Illinois Project for Local Assessment of Needs

Stark County Health Department

Illinois Project for Local

Assessment of Needs

“To protect and improve the health of the community.”

Submitted, June 2017

Table of Contents

Executive Summary……………………………………………………………………1

Community Health Needs Assessment

Purpose Statement…………………………………………………….………..2

Description of Community Participation………………………………...…….2

Methods…………………………………………………………………….…..3

Results………………………………………………………………….…..…30

Priorities………………………………………………………………….…...30

Community Health Plan

Purpose Statement…………………………………………………………….32

Community Participation……………………………………………….…….32

Community Health Plan Process……………………………………………..32

Priorities………………………………………………………………………32

Mental Health…………………………………………………………34

Poor Health Behaviors………………………………………………...38

Drug/Alcohol/Tobacco Use…………………………………………...42

Aging Population Needs………………………………………………46

Appendices

Documentation of Completion and Board of Health Review of Organizational Capacity

Assessment…………………………………………………………………………….52

Documentation of Board of Health Adoption…………………………………………53

Stark County IPLAN Planning Participants………………………………………..….54

August 31, 2016 Orientation Session…………………………………………….……57

October 26, 2016 Session…………………………………………………….………..62

December 14, 2016 Session……………………………………………….…………..86

Description of Community Resources…………………………………………………97

Resources for Planning………………………………………………………………..100

1

Executive Summary

The Stark County IPLAN (Illinois Project for Local Assessment of Needs) process was

conducted throughout 2016 and early 2017. A group of community representatives met with

members of the Stark County Health Department staff to form the IPLAN planning committee.

Health data and community perceptions were reviewed and three health problems were identified

as community priorities.

Following the identification of the priorities, plans were developed to address each priority.

Outcome and impact objectives were modeled after Healthy People 2020 goals. Below are the

priority health problems with selected interventions.

Mental Health

Promoting education among employers, schools and general public.

Promoting and participation in the countywide task force to address mental health

issues and challenges.

Conduct educational campaign to promote public awareness of mental health &

suicide prevention issues and reduce stigma associated with mental illness.

Poor Health Behaviors

Promoting worksite and community wellness programs.

Promoting chronic disease management educational series.

Promoting community health promotion events.

Drug/Alcohol/Tobacco Use

Institute a Narcan education, training, and kit distribution program for first

responders and law enforcement officials.

Provide drug overdose prevention training (including use of naloxone) to potential

Stark County responders.

Promote the importance that drug use is illegal and highly dangerous and that

complete abstinence from illegal drug use is the healthiest option.

Aging Population

Create new community programming partnerships for planning and distributing

health and well being educational campaigns.

Promote physical and mental wellness education programs among all Stark

County communities.

Conduct educational & screening events to promote public awareness of mental

and physical health issues of an aging population.

The Stark County Health Department IPLAN is a community health assessment and planning

process that is conducted every five years by local health jurisdictions in Illinois. Based on the

Assessment Protocol for Excellence in Public Health (APEX-PH) model, IPLAN is grounded in

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the core functions of public health and addresses public health practice standards. The

completion of IPLAN fulfills most of the requirements for Local Health Department certification

under Illinois Administrative Code Section 600.400: Certified Local Health Department Code

Public Health Practice Standards. The essential elements of IPLAN are as follows:

An organizational capacity assessment

A community health needs assessment

A community health plan, focusing on a minimum of three priority health problems


Purpose Statement The purpose of the Stark County IPLAN is to identify the most significant health problems in the

community and develop strategies to address those problems. This process results in a

community health plan, created at the local level, which addresses four health priorities with

time-referenced and measurable objectives within proven intervention strategies. The IPLAN

assessment will assist in the forward progression of the health status of Stark County. The data

acquired will also be of assistance in pursuing and procuring grant opportunities to benefit Stark

County residents by government and non-government organizations. The IPLAN is very much a

community process requiring the expertise and commitment of a number of people, both within

and outside of the health care community.

