2018–2020 Washoe County Community Health Needs Assessment The 2018-2020 Washoe County Community Health Needs Assessment was sponsored in full by the Washoe County Health District and Renown Health in collaboration with Truckee Meadows Healthy Communities. Published January 2018 TABLE OF CONTENTS 2018-2020 Washoe County Community Health Needs Assessment Acknowledgments .......................................................................................................................................... i Introduction .................................................................................................................................................. 1 Contents, Methodology, & Community Survey Demographics .................................................................... 2 Technical Notes ............................................................................................................................................. 9 Washoe County Geography & Demographics ............................................................................................ 11 Socioeconomic Status ................................................................................................................................. 17 Housing ....................................................................................................................................................... 46 Food & Hunger ............................................................................................................................................ 59 Access to Healthcare ................................................................................................................................... 69 Environmental Health ................................................................................................................................. 87 Unintentional Injuries & Deaths ............................................................................................................... 101 Crime & Violent-Related Behaviors .......................................................................................................... 111 Nutrition & Physical Activity ..................................................................................................................... 125 General Health .......................................................................................................................................... 141 Substance Use ........................................................................................................................................... 148 Mental Health ........................................................................................................................................... 172 Sexual Health ............................................................................................................................................ 182 Maternal & Child Health ........................................................................................................................... 191 Immunizations & Screenings..................................................................................................................... 212 Communicable Diseases ........................................................................................................................... 223 Chronic Diseases ....................................................................................................................................... 234 Mortality ................................................................................................................................................... 255 Community Needs Index ........................................................................................................................... 261 Community Strengths & Challenges ......................................................................................................... 271 Scoring, Ranking, & Prioritization ............................................................................................................. 292 Conclusion ................................................................................................................................................. 298 Appendix ................................................................................................................................................... 299 ACKNOWLEDGMENTS Heather Kerwin, MPH, CPH, Author & CHNA Coordinator CHNA Workgroup Members: Attended regular update and planning meetings related to the assessment, including review of indicators, development and dissemination of online community survey, and creation of focus areas. Sara Behl, Former Director of Programs & Projects, Washoe County Health District Lee Bryant, MPH, Health Educator, Washoe County Health District Wendy Damonte, Vice President Advocacy & Community Partnerships, Renown Health Kevin Dick, District Health Officer, Washoe County Health District Erin Dixon, MS, Public Health Supervisor, Washoe County Health District Rayona Dixon, Health Educator, Washoe County Health District Melanie Flores, MSW, Former Program Coordinator, Washoe County Health District Falisa Hilliard, Office Support Specialist, Washoe County Health District Nicole Lamboley, Administrator, Child Health Institute, Renown Health Chris Needham, Director of Member Health & Wellness, Renown Health Catrina Peters, MS, RD, Director of Programs & Projects, Washoe County Health District Cristina Want, MBA, Community Benefit Liaison, Renown Health Annie Zucker, Manager of Community Impact, Renown Health Subject Matter Experts: Reviewed indicators for quality and completeness, and provided feedback and edits to draft sections. Nevada Department of Health & Human Services, Division of Public & Behavioral Health Jennifer Bonk, MS, Chronic Disease Prevention & Health Promotion Section Manager Vickie Ives, MA, Maternal, Child and Adolescent Health Section Manager Scott Jones, PhD, Primary Care Officer Manager Melissa Peek-Bullock, State Epidemiologist Outside Organizations Jennifer DeLett-Snyder, MS, Executive Director & Certified Prevention Specialist, Join Together Northern Nevada Andy Gebhardt, Director Customer Relations, Truckee Meadows Water Authority Jeff Hardcastle, State Demographer Cari Herrington, MBA, Executive Director, Nevada Cancer Coalition Cherie Jamason, Director of Ending Hunger Initiatives, Food Bank of Northern Nevada Mike Kazmierski, President & CEO, Economic Development Authority of Western Nevada (EDAWN) Sheila Leslie, Behavioral Health Program Coordinator, Washoe County Human Services Agency Heidi Parker, MA, Executive Director, Immunize Nevada Kristen Power, Communications Director, Nevada Cancer Coalition Kim Robinson, MUP, Executive Director, Truckee Meadows Regional Planning Agency Steven A. Shane, MD, MS, Pediatrician, Community Health Alliance Jeremy M. Smith, PhD, GIS Coordinator, Truckee Meadows Regional Planning Agency Alex Woodley, Code Enforcement Manager, City of Reno Melvin D. Zeldin, Environmental Consultant University of Nevada, Reno Jamie Benedict, PhD, RD, LD, Associate Professor, Director of Didactic Program in Dietetics, Department of Agriculture, Nutrition & Veterinary Sciences Kristen Clements-Nolle, PhD, MPH, Associate Professor, Epidemiology, School of Community Health Sciences Reka Danko, MD, Clinical Assistant Professor, School of Medicine Melanie Flores, MSW, Field Educator, Nevada Public Health Training Center, School of Community Health Sciences Tabor Griswold, PhD, Health Services Research Analyst, Office of Rural Health & Statewide Initiatives, School of Medicine John Packham, PhD, Director of Health Policy Research, Office of Rural Health & Statewide Initiatives, School of Medicine Renown Health Nicole Lamboley, Administrator, Child Heath Institute Valerie Luevano, MSW, LSW, Director, Center for Social Justice & Health Equity Natalie Nicholson, MBA, MSN, RN, CNML, Director of Nursing - Women Services i ACKNOWLEDGMENTS Quinn Pauly, MD, FAAP, Section Chief, Renown Wellness Network & American College of Lifestyle Medicine, Board of Directors Anthony Slonim, MD, DrPH, President & CEO, Renown Health Vanessa Slots, MD, Department Chief, General Pediatrics & Behavioral Health Cristina Want, MBA, Community Benefit Liaison Washoe County Health District Charlene Albee, Director of Air Quality Management Division Nicole Alberti, MA, Health Educator Lei Chen, PhD, Senior Epidemiologist & Epidemiology Program Manager Stephanie Chen, MPH, Health Educator Brittany Dayton, MPA, EMS Coordinator Kevin Dick, District Health Officer Erin Dixon, MS, Public Health Supervisor Rayona Dixon, Health Educator Jim English, REHS, CP-FS, Environmental Health Specialist Supervisor Luke Franklin, REHS, BS, Senior Environmental Health Specialist Linda Gabor, MSN, RN, Public Health Nurse Supervisor Kelli Goatley-Seals, MPH, Health Educator Coordinator Daniel Inouye, Branch Chief of Air Quality Management Division Dave Kelly, REHS, Environmental Health Specialist Steve Kutz, RN, MPH, Director of Community & Clinical Health Services Division Lisa Lottritz, RN, MPH, Public Health Nurse Supervisor Catrina Peters, MS, RD, Director of Programs & Projects Randall Todd, PhD, Director of Epidemiology & Public Health Preparedness Division Lynnie Shore, RN, BSN, Public Health Nurse II & Immunization Program Coordinator Special thanks to… The many Divisions of the Washoe County Health District and the Nevada Office of Public Health