St. Clair County Community Health Needs Assessment Provides Valuable Insights – The Voice
St. Clair County Medical Officer of Health Dr. Annette Mercatante and VIP Research and Evaluation Chair Dr. Martin Hill spoke about the county’s 2021 Community Health Needs Assessment during the monthly Facebook live stream from the Health Department on June 9.
Mercatante said that every three to five years the county does a full CHNA.
“This is our second comprehensive health assessment,” she said. “We also used Dr Hill last time around so there is a lot of consistency. This information is so valuable to guide us in future decision making, intervention and to give us a very good overview of where we are healthy and where we are not and where we can make improvements.
The last Health Department assessment was in 2016. The CHNA is published in full on the Health Department’s website.
Hill said a CHNA is research to discover the health status of the community in terms of needs, problems, gaps in services, assets and resources.
“You really want this information to lead to the implementation of strategies and services where you can address all of these needs, and especially the health disparities in your community,” he said.
He noted that primary data was collected in four different forms, including a behavioral risk factor survey of community residents, in-depth interviews with key stakeholders, an online survey with key informants and a self-administered survey of underserved residents of St. Clair County. Additionally, secondary data was collected from websites such as mortality and life expectancy rates.
When asked how CHNA 2021 is different from the one that took place in 2016, Hill said there were questions about COVID-19, as well as questions about negative childhood experiences. .
Mercatante noted that during a global pandemic, stress levels may be high and people may perceive their environment or health more pessimistically.
“We’ve seen a reduction in people self-reporting their overall health and wellbeing, and is that because of COVID or is it because people’s health is really starting to continue to decline — it’s a community-wide decision or discussion that we need to have as we move forward,” she said.
Hill was asked to compare St. Clair County’s results to other communities. He said the county is doing very well in terms of access to health care and more people have health insurance and a primary care doctor and are confident in navigating the health care system. There were also fewer people foregoing healthcare due to cost than people in Michigan and the United States.
“All of those metrics were also better than they were in 2016,” Hill noted.
He said the county is also doing very well in terms of preventive clinical practices, such as cancer screenings.
“Although the mental health numbers have come down a bit and aren’t as good as the state or the nation in terms of people reporting poor mental health or reporting psychological distress, which I was pleasantly surprised to see is that the proportion … who are taking medications are treating these conditions was better than the state or the nation and also improved from 2016,” he said.
Mercatante noted that St. Clair County Community Mental Health has worked hard to expand its access to mental health treatment.
Hill said St. Clair County is not doing as well as the state or the nation in terms of people reporting their general health as fair or poor, people reporting their physical health as poor, people reporting their mental health as poor and chronic illnesses. .
“Risk behaviors too,” he said. “There are issues with smoking, binge drinking, vaping (and) fruit and vegetable consumption,” he said, but noted that people not eating enough fruit and of vegetables are a problem almost everywhere.
“I would say another issue that I think was a key finding is teen depression: worse than the state or the nation and on the rise since 2016,” he continued. “Also suicidal thoughts and attempts for teenagers or young adults, also in relation to the worse state or nation.”
He said few key informants, including clinicians, nurses, physician assistants, dentists, etc., clinically screen patients or clients for adverse childhood experiences, so this is an area that could see some improvement.
Hill said health disparities were also examined.
“Those with higher incomes or more education will be less likely to engage in risky behaviors – not alcohol, but things like smoking – and they will report better physical and mental health, among other things,” he said. . “We also highlighted other gender and age disparities, but I think the link between education and income is the strongest.”
He said if people with the lowest incomes and education are isolated, they are far more likely to have the worst outcomes, as shown in the behavioral risk factor survey.
Mercatante added that’s why many of the health department’s public health interventions focus on the vulnerable community.
Hill also mentioned that obesity rates have also increased, which is a problem in many counties.
Mercatante said the county’s infant mortality rate was high, while in 2016 it was tied. The county’s infant mortality rate is comparable, but its adult mortality rates were high in 2016 and remain high.
She also noted that the 2021 assessment saw more illnesses like diabetes and heart disease, but less asthma and chronic obstructive pulmonary disease, so the county saw no improvement in its health or health outcomes despite improved access to health care.
“It brings out the importance of the social determinants of health: the things that we don’t really talk about when we talk about health care, but things like transportation and the quality of the environment people live in, talking of education and income, what are the economic opportunities and the racism and other traumas that occur with our minority population,” she said. “So I think those are issues that…as this community moves forward, there needs to be some special attention, because to move that dial a little bit, we’re going to have to pay a little more attention to the social determinants.”
Hill noted that the extracted secondary data is a few years behind the primary data.
It was also noted that there is an increasing number of people considered to be part of the asset-limited, income-limited, employed, or ALICE population.
Mercatante said she thought the COVID-19 data was interesting.
“I’ll be the first to say that we took a lot of heat for some of our COVID mitigation strategies,” she said. “What we found was that the vast majority of people, 80% or more, followed the COVID mitigation strategies – masks and social distancing – and roughly that percentage thought they were having an impact. positive, so that was very reassuring.”
The assessment asked people if COVID-19 had a negative impact on their lives.
“For the community as a whole, about a third of the population said it had negatively impacted their lives in some way, but when we surveyed our underserved population, the population most more at risk, people who have less income, … they reported double that amount,” Mercatante said. “More than 60% of them experienced negative impacts from COVID, which tells us that COVID and really a lot of things that negatively impact our lives are not equally shared in the community.”
COVID-19 Update, Closing Comments
Earlier in the livestream, Mercatante also gave a COVID-19 update for the community.
From June 3-9, the county reported 246 new cases and two deaths.
“We see that our current risk level is low, and that’s because the risk levels (Centers for Disease Control and Prevention) weigh really heavily on the impacts on our health system and our hospitalizations and we don’t see this level of hospitalizations that we are doing with our other variants,” she said, noting that the county went from high-risk status to low-risk status due to her hospitalization status.
As of June 14, the county has reported approximately 43,015 total cases and 839 total deaths during the COVID-19 outbreak.
The June 9 Facebook live stream was Mercatante’s last as medical officer.
“I know it’s been a tough two years and things have changed quickly, but my team and I have worked very hard to bring you the best every time we’re here and we want to thank you for being there. listening,” she said. .
She said everyone will be dealing with COVID-19 for a long time, but she thinks the worst is behind everyone.
“If you’re like me and haven’t moved behind your desk in a while, start a walking program, reach out and talk to someone you’ve lost touch with, join a group that gives you fun and makes you want you have a purpose, do things that help you get through that,” she said. “Now that we’re on the other side, we have to rebuild and we have to recover. in a phase of recovery, both as a community and also as individuals, so I urge you all to keep working on this and stay healthy.If you hear anything that doesn’t sound like everything absolutely correct, look for another source and I can just guarantee that we will always continue to give you the best information possible…. It has been an honor and a pleasure for me to serve you all.