Description of Community Participation The Stark County IPLAN Planning Committee consisted of 18 representatives from the

community along with 5 staff members from the Stark County Health Department. Community

representatives came from a variety of backgrounds including agriculture, education, social

services, providers and media. Planning Committee members include:

John A. Ballentine, Stark County News

Bill Baumann, Stark County Citizen’s Mental Health Task Force

Doris Bogner, Stark County Health Board

Maggie Brooks, North Central Behavioral Health System

Dorothy David, Stark County Health Department

Chad Gripp, Bradford School District #1

Lee Hager, Stark County Health Board

Betty Hoy, Retired Pharmacist

Kelli Humphrey, Stark County Health Department

William Lamb, Stark County School District #100

Thomas Marten, Stark County Farm Bureau

Mary Prayne, Central Illinois Area Agency on Aging LPN

Crystal Rosebecke, Tri County Opportunities Council

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Sharon Sager, Stark County Health Board

Beth Smith, Stark County Health Department

Duane Stevens, Stark County Health Department

RaeAnn Tucker-Marshall, Stark County Health Department

Sue VanDeRostyne, Toulon Rehab

Stark County Community Health Educator, Beth Smith, presented a comprehensive Community

Overview data analysis of Stark County on October 26, 2016. Committee members were

encouraged to share data they found relevant to the needs assessment within their personal and

professional spheres of influence. A key component of the needs assessment was community

perception. Committee members were encouraged to contribute and collect perceived health

issues of interest to county residents.

Methods The community health assessment began in August 2016 with a review of the IPLAN process.

Examples of problem identification and analysis were provided. The procedure used in this

process was also outlined in the guidelines for IPLAN recertification. The APEX/PH manual

was used as a reference. A data analysis was conducted of secondary sources of information.

Topics include population size, race/ethnicity, age, gender, income, employment, crime, births,

deaths, health behaviors, morbidity, hospitalization, and health care utilization. Two major

sources of information for the Community Overview are the U.S. Census Bureau and Illinois

Department of Public Health. Much of the detailed Census information comes from the 2010

actual population counts and the 2010-2014 American Community Survey five-year estimates.

Other data sources include the Illinois Department of Public Health, the Illinois Behavioral Risk

Factor Surveillance System, the Illinois County Health Rankings, the National Institutes of

Health, the National Cancer Institute, the Centers for Disease Control and Prevention, the US

Department of Health and Human Services, the Illinois Youth Survey, the Illinois Department of

Children and Family Services, Illinois Hospital Association’s COMP data, and several other state

and local agencies.

The data was organized into the following categories:

Demographic & Socioeconomic Characteristics

Population

Importance of the measure: Population data characterizes the individuals residing within the

jurisdictional boundaries of Stark County. Population data provides an overview of population

growth and trends and builds a foundation for additional analysis of data.

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Growth Rates

Data from the last census indicate the population of Stark County has seen near negligible

decrease (1.6%) between 2010 and 2014.

Stark County’s 2010-2014 U.S. Census Bureaus’ American Community Survey estimates

population at 5,994 and it continues to decline witnessed during previous decades. The 5.3%

decline from 2000 to 2010 exceeds the 3.1% decline between 1990 and 2000. The steepest drop

of the past 60 years occurred in the 1980s (-11.6%). The chart below denotes the population

change from 2010-2015 which shows Stark County’s population experiencing a decrease of

2.3%; while Illinois (0.3%) and US (2.5%) saw population increases.

Stark County is located approximately 30 miles northwest of Peoria. Its land area is 288 square

miles. The largest community in Stark County is Wyoming at a population of 1,429. Toulon,

the County Seat is the second largest city with a population of 1,292.

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Age, Gender and Race Distribution

Age

As indicated in the graph below, the median age in Stark County stands at 45.9. This is

markedly older compared to the median age of Illinois (37.3) and the US (37.8).

Age by Generation

Looking at the breakdown of age groups in the generation analysis of Stark County; we see the

greatest percentage concentrations come in the 50s (14.1%), 60s (14.4%), and 70s (16.3%).

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Gender

In the two graphs below we see that Gender considerations in Stark County’s population are

fairly equal; as the Median ages between men and women, and the population size amongst the

two sexes are comparably the same.

Race

According to 2016 data from the U.S. Census Bureau, when classified into race/ethnic

categories, almost all (97.6%) of Stark County is white, non-Hispanic. Hispanics account for 1%,

Blacks, 0.8%, Asians, 0.6%.

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Family Composition

In Stark County, 2016 data from the US Census Bureau, shows that households in Stark County

are Married Couples (84%), Male Head Alone (7%) and Female Head Alone (9%) respectively.

Unemployment

According to the latest data from the American Community Survey and US Census, Stark

County has a 4.5% Unemployment compared to the State of Illinois and the US rates that stand

at 6% each.

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Educational Attainment

According to Education data using the latest 2016 American Community Survey, that chart

below shows the number of people 25 years or older who have graduated from high school or

completed the GED or equivalent credential. Stark County has 89% high school graduates or

better. The State of Illinois sits at 88% and the US at 87% for this same measure.

