assessment Report FRANKLIN COUNTY 2019 Maine Shared Community Health Needs Assessment Report TABLE OF CONTENTS Executive Summary �������������������������������������������������������������������������������������������������������������������������������������2 Acknowledgements �������������������������������������������������������������������������������������������������������������������������������������3 Health Priorities �������������������������������������������������������������������������������������������������������������������������������������������4 Access to Care ������������������������������������������������������������������������������������������������������������������������������������������5 Social Determinants of Health ������������������������������������������������������������������������������������������������������������������7 Mental Health ��������������������������������������������������������������������������������������������������������������������������������������������9 Physical Activity, Nutrition, and Weight ���������������������������������������������������������������������������������������������������11 Substance Use ����������������������������������������������������������������������������������������������������������������������������������������13 Community Characteristics ����������������������������������������������������������������������������������������������������������������������15 Key Indicators ��������������������������������������������������������������������������������������������������������������������������������������������18 Appendix A: References ���������������������������������������������������������������������������������������������������������������������������21 Appendix B: History and Governance ������������������������������������������������������������������������������������������������������22 Appendix C: Methodology ������������������������������������������������������������������������������������������������������������������������23 Key companion documents available at www.mainechna.org: • Franklin County Health Profile • Western District Health Profile • Maine State Health Profile • Health Equity Data Summaries, including state-level data by race, Hispanic ethnicity, sex, sexual orientation, educational attainment, and income FRANKLIN COUNTY 2019 CHNA • WWW.MAINECHNA.ORG 1 EXECUTIVE SUMMARY PURPOSE Table 1: Franklin County Health Priorities The Maine Shared Community Health Needs PRIORITY AREA % OF VOTES Assessment (Maine CHNA) is a collaborative Access to Care* 21% effort amongst Central Maine Healthcare (CMHC), Social Determinants of Health* 16% MaineGeneral Health (MGH), MaineHealth (MH), Mental Health* 14% Northern Light Health (NLH), and the Maine Center Physical Activity, Nutrition, and 14% for Disease Control and Prevention (Maine CDC)� This Weight* unique public-private partnership is intended to assess Substance Use 13% the health needs of all who call Maine home� *Also a statewide priority. For a complete list of state- • Mission: The Maine Shared CHNA is a dynamic wide priorities, see state health profile on our website, www.mainechna.org public-private partnership that creates shared Community Health Needs Assessment reports, engages and activates communities, and supports NEXT STEPS data-driven health improvements for Maine people� This assessment report will be used to fulfill the Internal • Vision: The Maine Shared CHNA helps to turn Revenue Service (IRS) requirements for non-profit data into action so that Maine will become the hospitals as well as the Public Health Accreditation healthiest state in the US� Board (PHAB) requirements for state and local public health departments� Required activities include: DEMOGRAPHICS • Obtaining input from the community, including Franklin is one of three counties that make up the providers and communities served, on leading Western Public Health District� Franklin County’s health issues and unmet needs population is 30,270 and 20�2% of the population is • Evaluating previous actions taken to address 65 years of age or older� The County is predominantly needs identified in previous assessments white (96�7%) and the average household income is $43,007� The high school graduation rate (89�5%) is • Choosing (with justification) which health needs higher than the state average, while the percentage of should be addressed the population with an associate’s’ degree or higher • For hospitals, creating an informed implementation (35�4%) is lower than the state average� strategy designed to address the identified needs • For District Coordinating Councils, creating District TOP HEALTH PRIORITIES Health Improvement Plans The forums held in Franklin County identified a list of • For the Maine CDC, creating an informed State health issues in that community through a voting meth- Health Improvement Plan odology outlined in Appendix C of this report� Table 1 is a list of the top five health priorities for Franklin In the coming months and years, policymakers, County� non-profits, businesses, academics, and other com- munity partners may also use these reports for their own strategic planning purposes� 2 FRANKLIN COUNTY 2019 CHNA • WWW.MAINECHNA.ORG ACKNOWLEDGEMENTS Funding for the Maine Shared CHNA is provided by Central Maine Healthcare, MaineGeneral Health, MaineHealth, and Northern Light Health, with generous in-kind support from the Maine Center for Disease Control and Prevention, an office of the Department of Health and Human Services and countless community partners and stakeholder groups� These stakeholder groups include the Metrics Committee, Data Analysis Workgroup, Community Engagement Committee, Local Planning Committees, and the Steering Committee� Special thanks to the Maine Health Data Organization for working with us to access their data� For a listing of committee members please visit www�mainechna�org and click on “About Maine CHNA�” Significant analysis was conducted by epidemiologists at the Maine CDC and the University of Southern Maine’s Muskie School of Public Service� John Snow, Inc� provided analysis, methodology, and design support� In addition, the Steering Committee gratefully acknowledges the countless community volunteers who gave their time and passionately committed to hosting, facilitating, attending, and engaging in this effort� From Aroostook to York, Oxford to Washington County, over 2,000 Mainers gave their time and talent to this effort� Thank you� FRANKLIN COUNTY 2019 CHNA • WWW.MAINECHNA.ORG 3 HEALTH PRIORITIES Health priorities for the county, public health district, Table 2: Franklin County Forum Voting Results and the state were developed through community participation and voting at community forums� The PRIORITY AREA % OF VOTES forums were an opportunity for review of the Franklin Access to Care* 21% County Health Profile, discussion of community needs, Social Determinants of 16% and prioritization in small break-out sessions followed Health* by a forum session vote� Table 2 lists all ten priorities Mental Health* 14% which arose from group break-out sessions at forums Physical Activity, 14% held in Franklin County� The priorities shaded are those Nutrition, and Weight* that that rose to the top� Substance Use* 13% Diabetes 9% This section provides a synthesis of findings for each Cancer 4% of the bolded top priorities� The following discussion Tobacco 4% of each priority are from several sources including the Intentional Injury 2% data in the county health data profiles, the information Older Adult Health/Healthy 2% gathered at community engagement discussions at the Aging community forums, and key informant interviews� See *Also a statewide priority. For a complete list of Appendix C for the complete methodology for all of statewide priorities, see state health profile on our these activities� website, www�mainechna�org 4 FRANKLIN COUNTY 2019 CHNA • WWW.MAINECHNA.ORG ACCESS TO CARE Whether an individual has health insurance—and QUALITATIVE EVIDENCE the extent to which it helps to pay for needed acute Many forum participants and key informants identified services and access to a full continuum of high-quality, the social determinants of health—particularly poverty, timely, and accessible preventive and disease manage- low wages, unemployment, inability to access reliable ment or follow-up services—is critical to overall health and affordable forms of transportation, and lack of and well-being� Access to a usual source of primary affordable and safe housing—as significant barriers to care is particularly important, since it greatly affects care� These are discussed in more detail in the “Social the individual’s ability to receive regular preventive, Determinants of Health” priority area� routine, and urgent care, and to manage chronic con- ditions� Though the percentage of uninsured individu- Participants discussed the need for comprehensive als in Franklin County has slightly declined over time and affordable health services for low-income indi- (from 11�2% in 2009–2011 to 10�9% in 2012–2016), viduals, specifically dental care and behavioral health uninsuance and underinsurance remains a leading services� Free care programs and MaineCare do not barrier to care in the region� Medicaid expansion, cover preventative oral health services for adults� Even which holds the promise of providing health insurance for those with insurance, deductibles, co-pays, and coverage for an additional 70,000 Mainers, was signed prescription medications may be unaffordable
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