MercyOne town hall offers look into community health assessment data

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By Willis Patenaude, Times-Register


In late January, MercyOne Elkader Medical Center made public a survey to “gather community feedback,” to update the required Clayton County Community Health Needs Assessment (CHNA). The purpose of the assessment is to seek “input from the community regarding health care needs in order to complete this update.” 


In order to accomplish this, MercyOne partnered with other community providers and retained VVV Consultants LLC, an independent health care consulting firm, to conduct this county-wide research. The goal was to understand the “progress in addressing community health needs cited in past reports while collecting up-to-date community health perceptions and ideas.”


According to MercyOne Elkader Chief Executive Officer Brooke Kensinger, the surveys were distributed via email to a listing of community partners/stakeholders, ranging from business owners, healthcare providers, law enforcement and school representatives, to name a few. The listing included 86 community stakeholders. 


The survey link was also shared to the public via the MercyOne Elkader Medical Center Facebook page and Guttenberg Municipal Hospital Facebook page, as well as the MercyOne Elkader Medical Center webpage. A press release was published in each of the county newspapers, with instructions on how to access the CHNA survey. 


The survey had a deadline of March 3, which was followed by a town hall style Zoom meeting on March 31, where the survey and VVV research results were shared. 


Representatives from MercyOne declined to participate in this article, deciding to wait for the final report to be published, but the data was fully discussed and communicated during the town hall meeting. 


During the research phase of the meeting, VVV laid out Clayton County rankings not just compared to the state’s 99 counties, but in comparison to 16 similar rural counties. This secondary research revealed some problematic areas, or trending toward the “yellow” or “red,” including health behaviors, clinical care like access and quality and social and economic factors. However, length of life and quality of life were trending toward “green,” outpacing the rural Iowa norm. 


When it comes to health indicators, issues trending yellow outpaced all others, including the 10.4 percent of persons in poverty, the fact the county has an aging population, with 24.4 percent 65 and older, and the 16.4 percent rate of depression. Adult obesity is also trending red to the point that VVV founder Vince Vandehaar declared the “obesity rate is out of control.”


According to VVV research, 41.1 percent of Clayton County is suffering from adult obesity, despite the research finding access to exercise opportunities was over 79 percent.


Two other indicators were also trending red, including excessive drinking and physical inactivity. Those indicators shed light on the causes of death, most of which are trending red in the county, including cancer, heart disease, diabetes and Alzheimer’s. 


While that research was revealing, the real purpose of the town hall was to discuss the results of the survey. That was almost immediately called into question when it was revealed only 104 people responded. Another complication with the results stems from who actually took the survey, with almost 33 percent working in a health-related field, while 21 percent represented businesses and city and community board members. 


In the responses to the question rating “overall quality” of healthcare delivery in the community, over 76 percent of respondents believed the quality of care is either good or very good. 


Similarly, the feedback suggested 46.1 percent of the community believes “overall community health quality” is increasing or moving up. The obesity rate suggests otherwise, as do the top five un-met needs and ongoing problem areas, which were mental health, drug and substance abuse, poverty, obesity and lack of specialist doctors like pediatricians and OBGYNs, all of which were trending red. Most surprising of all was the fact that awareness of healthcare services came in sixth on the list of un-met needs, as an ongoing problem area. 


Having established areas of poor health, the feedback addressed the root causes of it within the community and three areas trended red: limited access to mental health assistance, chronic disease prevention and limited access to specialty care. Two other areas, lack of health and wellness education and limited access to primary care, were trending yellow.


For ratings of hospital services, most notably where it comes to hospital services such as primary care, lack of access was mentioned as a root cause of poor health, despite being rated as trending green. Other areas that were highly rated were the ambulance services, emergency room, inpatient services, outpatient services and pharmacy, all of which trended green. 


Areas that were rated low or trending red included childcare, dentists, eye doctors, home health, hospice, telehealth, mental health, public health, visiting specialists and walk-in clinics.  


Interestingly, the data also found that 52.5 percent of respondents believe there are not enough providers and staff available at the right times to care for the community, which was trending red by a large margin when compared to similar rural communities. Additionally, 80 percent of respondents claimed that, in the past two years, either they or someone they knew had to receive care outside the community. 


When it comes to additional community feedback, in the comments provided during the Zoom meeting from survey respondents, three of the four directly mentioned health insurance problems. That included lack of affordable options, clinics not accepting certain insurance plans, including the eye care clinics not accepting certain healthcare plans. Several people also mentioned a lack of available care options at all hours, including nights and weekends. 


Of those in attendance, some of the more common answers regarding un-met needs, ongoing problems or areas of concern were drug use such as meth, vaping among teens, telehealth, pediatrics and access to affordable care. 


The data provides a starting point for MercyOne to assess the community’s health needs before the next required assessment in three years. The final report is expected to be released in May.

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