Median Household Income

The chart below reports median household income for the county, state, and U.S. from 2016 data

from the US Census Bureau. The chart shows a complete view of income which includes all

members in a household using the median household income and it has Stark County at $50,085

median income. Comparing median income to the United States average of $53, 889, Stark

County is about 7.6% smaller. Also compared to the State of Illinois, median income of

$57,574, Stark County is 15.0 % smaller.

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General Health and Access to Care

Importance of the measure: Preventative healthcare measures, including scheduling a routine

well-visit, getting a flu shot, engaging in a healthy lifestyle, and undertaking screenings for

diseases are essential to combating morbidity and mortality while reducing healthcare costs.

Healthy Lifestyle

A healthy lifestyle, comprised of regular physical activity and balanced diet, has been shown to

increase physical, mental, and emotional well-being.

Physical Exercise

According to recent data, 67.38% of Stark County residents exercised less than 3 times a week

for at least 30 minutes or more. According to the 2nd

graph, the 2 most common causes for

failure to exercise were not having enough time to or being too tired.

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Healthy Eating

Nutrition and diet are critical to preventative care. (58.72%) of Stark County residents report no

consumption or low consumption (1-2 servings per day) of fruits and vegetables per day. Note

that the percentage of Stark County residents who consume five or more servings per day is only

6.81%.

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Health Status

Importance of the measure: Self-perceptions of health can provide important insights to help

manage population health. Not only do self-perceptions provide benchmarks regarding health

status, but they can also provide insights into how accurately people perceive their own health.

Physical Health

According to the Illinois Behavioral Risk Factor Surveillance System there was a increase in the

percentage of Stark County residents reporting they felt physically unhealthy on 8 or more days

per month in 2014 (17.6%) versus 2009 (11.8%).

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Mental Health

Nearly 20% of residents in Stark County reported they had experienced 1-7 days with poor

mental health per month in 2007-2009, and 12.1% felt mentally unhealthy on 8 or more days per

month. In 2010-2014, there was a slight increase in the number of people that reported poor

mental health for 1-7 days and a slight decrease in people that reported poor mental health 8 or

more days per month.

Self Perceptions of Overall Health

Over half (63.95%) of Stark County Residents report having good overall physical health, while

3.86% rated themselves as having poor physical health. In regard to overall mental health,

77.82% of respondents stated they have good overall mental health and 2.58% stated it is poor.

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Accessibility

Importance of the measure: It is critical for healthcare services to be accessible. Therefore,

accessibility to healthcare must address both the associated financial costs and the supply and

demand of medical services.

Choice of Medical Care

Survey respondents were asked to select the type of healthcare facility used when sick. Six

different alternatives were presented, including clinic or doctor’s office, emergency department,

urgent-care facility, health department, no medical treatment, and other. The modified sample of

233 respondents was used for general population in order to more accurately reflect the

demographic characteristics for Stark County.

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The most common response for source of medical care was clinic/doctor’s office, chosen by

83.76% of survey respondents. This was followed by urgent care (10.26%), the emergency

department at a hospital (2.56%), not seeking medical attention (1.71%), and the health

department (0.85%).

Insurance Coverage

With regard to medical insurance coverage, data gathered from the CHNA Survey shows that

residents in Stark County healthcare coverage includes Private/Commercial (50.21%),

Medicare (45.96%), None (3.40%), and Medicaid (0.43%).

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Access to Care

In the CHNA survey, respondents were asked, “Was there a time when you needed care but were

not able to get it?” Access to four types of care were assessed: medical care, prescription

medications, dental care and counseling. Survey results show that 9.52% of the population did

not have access to medical care when needed; 6.03% of the population did not have access to

prescription medications when needed; 5.19% of the population did not have access to dental

care when needed; and 4.39% of the population did not have access to counseling when needed.

Demographic Factors Related to Access to Care

Several demographic characteristics show a significant relationship with an individual’s ability

to access care when needed. The following relationships were found using correlational analyses:

Access to medical care tends to be higher for older people, White people, and lower for Latino

residents and the homeless.

Access to prescription medications tends to be higher for White people, and those with higher

education and income. Homeless people are less likely to have access to prescription

medications.

Access to dental care tends to be greater for people with the following characteristics: older

people, White people, and those with higher education and higher income. Homeless people are

less likely to have access to dental care.

Access to counseling tends to be rated higher by White people.

Reasons for No Access – Medical Care

Survey respondents who reported they were not able to get medical care when needed were

asked a follow-up question. The leading causes of the inability to gain access to medical care

were too long to wait for an appointment (52.38%), the inability to afford the copay (23.81%),

and no insurance (19.05%), Refusal of insurance by physician (4.76%) was also relatively

frequent.

