County wants to know how you feel
BUCYRUS – Health officials working in Crawford County have a good fix on what health issues in our population demand the most attention. Even the average person, observing fellow shoppers in the supermarket — and what they're buying to eat — can get some idea of how healthy we are.
But there's nothing scientific, or even statistically relevant, about such an observation. It doesn't help, because it's not controlled data.
Within a year, however, Crawford County public health officials will have access to their first collection of primary statistics, collected directly from residents, on the overall health status of the people who live here — that is, if those same residents cooperate by returning surveys in the county's first community health assessment.
"This will be the first time where we go out and actually ask the people, and then weigh the responses and see what the actual problems are, not just whatever the state thinks based on the averages around us. With that information we'll be able to go back and compare ourselves to other counties around us. It gives us a really good feel for where we stand in our region, then we can compare it to state data and national data," Nathan Benich, emergency planner for Crawford County Public Health, said.
"It's not just that we want to identify our problems. We want to figure out how we're going to deal with our problems," Kate Siefert, chief administrator for the county health department, said.
The county doesn't really have a choice in this matter. Ohio is the first state in the nation requiring county health departments to become accredited by the end of the decade, a process that begins with a community health assessment. That will followed by the creation of a community health improvement plan, and then its implementation, with the process beginning over again five years later.
"Actually, the only thing it is truly is is a minimum standard," Siefert said of accreditation. "Although becoming accredited, because Ohio is the first state to make it mandatory, sounds like a big achievement, all it means is that we've met the standard. Improvement will still need to continue and continue and continue."
"It may not be that we have to make up a whole new program or agency. It could be as simple as tweaking one we already have or just letting people know we offer a service that some people don't know about. Some of the things may already be in place, but we just have to do a better job of advertising them," Benich said.
The opportunity to process primary data about the health behaviors of Crawford County residents, however, is a big deal, and one that could yield concrete benefits, as these assessments have already done in other Ohio counties.
"Wyandot County, which is similar in size to us, got $412,000 in new grants to implement new programs or improve the programs they already have. Once you have that data, it's a lot easier to find that funding. If the schools want to apply for a grant and they need data to show the need in the community, this will be available to reference for their grant writing," Benich said.
"The point isn't for all health departments to be doing the same thing. You're supposed to be doing what your local community actually needs, not just what we perceive, but what the data actually shows," Siefert said.
The drafting of the county's first community health assessment, which began in earnest on Thursday, is also giving several local entities, of which Crawford County Public Health is just one, the opportunity to work together on improving the county's health.
Officially, the health assessment is being created, with the substantial assistance of the Hospital Council of Northwest Ohio, by the health departments for the county and for Galion, the cities of Bucyrus and Galion, Crawford County Partnership for Education and Economic Development, Avita Health Systems, ADAMH, United Way and Children and Family First.
They are also funding the assessment, which will cost $30,000, followed by another $15,000 for the health improvement plan. A random sampling of residents will receive a mailing stating that they may be asked to participate in a survey this fall, following by another mailing identifying those who will actually receive the survey. Participation is voluntary, and residents who turn in a completed survey will receive a $2 bill.
It will take more than just a few minutes to fill out the survey. Officials on Thursday spent several hours selecting the 115 questions that will be included in the survey, on everything from mental health to health care access, alcohol consumption to sexual behavior to diet, exercise and parenting, and much more.
"Electronic medical records are not set up across the system yet. This will give you primary data. This way you know where to beef up your services," Britney Ward, director of community health improvement for the Hospital Council of Northwest Ohio, said at Thursday's meeting, at Galion Community Hospital.
"We'll definitely see some of our chronic issues, like heart disease, obesity. We're also going to score very high for tobacco use. Infant mortality is high in Ohio compared to other states. I'm not sure if that's going to be prevalent in Crawford County. I'm hoping we don't fall into that statistic," Siefert said.
"I think we'll see issues come up with drug overdoses and some of the youth risk behaviors. Drug overdoses have changed since I've been here. It's not just that you hear about people using, now you hear about people dying from using. That has definitely changed."
Drug use will be addressed in the survey, but Ward cautioned against reading too much into those responses.
"It's going to give you something, but you just have to realize it's going to be underrepresented," she said. "We have to update those questions all the time because the drugs keep changing."
At Thursday's meeting, ADAMH's Jody Bemo-Hodges observed that "50 percent of addiction is family history."
Trish Factor, commissioner of Galion's health department, asked the question that will likely be reiterated by many officials after the surveys come in and a public presentation on the findings, tentatively scheduled for early next year, is made.
"What are we going to do with the data?" she asked.
"If people are buying their food at Walmart," Ward asked, "what are you going to do about that?"
"What we do, it's different from hospital and doctors where it's personal health. We're doing population health, community health," Siefert said in an interview earlier this week.
"So we'll look at what opportunities are out there for physical activity. Does our community lack in that, are there ways we can work with our partners for providing more access to physical activity? We do have nutritionists on staff with the WIC, but what else can we do with our hospitals, our schools in providing better eating choices?"
"We can't just become accredited and then just stay at the same level. We still have to make progress. It's kind of a revolving door — time to improve again, time to improve again," Benich said.
thill3@nncogannett.com
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Sample questions from first county health assessment
Thinking about your mental health, which includes stress, depression and problems with emotions, for how many days during the past 30 days was your mental health not good?
Was there a time in the past 12 months when you needed to see a doctor but could not because of cost?
Have you smoked at least 100 cigarettes in your entire life?
During the past 12 months, with how many different people have you had sexual intercourse?
On average, how many servings of fruits and vegetables do you have per day?
Source: Hospital Council of Northwest Ohio
Topics addressed in first county health assessment
Health status
Health care utilization
Health care coverage
Heath care access
Oral health
Alcohol consumption
Preventive medicine and health screenings
Preventive counseling services
Tobacco
Marijuana and drug use
Women's health
Men's health
Sexual behavior
Weight control
Exercise
Diet and nutrition
Mental health and suicide
Quality of life
Social context
Parenting
Miscellaneous health
Demographics
Community issues
Source: Hospital Council of Northwest Ohio