A robust community knows what its biggest health issues are and determines strategies to tackle them.
To accomplish that, Teton County uses data and community insight to determine the most pressing health care issues, and it recently published the results in the form of a Community Health Needs Assessment. Although the full assessment won’t be released until spring 2018, newly prioritized health issues were just made public.
They are, in order, mental health, alcohol, sexual/reproductive health, chronic disease and cancer screenings, and smokeless tobacco.
Like the first iteration released in 2015, Teton County Public Health and St. John’s Medical Center partnered to conduct the assessment. The organizations follow a process framework called MAPP, or Mobilizing for Action through Planning and Partnerships. This framework helps identify trends year to year, Public Health Response Coordinator Rachael Wheeler said.
The assessment will be done every three years. The results are simply what has been identified and are not associated with funding.
“It doesn’t mean that other issues aren’t important,” Wheeler said.
The National Association of County and City Health Officials developed the framework, which is seen as the best practice for communities around the country to identify and address community needs.
Public health staff say implementing the MAPP process helped expand the scope of the assessment to incorporate community participation.
The community completed more than 1,300 quality of life surveys this year. Three hundred of the responses were in Spanish.
In addition to community responses, data was included from the Centers for Disease Control and Prevention, the Wyoming Department of Health, county health rankings and the local Network of Care.
Community health issues were identified when Teton County’s data didn’t meet the goals of Healthy People 2020 — a nationwide initiative run by the Office of Disease Prevention and Health Promotion that develops a new set of objectives to improve American health every decade — and when Teton County had a negative statistically significant difference when compared to Wyoming. The top community health issues identified in the quality of life surveys were used to back up the issues identified from the quantitative data.
A steering committee of local stakeholders prioritized the issues.
The committee also differentiated between community health issues and social determinants of health. Healthy People 2020 defines social determinants of health as “conditions in the environments in which people are born, live, learn, work, play and age that affect a wide range of health outcomes and risks.”
Conditions can include factors like socioeconomic status, education, the physical environment, employment and social support networks, with Public Health Director Jodie Pond calling them “multifaceted” and requiring a “systemwide approach” to be addressed.
The prioritized social determinants of health are, in order: severe housing, access to care and food insecurity.
Severe housing is defined as households that have one or more of the following: lack of a complete kitchen facility, lack of complete plumbing, and being severely overcrowded or severely cost burdened. Severe overcrowding is defined as 1 1/2 or more persons per room; severe cost burden means the cost of rent plus utilities exceeds 50 percent or more of monthly income.
Wheeler said that 19 percent of the housing stock in Teton County falls in this general category.
With top needs identified and prioritized a community health implementation plan will be put in place, identifying goals and strategies for addressing each issue.
“The best part about MAPP is that it doesn’t just end at the assessment,” Wheeler said. “We are bringing together action groups like we did last time, and those action groups will create goals and strategies to shift the needle on some of these issues for the next few years.
“Clearly, some of these issues are going to take more than a few years to solve. But what can we do, as a group, to start chipping away at the small things?”