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Reasons for No Access – Prescription Medication

Survey respondents who reported they were not able to get prescription medications when

needed were asked a follow-up question. In Stark County, the leading causes of the inability to

gain access to prescription medicine were the inability to afford copayments or deductibles

(40%) and no insurance (20%). Note that total percentages do not equal 100% as respondents

could choose more than one answer or did not respond to the question.

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Reasons for No Access – Dental Care

Survey respondents who reported they were not able to get dental care when needed were asked

a follow-up question. The leading causes of inability to gain access to dental care were no

insurance (42.86%), and the inability to afford copayments or deductibles (35.71%). The dentist

refused to take my insurance or Medicaid was also a frequently cited cause, with 7.14%. Note

that total percentages do not equal 100% as respondents could choose more than one answer.

Reasons for No Access – Counseling

Survey respondents who reported they were not able to get counseling when needed were asked

a follow-up question. In Stark County, the leading causes of the inability to gain access to

counseling were the lack of insurance (25%), health provider refused to take my insurance or

Medicaid (16.67%), and didn’t know how to find a mental health provider (16.67%). Note that

total percentages do not equal 100% as respondents could choose more than one answer.

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Maternal and Child Health

Healthy Babies

Importance of the measure: Regular prenatal care is a vital aspect in producing healthy babies

and children. Screening and treatment for medical conditions as well as identification and

interventions for behavioral risk factors associated with poor birth outcomes are important

aspects of prenatal care. Research suggests that women who receive adequate prenatal care are

more likely to have better birth outcomes, such as full term and normal weight babies. Prenatal

care can provide health risk assessments for the mother and fetus, early intervention for medical

conditions and education to encourage healthy habits, including nutritional and substance-free

health during pregnancy.

Low Birth Weight Rates

Low birth weight rate is defined as the percentage of infants born below 2,500 grams or 5.5

pounds. Very low birth weight rate is defined as the percentage of infants born below 1,500

grams or 3.3 pounds. In contrast, the average newborn weighs about 7 pounds. According to the

County Health Rankings in Illinois the percentage of babies born with low birth weight in Stark

County stood at (8.6%). That same year the State of Illinois average was (8.4%) and the U. S.

average was (8.2%).

Early Sexual Activity Leading to Births from Teenage Mothers

According to 2016 data from the US Census Bureau (see the graphs below) Stark County far

outpaced the State of Illinois and the US in the percentage of Teenager Birth Rates as Stark

County stands at (17%) and Illinois and the US at (5%) each.

This is echoed in the rates for Unwed Mothers as % of All Births. Stark County is at (39%) and

Illinois and the US are both at (36%).

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Preterm Births

According to 2016 data from US Department of Health and Human Services and the Centers for

Disease Control and Prevention the percentage of Preterm Births for Stark County is 13.0%. The

Median Average for the United States is 12.1% and the Healthy People 2020 goal is 11.4%.

Chronic Disease, including Cancer Incidence

Mortality

Importance of the measure: Presenting data that focuses on causes of mortality provides an

opportunity to define and quantify which diseases are causing the most deaths. The top two

leading causes of death in the State of Illinois and Stark County are similar as a percentage of

total deaths in 2013.

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Overweight and Obesity

Importance of the measure: Individuals who are overweight and obese place greater stress on

their internal organs, thus increasing the propensity to utilize health services. Research strongly

suggests that obesity is a significant problem facing youth and adults nationally, in Illinois, and

within Stark County. The US Surgeon General has characterized obesity as “the fastest-growing,

most threatening disease in America today.” According to the Obesity Prevention Initiative from

the Illinois General Assembly, 20% of Illinois children are obese. The financial burden of

overweight and obese individuals is staggering, as the estimated annual medical costs attributed

to obesity in Illinois for 1998-2000 exceeded $3.4 billion, ranking Illinois 6th in the nation for

obesity-attributed medical costs.

With children, research has linked obesity to numerous chronic diseases including Type II

diabetes, hypertension, high blood pressure, and asthma. Adverse physical health side effects of

obesity include orthopedic problems due to weakened joints and lower bone density. Detrimental

mental health side effects include low self-esteem, poor body image, symptoms of depression

and suicide ideation. Obesity impacts educational performance as well; studies suggest school

absenteeism of obese children is six times higher than that of non-obese children.

With adults, obesity has far-reaching consequences. Testimony to the Illinois General Assembly

indicated that obesity-related illnesses contribute to worker absenteeism, slow workflow, and

high worker compensation rates. A Duke University study on the effects of obesity in the

workforce noted 13 times more missed workdays by obese employees than non-obese

employees. Nationwide, lack of physical activity and poor nutrition contribute to an estimated

300,000 preventable deaths per year.

