Mental health and drug use, chronic conditions such as heart disease and breast cancer, community conditions such as transportation and housing, access to health care, and nutrition and healthy eating were identified as most significant in an assessment of community health needs by the Geauga Public Health department.
The community health needs assessment is conducted every three years and is used to help guide priorities in terms of health and social needs in the county and to inform different organizations’ expanding in services, said Geauga Public Health epidemiologist Sarah Sullivan.
This is the first year that New Jersey-based company Conduent was chosen for data analysis for the county’s community health needs assessment. The contract with Conduent is split halfway between University Hospitals and Geauga Public Health. Geauga Public Health’s portion is $32,500. The previous organization that was used was the Hospital Council of Northeast Ohio.
The significant health needs were determined by three factors: secondary data from the Healthy Communities Institute, interviews and focus groups with community members informed about health topics due to their experience serving various populations in the community, and an online community survey made available to Geauga County residents in English.
It was noted that the survey, with 397 respondents out of 93,657 total residents in the county, is meant to be informative.
“The responses are representative of the county, but we would like to continue to see the number of total respondents to increase for future assessments to gather as much input as possible,” said Ms. Sullivan.
The previously identified significant health needs for the 2020 community health needs assessment were mental health and addiction, chronic conditions, access to health care, transportation, adverse childhood experiences, food insecurity, housing, and domestic violence.
Interviewees and survey respondents identified mental health and drug misuse as the top concern affecting health in the county, said project manager Era Chaudhry from Conduent.
“It was also mentioned that COVID-19 has exacerbated these issues,” said Ms. Chaudhry. “Even though mental health and substance misuse was identified as the most common problem among all populations, younger populations and LGBTQ populations are most affected.”
The vicious cycle between mental health and drug use behaviors also came up in interviews with informed individuals, said Ms. Chaudhry. For instance, unmanaged mental health issues can lead to increased smoking and drug use.
The age-adjusted death rate due to suicide, increased number of adults who binge drink and drink excessively, consumer expenditures on tobacco and legal marijuana, and number of adults who used smokeless tobacco in the past 30 days, as reported by the Healthy Communities Institute, all show the need to address this health topic, said Ms. Chaudhry.
Thirty-two percent of survey respondents considered attempting suicide in the last 12 months.
Huntsburg is the county’s geographic location with the highest measure of social determinants and health factors correlated with self-reported poor mental health.
Chronic conditions, including heart disease and breast cancer, was ranked second-highest among the county’s top health concerns due to the significant impact it has on the health of community members.
Other indicators of these chronic conditions’ prevalence were the county’s breast cancer incidence rate, the age-adjusted death rate due to breast cancer, the number of adults who experienced coronary heart disease, and the high prevalence of cholesterol in adults.
Community conditions like transportation and housing were found to be adversely affecting vulnerable populations such as disabled and senior citizens.
Transportation presents a barrier to care and services to those populations. Interviewees expressed a need for a more robust public transportation system and affordable housing, including rental properties, within the county, said Ms. Chaudhry.
“It was mentioned that homelessness is sometimes not visible in Geauga County because people are couchsurfing or sleeping in cars,” said Ms. Chaudhry.
She went on to say that transportation is important for the senior population so they can attend their appointments without solely relying on their families to provide that transportation. In the past year, 17.9 percent of survey respondents needed assistance with transportation but did not receive it.
“The trend of car ownership in Geauga County is getting worse with time, and vehicular ownership is directly related to the ability to travel,” said Ms. Chaudhry. “This limits the access to essential services such as supermarkets, post offices, doctors’ appointments, and hospitals.”
Health care access and quality was found to be negatively impacting senior and homebound citizens, non-English speakers, and those without a private vehicle.
Delay in care, lack of investment in preventative health care, difficulty navigating the health care system, staff shortages, language barriers, and financial barriers were all found to be part of this problem, said Ms. Chaudhry.
Middlefield was identified as the area of this county with the highest need in this area, followed by Huntsburg.
Lack of healthy, affordable food and health literacy and the cost of healthy food made nutrition and healthy eating the fifth-highest concern in the county.
Consumer expenditures on fast food and foods high in sugar were seen as indicators of this problem.
Seventy-eight percent of survey respondents said they had no problems affording food in the past 12 months. Twenty-one percent of respondents said they ate less as there was not enough money to buy food.
Middlefield has the highest measure of food insecurity in the county, followed by Huntsburg and Burton, according to the Healthy Communities Institute.
Healthy education programs offered in the evening and in Spanish were proposed as solutions, said Ms. Chaudhry, along with making sure seniors have food, know where to get it, and understand what a nutritious meal is.
The community health needs assessment will be used to create objectives among health-related community organizations.