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2013 Community Needs Assessment

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2013 Community Needs Assessment LLCHC Service Area Needs Assessment Final Report Lower Lights Christian Health Center Service Area Community Health Assessment Exploring Health Issues, Policies, Services and Citizen Involvement impacting residents of Franklinton, Ohio. Created: October 21, 2013 Board Reviewed & Approved: November 05, 2013 by Cornerstone Management Wheelersburg, OH LLCHC Service Area Needs Assessment INTRODUCTION Medicine and medical care come to mind when discussing health issues. However, there are several factors which directly impact a person’s health which are not medical in nature. These broad health status indicators deal with poverty, housing, education, environment and more. It is these underlying causes of disease that is the focus of this project. The health of the community concerns everyone. A healthy community is well equipped with active, productive, participating citizens who are free to use their energies toward the good of their employers, school systems, volunteer groups, and churches. The kind of community that successfully joins together for the common good is made up of clean neighborhoods of healthy families that support the mental and physical health of each individual. Few communities completely obtain this goal. Most are plagued to some degree by polluted streets, emotional health issues, excessive rates of preventable disease and death, increasing costs of medical care, and an overall decline in the quality of life. When citizens’ health is poor, productivity declines, employers are forced to deal with high rates of absenteeism, education suffers, and the pool of available volunteers decline. Prevention and early intervention are the keys to creating a healthy population living in healthy communities and so maximizing their ability to thrive. It is, therefore, of vital importance to assess the underlying causes of poor health and the availability of healthcare resources in the community in order to address the issues that are creating health problems. This report contains a baseline of measurable data upon which to build. It lays the groundwork for developing a dynamic plan to continually assess and improve the health status of Franklinton residents. This project will guide the development of strategies to implement community health programs with an emphasis on prevention and provision of cost effective, high quality comprehensive early intervention health care for all. BACKGROUND In the rapidly changing world of health care in our nation and in our state, we must strive to keep current with changes that affect the health of the community. Health providers must become more versatile in providing programs that meet the changing needs of the public. The Nationally focused Healthy People 2020 Project and Ohio’s Public Health Plan have identified certain core functions which are necessary to effectively change the way health providers organize resources and programs. Community health needs assessment is identified as a strong tool by which a community can identify important health problems by both of those projects, and begin to aggressively address them. Health assessments include broad community representation that provides necessary input to a data-driven assessment of the current state of the community’s health. LLCHC Service Area Needs Assessment A review of the Lower Lights Christian Health Center programs precipitated the overall project. This was followed by an assessment of the Franklinton community’s health delivery system in order to determine, among other variables, the availability, accessibility, and quality of care being offered. While these two facets of the project were taking place, a survey of Franklinton residents was also implemented to obtain what “the people” considered their biggest health problems. Concurrently, our researchers performed a background secondary data analysis and review of historical data, conducted a series of interviews with health personnel and clientele, completed a telephone survey of healthcare providers, conducted a random telephone sampling of community members, and investigated similar sized systems for a comparative analysis. This sampling provided a true research based assessment of the problems affecting the health status of Franklinton residents. SCOPE This assessment is intended to provide insight into the community health status of Franklinton, a suburb of Columbus, Ohio. It seeks to discover perceived problems from the community at large and problems identified by those who work in the health professions. The core focus of the project considers the primary health care needs and barriers to care for the approximately 12,000 of Franklinton residents with incomes below 200% of federal poverty guidelines. Therefore, before further developing the descriptions of poverty and health concerns of Franklinton, it is important to understand the basis-for estimates of the statistics used to describe the target population. Access Ohio notes that there is little health care data kept below the county level in Ohio. As Access says, "health status indicators are not available for many cities, townships, rural counties nor for specific population groups." Therefore, they conclude, most reliable information is available at the county level. Nonetheless, there are a number. of census statistics kept at the census tract level, (such as age, sex, race, poverty status, home ownership,) which impact health status and do provide some specific numbers with respect to the Franklinton population. In many cases, however, the best estimate of the degree of a problem in the target population is the same as the figure for Franklin County as a whole, unless there is some circumstance that makes it possible to conclude that the manifestations of the problem in the target population are greater or less than the manifestations of the problem county-wide. Also, the under 200% of Poverty population is faced with significant health disparities as evidenced by characteristics developed by the National Center for Health Statistics. In every category, persons with low incomes fare significantly worse than persons with higher incomes: having health insurance rates are lower; doctor visits are lower; dental visits are lower; dental caries are higher; and routine cancer screening rates are lower. It is clear that health disparities exist in the lower income ranges. Page 3 of 19 3 LLCHC Service Area Needs Assessment Table 1. Healthcare Disparities by Poverty Level Income below 100% of Incomes between Incomes Over 200% of the Federal Poverty 100% and 200% of the the Federal Poverty Level Federal Poverty Level Level % of children without a 13.5% 9.8% 3.8% usual source of health care % of children without a 17.2% 14.7% 10.1% healthcare visit in the last 12 months % of adults without a usual 27.5% 24.5% 12.6% source of healthcare % of persons without a 53.0% 48.1% 26.6% dental visit in the past year % of persons with untreated 33.8% 29.5% 12.7% dental caries Income below 100% of Income above 100% of the Federal Poverty the Federal Poverty Level Level % of women over 40 45.2% 27.9% without a mammography in the last two years % of women over 18 27.9% 13.8% without PAP in the last 3 years Income below 100% of Income between 100% Income between 150% Income over 200% of the Federal Poverty and 149% of the and 199% of the the Federal Poverty Level Federal Poverty Level Federal Poverty Level Level % of the population under 31.4% 32.8% 25.6% 10.9% 65 with no health care insurance % of the population under 26.7% 39.2% 56.6% 83.9% 65 with private health care insurance Source: National Center for Health Statistics Page 4 of 19 4 LLCHC Service Area Needs Assessment METHODOLOGY Cornerstone Management, with significant input from the Lower Lights Christian Health Center staff, collected, organized and analyzed the health assessment data from a number of major sources. Sources include the US Census Bureau, Ohio Department of Health, Ohio Department of Development, US Department of Health and Human Services, and the National Center for Health Statistics. An external resource assessment was also completed in conjunction with the Franklin County and Columbus City Health Departments. Questions centered on leadership, community, public perceptions, professional staff, and additional resources their clinics offer. This health assessment provides an understanding of not only the community’s health status but also the internal strengths and limitations of the Franklinton health delivery system. Its design also assists in determining residents’ perceptions of health issues and healthcare providers. To increase the quality of responses, personal interview methodology was employed as often as possible. The statistical sampling included: Fifty (50) randomly selected Franklinton households, contacted by telephone for a general health and needs assessment. This provided an initial identification of health issues, attitudes, and service and provider utilization by community members. Approximately 30 of the 50 households contacted agreed to complete the survey for a response rate of 60%. Of those declining to participate, about 60% pleaded time constraints, 37% simply declined or seemed fearful of providing information and 3% were unable to understand the purpose of the survey. Primary care physicians were polled as to available services. There were 3.9 physicians providing services in 2 locations. Some respondents were unable or unwilling to answer all the questions. None, other than Lower Lights, accepted new Medicaid patients or
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