In Stark County, the number of people diagnosed with obesity and being overweight has

increased over the years from 2007-2009 to 2010-2014. According to the Illinois Behavioral

Risk Factor Surveillance System in 2013 the percentage of Stark County residents considered

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Overweight (37%) and Obese (32.80%) were greater than the average for the State of Illinois

Overweight (35.30%) and Obese (29.40%).

Predictors of Heart Disease

Residents in Stark County report a higher than State average prevalence of high cholesterol.

According to data from the Illinois Behavioral Risk Factor Surveillance System, in both 2009

and 2013 the percentage of residents who report they have high cholesterol is higher in Stark

County (40.9% and 48.8%) than the State of Illinois average of (37.3% and 36.6%).

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With regard to high blood pressure, Stark County has a higher percentage of residents with high

blood pressure than residents in the State of Illinois as a whole. The percentage of Stark County

residents reporting they have high blood pressure increased from 33.9% in 2009 to 53.50% in

2013.

MORBIDITY AND MORTALITY

Given the lack of recent disease/morbidity data from existing secondary data sources, much of

the data used in this chapter was manually gathered from Stark County area hospitals using

COMP data. Note that hospital-level data only show hospital admissions and do not reflect

outpatient treatments and procedures.

Respiratory

Importance of the measure: Disease of the respiratory system includes acute upper respiratory

infections such as influenza, pneumonia, bronchitis, asthma, emphysema, and Chronic

Obstructive Pulmonary Disease (COPD). These conditions are characterized by breathlessness,

wheezing, chronic coughing, frequent respiratory infections, and chest tightness. Many

respiratory conditions can be successfully controlled with medical supervision and treatment.

However, children and adults who do not have access to adequate medical care are likely to

experience repeated serious episodes, trips to the emergency room and absences from school and

work. Hospitalization rates illustrate the worst episodes of respiratory diseases and are a proxy

measure for inadequate treatment.

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Asthma

The percentage of residents that have asthma in Stark County has decreased slightly between

2007- 2009 and 2010-2014, while State averages are increasing slightly. According to the Illinois

BRFSS, asthma rates in Stark County (6.3%) are lower than the State of Illinois (13.8%).

Cancer

Importance of the measure: Cancer is caused by the abnormal growth of cells in the body and

many causes of cancer have been identified. Generally, each type of cancer has its own

symptoms, outlook for cure, and methods for treatment. Cancer is the 2nd

leading cause of death

in Stark County. The most prevalent cancers in the State of Illinois are prostate cancer, breast

cancer and lung and bronchus cancer, respectively. The Stark County incidence of these cancers

can be seen below.

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Diabetes

Importance of the measure: Diabetes is the leading cause of kidney failure, adult blindness and

amputations and is a leading contributor to strokes and heart attacks. It is estimated that 90-95%

of individuals with diabetes have Type II diabetes (previously known as adult-onset diabetes).

Only 5-10% of individuals with diabetes have Type I diabetes (previously known as juvenile

diabetes).

Data from the Illinois BRFSS indicate that in 2012 8.6% of Stark County adult residents have

diabetes. Trends are concerning, as the prevalence of diabetes is increasing dramatically in Stark

County and is approaching the State of Illinois average.

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Infectious Diseases

Importance of the measure: Infectious diseases, including sexually transmitted infections and

hepatitis, are related to high-risk sexual behavior, drug and alcohol abuse, limited access to

healthcare, and poverty. It would be highly cost-effective for both individuals and society if more

programs focused on prevention rather than treatment of infectious diseases.

Chlamydia and Gonorrhea Cases

The data for the number of infections of Chlamydia in Stark County from 2012 indicate an

infection rate (per 100,000 pop.) of 247 compared to the State of Illinois at 526.1 and the U.S. at

456.7. The second graph shows this infection rate has continued in a steady increase since 2003.

The graph on Gonorrhea incidence rates shows increases as well, but numbers that still trail State

and U.S. rates.

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Environmental, Occupational and Injury Control

Tobacco Use

Importance of the measure: In order to appropriately allocate healthcare resources, a thorough

analysis of the leading indicators regarding morbidity and disease must be conducted. In this

way, healthcare organizations can target affected populations more effectively. Research

suggests tobacco use facilitates a wide variety of adverse medical conditions. There was a slight

decrease in the percentage of Stark County residents reporting they were current smokers

between 2007-2009 (21%) and 2010-2014 (14.8%). There was also an increase in the percentage

of Stark County residents reporting they were current non-smokers between 2007-2009 (54.2%)

and 2010-2014 (55%).

