by NATHANIEL NELSON
A new study of Winona County residents shows that for the past nine years, a large percentage of the community has struggled with depression, obesity, food shortages and drinking problems –– and now, Winona Health and county officials are once again working to develop strategies to help.
Winona Health’s community health needs assessment (CHNA), a triennial survey of Winona County residents –– this year’s assessment is the third –– covers a wide variety of topics to hone in on exactly where the county’s residents struggle.
“The goal is to do a broad study of our county to identify priority areas and create an action plan to address them in the community,” Jessica Remington said. “It helps us align with what our priorities are.”
Remington, the director of health and wellness services at Winona Health, is leading the assessment process this year, and explained that it is used to create a plan for the hospital to follow over a three-year period, and identify those areas which most need attention and assistance.
But what do this year’s results show?
“It validated what we have been working on for the last three years in studying social determinants of health,” she explained.
According to Remington, the three biggest priority areas in 2016 were obesity, mental health problems and health equity. While the final data is still being compiled, early results show many of the same areas being a problem for the community this year.
For instance, according to the data, 69.3 percent of Winona County residents are considered overweight or obese, when using their body mass index (BMI) as an indicator. While BMI isn’t always the most accurate predictor of obesity –– for example, highly muscular people have a high BMI –– it is a strong indicator of where a population is at on average, Remington said.
Mental health problems remain at the same percentage as the previous survey –– 28.8 percent of respondents said they suffered from a mental health problem –– but there was more information that showed bleaker news.
“Five-point-six percent of the population has had suicidal thoughts in the last 12 months,” Remington said. “That’s startling.”
While the specific data points for different health problems showcase commonality among county residents, the more important part of the survey is how social issues affect health, Remington explained.
“If you are worried about the basic necessities like food and shelter, you don’t have time to worry about things like when you go and exercise,” she said. “When you’re trying to survive through the day, that’s all you can worry about.”
As an example, Remington highlighted the drinking statistics in the county. For English speakers, 41.8 percent are either heavy drinkers or binge drinkers. Through the data, it may be possible to project that depression and other mental health problems may have causality with drinking problems.
There are also differences between the English responses and the responses translated by Project FINE. According to the survey, 4.4 percent of English-speaking respondents used the community food shelf, while 22.5 percent of non-English speaking respondents used it. Just over 80 percent of English respondents said they never worry about running out of food, while only 46.8 percent of the translated respondents said the same.
“There are also several good drill-down areas we can do to narrow in who we have to serve,” Remington added, noting that the vast majority of e-cigarette users are between the ages of 18 and 34, as an example.
These statistics allow community organizations to hone in on exact demographics and populations that need help, Remington said. Winona Health uses the data to create a plan for three years of initiatives and programs, but it’s not the only organization that uses the data. Multiple non-profits across the county, including Live Well Winona and the local food shelf, use the data to find ways to help complete their missions.
“Collectively, as a community, we now have this data to create an action plan,” Remington said.
Winona Health has always had –– and identified –– priority areas on which to work, Remington explained, but in 2013, it began conducting the more formal CHNA as a result of the Patient Protection and Affordable Care Act (ACA). The ACA requires all hospitals to conduct a CNHA and enact a strategy once every three years to find areas on which to focus resources and strategies.
The assessment has several stages, she explained, and is conducted through a partnership with multiple county organizations. Winona County is required by law to conduct a similar survey every five years, so it works with Winona Health for the CNHA development every three years instead, and Project FINE assists by sending and translating the survey to non-English speaking community members.
“The idea is if we can work together, we get better alignment,” she explained.
The first stage of the CNHA is a survey, which is sent out to 4,000 random county residents. From there, the data is compiled into a draft and shown at a number of public sessions, where community members and stakeholders can discuss the results and let Winona Health officials know what makes sense or what doesn’t. Finally, the results are shared with the community and accessible to the public at any time in the year.
Jill Johnson, Winona County interim community health services administrator, explained that Winona County has done a CNHA for a number of years, even before Winona Health began its work. With the partnership, the county now collaborates with Winona Health though programming and funding, including providing money from a Statewide Health Improvement Partnership grant. Like Winona Health, the county’s community health board uses the data to create long-term plans for community initiatives.
“We will take and look at one of those priorities and see what we can do to improve that over the next few years,” Johnson said.
The data, in covering such a wide variety of different topics and trends, allows for organizations to find information from which they in particular will benefit, Johnson added, whether it’s housing statistics, smoking statistics, exercise or the cost of fruits and vegetables.
“Not all of it is directly the same as what the hospital will use it for, but in a big picture, we want to see the needs in the community that we can work on –– not just in our programs here, but with other groups in the community as well,” Johnson said.