Page | 1 Table of Contents Disclaimer ............................................................................................................................. 5 Acknowledgements ............................................................................................................... 6 Project Management Team ................................................................................................... 6 Community Health Assessment Team (CHAT) ........................................................................ 6 CHAT Members ................................................................................................................ 7 Executive Summary ............................................................................................................... 8 Method ............................................................................................................................ 8 Findings ........................................................................................................................... 8 Response ......................................................................................................................... 9 Target Population ................................................................................................................ 10 Service Area ........................................................................................................................ 10 Community Health Improvement Process ............................................................................ 11 Step 1: Conduct CHNA .................................................................................................... 11 Community Health Survey (CHS) ........................................................................................... 11 Target Population Focus Groups ........................................................................................... 11 Stakeholder Survey .............................................................................................................. 12 Secondary Data Collection .................................................................................................... 12 Prioritization ........................................................................................................................ 12 CHNA Report ....................................................................................................................... 12 Step 2: Strategic Planning .............................................................................................. 13 Step 3: Implementation Strategy .................................................................................... 13 Step 4: Program Implementation ................................................................................... 14 Step 5: Evaluation .......................................................................................................... 14 Community Collaboration and Collective Impact .................................................................. 15 Healthy Franklin County ................................................................................................. 16 Description of the Community ............................................................................................. 17 Primary Data and Community Engagement .......................................................................... 19 Stakeholder Survey Results ............................................................................................ 19 Needs and Barriers ............................................................................................................... 19 Localities with the Greatest Unmet Need .............................................................................. 21 Populations with the Greatest Unmet Need .......................................................................... 21 Resources ............................................................................................................................ 22 Page | 2 Initiatives and Changes ........................................................................................................ 22 Target Population Focus Group Results .......................................................................... 24 Focus Group Locations ......................................................................................................... 24 Focus Group Results ............................................................................................................. 29 Franklin County / Bassett Community Health Survey ...................................................... 37 Methodology ....................................................................................................................... 37 Survey Results ..................................................................................................................... 39 Secondary Data ................................................................................................................... 76 Demographics and Socioeconomic Status ....................................................................... 76 Social Determinants of Health .............................................................................................. 76 Population, Gender, Race and Age........................................................................................ 77 Academic Attainment .......................................................................................................... 81 Income and Poverty Status ................................................................................................... 85 Households and Marital Status ............................................................................................. 97 Employment Status .............................................................................................................. 99 Transportation ................................................................................................................... 100 Access to Health Care ................................................................................................... 101 Health staffing shortages and designations ......................................................................... 101 Health Services Professionals ............................................................................................. 102 Source of Primary Care and Cost of Services ....................................................................... 105 Insurance Status ................................................................................................................ 106 Health Status of the Population ................................................................................... 108 Death Rates ....................................................................................................................... 109 Prevention Quality Indicators ............................................................................................. 113 Mental Health and Substance Abuse .................................................................................. 114 Oral Health ........................................................................................................................ 116 Prevention and Wellness .............................................................................................. 118 County Health Rankings ..................................................................................................... 119 Health Risk Factors............................................................................................................. 119 Nutrition, Weight Status, and Physical Activity ................................................................... 121 Clinical Preventive Screenings ............................................................................................ 125 Maternal, Infant, and Child health ............................................................................... 126 Prenatal and Perinatal Health Indicators ............................................................................. 126 Preventive Screenings ........................................................................................................ 127 Page | 3 Infectious diseases ....................................................................................................... 128 HIV Infection Prevalence and Other Sexually Transmitted Infections Rate ........................... 128 Social environment ...................................................................................................... 129 Community Health Need Prioritization .............................................................................. 130 Appendices ....................................................................................................................... 131 Appendix 1: Community Health Improvement Process .................................................. 131 Appendix 2: Gantt Chart .............................................................................................. 132 Appendix 3: Community Health Survey ........................................................................ 133 Appendix 4: Stakeholder Survey .................................................................................. 138 Appendix 5: 2016 Stakeholder Survey Locations..........................................................