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The Health of Morrison County 2016: a Community Health Needs Assessment

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The Health of Morrison County 2016: a Community Health Needs Assessment The Health of Morrison County 2016: A Community Health Needs Assessment May 3, 2016 Morrison County will provide cost effective, high quality services to county residents in a friendly and respectful manner. 2 TABLE OF CONTENTS Table of Contents . page 3 Acknowledgements . page 3 Executive Summary . page 4 Introduction . page 6 Section I: What the People Told Us . page 9 Section II: What the Stakeholders Told Us . page 23 Section III: What the Secondary Data Told Us . page 31 Section IV: What’s Available – Community Health Assets and Other Resources . page 53 Section V: Summary and Conclusions . page 62 Section VI: Implementation Strategy/Action Plan . page 63 Appendices: I.A through III.O . pages A-1 to A-64 Acknowledgements Special thanks are extended to the multiple individuals who assisted with the completion of this community health needs assessment, both those from within CHI St. Gabriel’s Health as well as our collaborators— Morrison County Public Health and Morrison County Social Services— and other community partners. In particular, I would like to recognize the Katy Kirchner and Brad Vold (and their staff members). Morrison County is a great partner on this project, and I’d especially like to thank Katy for her editing skills. In addition, I want to recognize the Initiative Foundation, notably Katie Spoden and Kathy Gaalswyk, for their support, funding and “community-mindedness,” in conducting the stakeholder interviews. I’d also like to thank the other written survey collaborators—Todd County Public Health, Wadena County Public Health, CentraCare Health – Long Prairie, LakeWood Health in Staples and Tri-County Health in Wadena—for their financial support and financial assistance with the development of the survey instrument and identifying stakeholders for the stakeholder interviews. Thanks also goes to Ann Kinney, research scientist from the Minnesota Department of Health for her expertise in the development of the survey instrument and the analysis of the results. Patrick Rioux Coordinator, Community Health Needs Assessment Manager of Communications, CHI St. Gabriel’s Health 3 Executive Summary The Health of Morrison County 2016 is a comprehensive community health needs assessment (CHNA) conducted by three partners—Morrison County Public Health (MCPH), Morrison County Social Services (MCSS) and CHI St. Gabriel’s Health. It is modeled after the assessment process outlined in Assessing and Addressing Community Health Needs, a publication developed by the Catholic Health Association, with additional evidence-based practices offered by Catholic Health Initiatives—the parent organization for St. Gabriel’s Hospital. The Health of Morrison County 2016 has six sections: Section I – What the People Told Us is a report on a written survey mailed to county residents in the spring of 2016, Section II: What Stakeholders Told Us is results of twenty face-to-face interviews with community stakeholders, Section III: What the Secondary Data Told Us is a summary of secondary data on indicators affecting the health of the people of Morrison County, Section IV – What’s Available: Community Health Assets and Other Resources is a directory listing of the system capabilities for addressing the health needs of the people of Morrison County including system capacity and gaps in resources, Section V: Conclusions is based on the previous four sections, and Section VI: Implementation Strategy - Our Three-Year Action Plan is a plan for improving the health of Morrison County residents. The Implementation Strategy will be developed and approved by the CHI St. Gabriel’s Health governing board by the Internal Revenue Services’ November 15, 2016 deadline. The CHNA also includes an extensive list of appendices most relevant to the CHNA. The written survey provided useful information on community perceptions of the health of Morrison County. It included what respondents thought were the most serious community health issues impacting quality of life in the county. Illegal drug use was listed as the most serious health issue by survey respondents and overweight/obesity coming in as the second most serious community health problem. These two issues switched place from the 2013 CHNA. In addition, several of other top 10 issues in 2013 were also noted in 2016. It is worthy to note “families not able to earn a livable wage” made the Top 10 list in 2013 and was not a choice on the 2016 survey. Children in poverty and unemployment were the choices most closely related livable wage. Smoking/tobacco use, chemical use/abuse both among adults and teens, and mental health issues were common among respondents in both survey years. Chronic diseases, such as heart disease and diabetes, and bullying were also significantly reported as concerns. While the demographics of respondents to the written survey are slightly different from demographics of the county population as a whole, the written survey provides a view of public perceptions of the health issues facing the county. The top concerns from the stakeholder interviews were similar to the concerns from the written survey. Local health leaders, and others with in-depth knowledge of the local health care environment, were identified for the stakeholder interviews. Stakeholders with close contact to those in poverty were specifically sought out to ensure the needs of individuals in poverty were represented in the survey process. Stakeholder interviews were conducted gratis by the Initiative Foundation’s Katie Spoden at no cost to the CHNA sponsors—Morrison County Public Health, Morrison County Social Services and CHI St. Gabriel’s Health. Morrison County stakeholders spoke of five common themes related to the health issues facing the county: chemical use and abuse, obesity and being overweight, physical activity infrastructure, mental health resource limitations, and non-health-related issues. In addition, stakeholders discussed other issues common across stakeholders in Morrison, Todd and Wadena counties: poverty, transportation, learned behaviors, individual and family engagement in health issues, parenting, domestic violence, and bullying. The stakeholder interviews provide qualitative data about community health issues, including stakeholder solutions to address the issues. Secondary data is data collected by someone other than the CHNA partners, the written survey and stakeholder interviews. The data in this report supplemented the perceptions of written survey respondents and stakeholders. The list of county-specific data sources included in the CHNA can be found in Appendices III.a – III.i, pages A- 4 12 through A-64. People with interests in a specific health topic are encouraged to review the List of Appendices. High points and summaries of the various secondary data are included in Section III. In 2013, an easy-to-use comprehensive directory of health care resources in Morrison County was added to the CHNA. The directory was compiled to determine what assets are available to address community health issues and where there are gaps in the resources. Through healthcare data, it was noted the county has fewer primary care providers, mental health providers and dentists per capita than state and national benchmarks. Also, the county lacks mental health or chemical dependency inpatient treatment facilities; although both services are available approximately 30 minutes from the county seat in Little Falls. Another area for improved access is domestic violence resources like the women’s shelter and child visitation center which are not available in the county. After review of the Morrison County directory, the county should focus on primary care, mental health and dental services as areas to meet the access needs for the people of Morrison County. In the conclusion, the reader is given a summary of all information sources—written survey, stakeholder interviews, secondary data collection and health assets directory. This section demonstrates the need for community agencies, including the healthcare, work collaboratively to utilize their health care assets to improve the health of the people in the county. This could happen through coordination among the various entities working on health issues. Shortages of primary care (especially internal medicine), chemical dependency, mental health and dental providers will be addressed through the Implementation Strategy. Data from the Minnesota Department of Health will be among the data sources CHNA collaborators will be utilizing to monitor the effectiveness of the implementation strategies. The Implementation Strategy is the blueprint for improving the health of Morrison County over the next three years. It will be developed in collaboration with a variety of community individuals representing several organizations by the aforementioned November 15 deadline. A collective and integrated effort will be used to address priorities identified through the CHNA. Community partners will be identified for what priorities they could realistically have an effect on and what priorities would be better suited for other community partners. Success in achieving the goals and objectives in the CHNA implementation strategy/action plan depends upon further developing the relationships within the community. This Community Health Needs Assessment is truly for the people of Morrison County and participation by individuals and organizations throughout Morrison County is essential. 5 Introduction The Health of Morrison County is a comprehensive community health needs assessment (CHNA)
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