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Drug and Alcohol Abuse

Importance of the measure: Alcohol and drugs impair decision-making, often leading to adverse

consequences and outcomes. Research suggests that alcohol is a gateway drug for youth, leading

to increased usage of controlled substances in adult years. Accordingly, the substance abuse

values and behaviors of high school students is a leading indicator of adult substance abuse in

later years.

Data from the 2016 Illinois Youth Survey measures illegal substance use (alcohol, tobacco, and

other drugs – mainly marijuana) among adolescents. Stark County is at or below State averages

in all categories among 8th graders except for cigarette usage.

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Injuries

Importance of the measure: Unintentional injuries are injuries or accidents resulting from car

accidents, falls and unintentional poisonings. In many cases, these types of injuries—and the

deaths resulting from them—are preventable. Suicide is intentional self-harm resulting in death.

These injuries are often indicative of serious mental health problems requiring the treatment of

other trauma-inducing issues.

Intentional – Suicide

According to 2016 data from the CDC, the death/suicide rate per 100,000 in Stark County

indicates higher incidence than the State of Illinois, as the Stark County rate was 16 per 100,000

and the State rate was 10.46.

Unintentional – motor vehicle

Research suggests that car accidents are a leading cause of unintentional injuries. In Stark

County, the number of incidents between 2009 and 2013 for several types of motor vehicle

collisions and accidents has increased slightly but is significantly higher than State of Illinois and

U.S. averages.

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Violent Crimes

Violent crimes are defined as offenses that involve face-to-face confrontation between the victim

and the perpetrator, including homicide, forcible rape, robbery, and aggravated assault. Violent

crime is represented as an annual rate per 100,000 people. According to the latest data from the

CDC the rate of violent crime for Stark County stands at 134.4 in comparison to the U.S. rate of

199.2.

Sentinel Events

Suicide: Healthy People 2020 identified the target suicide rate of 10.2 per 100,000. Based on

2016 data from the CDC, the Stark County’s suicide rate was 16. This was over the rate in

Illinois which stands at 10.46.

Sentinel Events Indicating Lack of Access to Care: These are conditions that the presence of

which will indicate that the community lacks access to primary care. A reduction in

hospitalization for these conditions does not necessarily mean a reduction in incidence of those

diseases, but may infer they are being addressed at primary care clinics, which, in turn, reduces

unnecessary hospitalization.

Sentinel Events Indicating Cancer: This includes cancers in their late stages, the presence of

which indicate lack of access to care in the community. Stark County’s cancer death rate per

100,000 is 187.6. This outpaces the rate for the State of Illinois at 161.22.

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PRIORITIZATION OF HEALTH RELATED ISSUES

In this section, we identify the most critical health-related needs in the community. To

accomplish this, we first consider community perceptions of health issues, unhealthy behaviors

and issues related to well-being. Using key takeaways from each chapter, we then identify

important health-related issues in the community. Next, we complete a comprehensive inventory

of community resources; and finally, we prioritize the most significant health needs in the

community.

Specific criteria used to identify these issues included: (1) magnitude in the community; (2)

severity in the community; (3) potential for impact to the community.

Perceptions of Health Issues

The CHNA survey asked respondents to rate the three most important health issues in the

community. Respondents had a choice of 15 different options.

The health issue that rated highest was aging issues. It was identified 61.34% of the time. This

was followed by cancer, and several specific concerns such as heart disease, diabetes, mental

health, and obesity.

Note that perceptions of the community were accurate in some cases. For example, cancer is a

leading cause of mortality in Stark County. Also, obesity is an important concern and the survey

respondents accurately identified these as an important concern and the survey respondents

accurately identified these as an important health issues.

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Perceptions of Unhealthy Behaviors

Respondents were asked to select the three most important unhealthy behaviors in the

community out of a total of 12 choices. The two unhealthy behaviors that rated highest were

drug abuse and alcohol abuse.

Results

Health indictors were analyzed for trends and also compared with corresponding state, national,

as well as Healthy People 2020 goals where available and applicable. Stark County is very

heterogeneous geographically, racially, and ethnically. Therefore, effort was made to compare

rates among communities and also highlight racial/ethnic disparities where available and

relevant.

Priorities

The committee reviewed the results of the prioritization process and determined the following

priorities:

Mental Health


Aging Population


Stark County narrowed the focus to four health priorities. Four sub-groups were formed from

the larger committee to deliberate the community health plan for each of these priorities.

