When you walk along a neighborhood street in a local community, behind the closed doors you pass, the stories of our region’s social, economic, and health challenges will be unfolding.
If that neighborhood street reflects the region in general, the stories there might be something like these:
Behind the closed door of the first house, an elderly man, living alone, is unable to go to the grocery store because he doesn’t own a car. He has diabetes, and lives in poverty.
Behind another closed door, a single mother is struggling to care for her children. She spends nearly a third of her paycheck on rent. She smokes and doesn’t get much exercise. She would like to improve her and her children’s health, but doesn’t know how.
Behind another closed door, a teenage girl is at risk of becoming pregnant. She feels on edge every day and has experimented with marijuana. She doesn’t know where to turn for help with her mental and sexual health.
On a street where 100 people live—if that street reflects the statistics in our region—80 of the people will be adults and 20 will be young people under 18. Among those 80 adults, 26 will be struggling with obesity, seven will have diabetes, and six will live with depression. Twenty of the adults will be living in poverty, and 32 would say they don’t feel safe in the community. Sixteen feel they can’t afford to see a doctor when they’re sick or injured, and 14 have no health insurance. Every year, one person—either on this street or within one block—will be diagnosed with cancer. And every year one person, on this street or within one block, will become the victim of violent crime.
These numbers are based on data from a recent assessment of community health needs, undertaken by Gila County’s Division of Health and Emergency Management (GCDHEM) and Cobre Valley Regional Medical Center (CVRMC). The assessment puts specific numbers to the needs and challenges of our region’s population, with the goal of helping the county, the hospital, and other organizations see where efforts and money would best be spent to improve public health in the region.
This is the first time the county, the hospital, and other community partners have “really worked together to identify what’s happening in the community, who can do what, pool the resources, and choose a few different areas to make some improvements in,” according to Michael O’Driscoll, Director of GCDHEM. “It’s more of a community health approach … because nobody really has the resources to tackle a lot of these huge health issues alone.”
The hospital is required to complete a community health needs assessment every three years in order to maintain its accreditation, and the county is required to do a community health assessment every five years. Last fall the county and the hospital collaborated and performed an assessment jointly. They gathered information through 637 surveys, six focus groups, and 14 interviews with key informants, such as the City of Globe, the Apache tribe, and Resolution Copper. The assessment covered all of Gila County plus a few other areas outside the county that are served by CVRMC. According to the assessment document, “The end result is a comprehensive summary of leading health issues affecting Arizonans across Gila County and the CVRMC service region.”
In January, the assessment results were presented to an advisory committee and made available to the public. The assessment document compares the regional data to other populations, to show how our region’s factors stand in relation to similar regions, the state, or the country as a whole. The advisory panel then selected priorities, long-term goals, and strategies. These priorities, goals, and strategies were outlined in a Community Health Improvement Plan (CHIP), which is a five-year strategic plan for improving health in the region. This summer, committees are preparing specific action plans to implement the strategies.
The advisory committee selected four priority health issues as the top problems to address. These priorities were chosen based on criteria like: How large is the problem—how many people are affected? How serious is the problem—does it cause severe impacts to quality of life or health care costs? Is it feasible to address the problem—are potential solutions cost effective and achievable? Can existing resources be leveraged to address this issue? Can preventive measures have a high impact?
The top four priorities that the advisory board selected were: obesity, substance abuse, access to quality health care including mental health services, and sexual health.
1) Obesity: According to the CHIP, people who responded to the community survey highlighted obesity as one of the top health issues in Gila County and one of the top health challenges they themselves face. Goals focus on increasing physical activity and consumption of fruits and vegetables. As strategies to meet these goals, the community might see improvements in walking trails and the possible opening of playgrounds and recreation areas outside school hours.
2) Substance abuse: Drug addiction was another top health challenge identified in the community survey, and lack of access to support services was highlighted. The advisory committee determined that focusing on youth and prevention would be most effective, and they identified heroine and prescription opioid abuse as the most serious problems in our region. Strategies being considered include helping to provide caring and supportive relationships for adolescents, and establishing a monitoring program for prescription drugs.
3) Access to quality health care including mental health services: According to the CHIP, it has been difficult to bring health care providers to the area because of our region’s limited economic resources. However, Margo Badilla, CVRMC’s Referral Coordinator, notes that “Globe really does have a lot as far as services are concerned.” To help people make the best of use of providers and resources that are available locally, the county plans to create an Internet resource that lists all key health care services in the county. The county and the hospital will also continue to encourage the public to use One Call, CVRMC’s free service to help people find services and navigate systems.
4) Sexual health. Our region has a high teen birth rate and high rates of sexually transmitted diseases. The advisory committee chose to focus on prevention and reduction of risky behaviors. Strategies will include programs for teaching teens in an appropriate manner about reproductive health, as well as clinical interventions to reduce risky behaviors.
According to O’Driscoll, Gila County has already received two major grants that will support efforts with regard to obesity and substance abuse. The first is a grant for nutrition education (the SNAP-Ed program), and the second is a grant for prescription drug abuse program, which will allow doctors and pharmacists to access a database so they can see a patient’s history with prescription drugs.
“We need to create a healthy community,” says Evelyn Vargas, CVRMC’s Public Relations Director. “When people are healthier, they’re engaged more at their workplaces, kids get better grades, there’s less absenteeism in both the education arena and the work force.” Vargas notes that by September, people should begin seeing programs that are part of the community health improvement plan.