Polk County 2015 Community Health Assessment

[Pages:74]POLK COUNTY 2015 COMMUNITY HEALTH ASSESSMENT

Brought to you by: Polk Vision's

Community Health Assessment Team

Table of Contents

SECTION I: EXECUTIVE SUMMARY.......................................................................1

INTRODUCTION........................................................................................................ 2 OVERVIEW AND METHODS......................................................................................... 3 KEY THEMES ........................................................................................................... 4

SECTION II: QUALITY OF LIFE ...............................................................................9

CONSUMER OPINION .............................................................................................. 10 OPINION OF THE PUBLIC HEALTH COMMUNITY ............................................................. 11 POPULATION DEMOGRAPHICS................................................................................... 12 ACCESS TO CARE.................................................................................................... 17 HEALTH DISPARITIES ............................................................................................... 22

SECTION III: HEALTH AND SAFETY .....................................................................28

MAJOR CAUSES OF DEATH ....................................................................................... 29 CHRONIC DISEASES................................................................................................. 31 WEIGHT .............................................................................................................. 34 MENTAL HEALTH ................................................................................................... 38 SUBSTANCE ABUSE................................................................................................. 41 CRIME AND SAFETY ................................................................................................ 46 COMMUNICABLE AND INFECTIOUS DISEASES................................................................. 49 MATERNAL AND INFANT HEALTH ............................................................................... 55 CHILD HEALTH ...................................................................................................... 59

SECTION IV: RESOURCES ...................................................................................66

STRATEGIC ALIGNMENT ........................................................................................... 67 DATA SOURCES ..................................................................................................... 68 ACKNOWLEDGEMENTS ............................................................................................ 70

Section I:

Executive Summary

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Introduction

This Community Health Assessment is the result of a 2-year process seeking to identify the major health and social issues affecting the health status and quality of life in Polk County. It seeks to provide a compilation of consumer opinion from local residents, input from members of the local public health system including key stakeholders, and statistical data garnered from multiple sources. A community health assessment looks outside of the performance of an individual organization serving a specific segment of a community to the way in which the activities of many organizations contribute to community health improvement. Polk Vision's Community Health Assessment Team comprised of a diverse group of public, private, non-profit, social services, and governmental entities that make up the public health system in Polk County utilized a nationally recognized model called MAPP (Mobilizing for Action through Planning and Partnership) to conduct the 2015 Community Health Assessment. The MAPP process is described on the following page. The information in this document can be used to plan community health improvement projects and assist community partners in aligning resources focused on improving the health of the community. Impact of Previous Assessments Prior MAPP assessments have been used to initiate community health improvement efforts. In 2008, lack of access to primary health care by uninsured residents resulted in frequent visits to local emergency departments. Community partners came together and with the financial aid of a low income pool grant were able to create access to medical, dental, and behavioral health care for many uninsured low income residents in Polk. In 2012, obesity was recognized as a significant public health threat in Polk County. A group of community partners brought together by Polk Vision established Building a Healthier Polk to focus efforts on reducing the obesity rate in Polk County.

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Overview and Methods

Goal

To work collaboratively as a community to improve the health and well-being (quality of life) of Polk County.

Mobilizing for Action through Planning and Partnerships

Mobilizing for Action through Planning and Partnerships (MAPP) is a community-wide strategic planning tool or process for improving community health. MAPP was developed by the National Association of County and City Health Officials (NACCHO) in cooperation with the Centers for Disease Control and Prevention (CDC). This process includes four community health assessments used to better understand the assets and needs of a community and assist public health system partners as they focus on aligning resources toward improving the health and well-being (quality of life) of the community.

MAPP assessments conducted in 2014 and 2015:

Community Themes & Strengths Assessment

Identified issues that interest the community, perceptions about quality of life, and community assets. This report was compiled from over 3,500 consumer surveys, 9 focus groups comprised of 72 residents and 5 key informant interviews.*

Forces of Change Assessment

Identified forces that are or will be affecting the community or local public health system. Threats and opportunities were compiled from facilitated discussions with representatives from various organizations in Polk.*

Local Public Health System Assessment

Measured capacity and performance of the local public health system and entities that contribute to the public's health. Over 80 subject matter experts from a cross section of professional entities participated in a one day workshop to complete this assessment.*

Community Health Status Assessment

Assessed data about health status, quality of life and risk factors in the community.*

The results of the MAPP assessments were analyzed and compiled into this report, entitled the Polk County 2015 Community Health Assessment. * A summary of these reports can be found on pages 10-11.

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Key Themes

Key Themes were re-occurring topics or concerns discovered during the assessment process. These issues were recognized in consumer opinion surveys, in public health community discussions, and in

analysis of statistical health data.

Access to Care

Consumer Opinion in Polk Access to health services was rated as important to health and quality of life by residents in

2011 and 2014. 68% of survey respondents perceived access to basic health services for them and their family

as good or excellent. 67% of respondents indicated they had some form of health insurance. Lack of access to mental health services was mentioned as a concern in both key informant

and focus group participants. In the Forces of Change assessment the public health community expressed concern over

what would happen to the uninsured and underinsured residents of Polk, if the 1/2 cent Indigent Health Care surtax is not renewed by Polk voters. This surtax is scheduled to sunset in 2019. Polk County's ability to link people to needed health services and assure health care was identified as an area for improvement by the local public health community (Local Public Health System Assessment). Access to transportation was rated as important to health and quality of life by residents, as this enables people to get to the grocery store, jobs, and medical appointments. Lack of transportation was mentioned as a contributing factor to health problems in 2011 and in 2014. Health Data In 2013, 19% of Polk residents were uninsured, 20% had Medicaid, 22% had Medicare, and 38% had private insurance. Barriers to access include lack of insurance, health literacy, language barriers, transportation, patient mistrust and refusal of services. In 2014, the Indigent Health Care program served nearly 47,000 people by funding direct care services through the Polk Health Care Plan or by providing some funds to free and low-cost medical, dental and behavioral health clinics. It is estimated that an additional 70,000 Polk County residents did not receive routine primary care. The 2014 Physician Workforce Annual Report shows an aging physician workforce and one that is becoming more specialized.

Health Disparities

Health disparities exist when one group of people gets sick or dies more often than another group. Addressing health disparities in Polk is important because these issues contribute to increased healthcare costs.

For example in Polk: Blacks make up a disproportionate number of hospitalizations from diabetes, asthma and stroke. Whites have higher diagnoses of diabetes and hypertension. Hospitalizations from diabetes and asthma are higher in minorities. Hispanics are more likely to report they could not see a doctor or a dentist in the past year due to cost. Whites are less likely to have consumed five fruits and vegetables per day. Whites are more likely to have had their cholesterol checked in the past 2 years.

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