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Prioritization Method & Results Following the presentation of data located in the Appendices to the committee, a modified

version of the Hanlon method of problem prioritization was utilized. The committee was guided

through a facilitated discussion of areas of concern following the presentation of the data. Nine

areas emerged as areas of concern:

Mental Health

Substance Abuse

Youth Mental Health

Aging Population Needs

Diet and Exercise

Obesity

Tobacco Use

Diabetes

Alcohol

Community Resources

After summarizing potential categories for prioritization in the Community Health Needs

Assessment, a comprehensive analysis of existing community resources was performed to

identify the efficacy to which these 9 health-related areas were being addressed. Justifications

for these areas of concern were presented to the committee. The committee members were asked

for input on public perception of what health problems were most prevalent in Stark County.

The prioritization method used was the modified version of the Hanlon method. This method,

which has been called both the Hanlon Method and the Basic Priority Rating System (BPRS), is

described in Public Health: Administration and Practice (Hanlon and Pickett, Times

Mirror/Mosby College Publishing) and Basic Health Planning (Spiegel and Hyman, Aspen

Publishers).

The method has three major objectives:

to allow decision-makers to identify explicit factors to be considered in setting priorities

to organize the factors into groups that are weighted relative to each other

to allow the factors to be modified as needed and scored individually.

The committee deliberated and individually ranked the size of the problems, seriousness, and

known interventions for each problem and submitted their top three health concerns. Committee

members were encouraged to share the data among their family and friends and share their

thoughts of the most prevalent and serious health problems in Stark County. The following

health problems emerged as IPLAN priorities:

Mental Health

Poor Health Habits

Aging Population

Alcohol and Abuse

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Community Health Plan

Purpose

The purpose of the Stark County community health planning process was to develop a strategic

approach to community health improvement that would leverage resources countywide to

address priority health problems through the development of a local community health plan,

incorporating agencies and organizations whose efforts can contribute to the health of the

community.

Community Participation

Key community stakeholders of the Stark County public health system were invited to

participate in the development of a community health plan that would address the priority health

issues. These participants included local hospitals, members of the medical profession, mental

health service providers, social service agencies, educational institutions, community health

centers, advocacy organizations, and the Stark County Health Department.

Community Health Process

Committee members met on December 14, 2016 in Toulon, Illinois to complete the Health

Problem Analysis Worksheets organized around the three strategic issues. Committee members

shared community perception and reviewed direct and indirect contributing factors for each

issue. The results of the Health Problem Analysis Worksheets were compiled and a final version

of each Health Problem Analysis Worksheet is included within each community health priority.

Description of Priorities

Mental Health

Nearly 20% of residents in Stark County reported they had experienced 1-7 days with poor

mental health per month in 2007-2009, and 12.1% felt mentally unhealthy on 8 or more days per

month. In 2010-2014, there was a slight increase in the number of people that reported poor

mental health for 1-7 days and a slight decrease in people that reported poor mental health 8 or

more days per month. One of the most common non birth-related diagnoses for hospitalization

was psychoses. Psychoses and behavioral and developmental disorders were the leading causes

of hospitalization for ages 5-17 and psychoses was the leading cause of hospitalization among

ages 18-44. With a growing Medicaid population and the limited availability of behavioral

health providers accepting Medicaid, appropriate access to services to identify, diagnose, and

treat individuals with depression were of great concern to Planning Committee members.

Healthy People 2020 identifies the target of 10.2 suicides per 100,000. Based on the latest data

from the CDC, the Stark County suicide rate is 16.

34


Cardiovascular (heart and stroke) death is the leading cause of death in Stark County.

Cardiovascular disease, diabetes, and many forms of cancer share common risk factors. These

factors include aging, high blood pressure, high blood cholesterol, inactivity, poor nutrition, and

obesity. Residents in Stark County report a higher than State average prevalence of high

cholesterol. According to data from the Illinois Behavioral Risk Factor Surveillance System , in

both 2009 and 2013 the percentage of residents who report they have high cholesterol is higher

in Stark County (40.9% and 48.8%) than the State of Illinois average of (37.3% and 36.6%).

With regard to high blood pressure, Stark County has a higher percentage of residents with high

blood pressure than residents in the State of Illinois as a whole. The percentage of Stark County

residents reporting they have high blood pressure increased from 33.9% in 2009 to 53.50% in

aging, high blood pressure, high blood cholesterol, inactivity, poor nutrition, and obesity.

Individuals, who are overweight and obese, place greater stress on their internal organs; thus

increasing the propensity to utilize health services. Research strongly suggests that obesity is a

significant problem facing youth and adults nationally, in Illinois, and within Stark County. The

US Surgeon General has characterized obesity as “the fastest-growing, most threatening disease

in America today.” Nationwide, lack of physical activity and poor nutrition contribute to an

estimated 300,000 preventable deaths per year.

Aging Population

The median age in Stark County stands at 45.9 which is markedly older compared to the median

age of Illinois (37.3) and the US (37.8). Looking at the breakdown of age groups in the

generation analysis of Stark County; we see the greatest percentage concentrations come in the

50s (14.1%), 60s (14.4%), and 70s (16.3%). Approximately 92% of older adults have at least one

chronic disease, and 77% have at least two. Four chronic diseases—heart disease, cancer, stroke,

and diabetes—cause almost two-thirds of all deaths each year. Chronic diseases account for 75%

of the money our nation spends on health care, yet only 1% of health dollars are spent on public

efforts to improve overall health. The Planning Committee feels the health concern of this

important and majority sector of the Stark County population should be considered and

addressed.


Research suggests tobacco use facilitates a wide variety of adverse medical conditions. There

was a slight decrease in the percentage of Stark County residents reporting they were current

smokers between 2007-2009 (21%) and 2010-2014 (14.8%). There was also an increase in the

percentage of Stark County residents reporting they were current non-smokers between 2007-

2009 (54.2%) and 2010-2014 (55%). Alcohol and drugs impair decision-making, often leading to

adverse consequences and outcomes. Research suggests that alcohol is a gateway drug for youth,

leading to increased usage of controlled substances in adult years. Data from the 2016 Illinois

Youth Survey measures illegal substance use (alcohol, tobacco, and other drugs – mainly

marijuana) among adolescents. Stark County is at or below State averages in all categories

among 8th graders except for cigarette usage. Accordingly, the substance abuse values and

behaviors of high school students is a leading indicator of adult substance abuse in later years.

35

Analysis of Priorities

Mental Health

Mental health is a state of successful performance of mental function, resulting in productive

activities, fulfilling relationships with other people, and the ability to adapt to change and to cope

with challenges. Mental health is essential to personal well-being, family and interpersonal

relationships, and the ability to contribute to community or society. Mental disorders and mental

illness are not homogeneous terms. Mental disorders are health conditions characterized by

alterations in thinking, mood, and/or behavior that are associated with distress and/or impaired

functioning. Mental disorders contribute to a host of challenges that may include disability, pain

or even death. Mental illness is the term referring collectively to all diagnosable mental

disorders.

Mental disorders generate an immense volume of public health burden of disability. According

to the National Institute of Mental Health (NIMH), in any given year, an estimated 13 million

American adults (approximately 1 in 17) have a seriously debilitating mental illness. Mental

health disorders are the leading cause of disability in the United States and Canada, accounting

for 25 percent of all years of life lost to disability and premature mortality. Moreover, suicide is

the 11th leading cause of death in the United States, accounting for the deaths of approximately

30,000 Americans each year.

Accessing mental health care is difficult for some individuals. Barriers include lack of

knowledge about available mental health services, skepticism about the effectiveness of

treatment, lack of a usual source of primary care, which is frequently the first line in diagnosing

mental disease, transportation, and lack of mental health insurance or funds to pay for treatment.

System barriers may include lack of resources or attention devoted to mental health diagnosis

and treatment.

Mental health and physical health are closely connected. Mental health plays a major role in

people’s ability to maintain good physical health. Mental illnesses, such as depression and

anxiety, affect people’s ability to participate in health-promoting behaviors. In turn, problems

with physical health, such as chronic diseases, can have a serious impact on mental health and

decrease a person’s ability to participate in treatment and recovery.

Demographic Study

According to 2016 data from the CDC, the death/suicide rate per 100,000 in Stark County

indicates higher incidence than the State of Illinois, as the Stark County rate was 16 per 100,000

and the State rate was 10.46. Healthy People 2020 identified the target rate of 10.2 suicides per

100,000. Of the Stark County residents participating in the 2010-2014 BRFSS, 11.3% indicated

eight or more days they were not in good mental health in the past month. One of the most

common non birth-related diagnoses for hospitalization was psychoses. Psychoses and

behavioral and developmental disorders were the leading causes of hospitalization for ages 5-17

and psychoses were the leading cause of hospitalization among ages 18-44. One barrier to

receiving mental health services is the inability to afford appropriate care. According to U.S.

36

Census 2005-2009 American Community Survey and decennial Censuses, 18.7% of children

under age 18 live in poverty.

Health Problem

Beyond access challenges with the mental health system, there is a lack of awareness of the need

for and appropriate utilization of mental health services among those in need, and awareness of

providers in the larger health care system is believed to be low. Marketing and promotion of

mental health issues and services to both public and primary care providers is inadequate.

Barriers such as stigma, transportation, and language reduce demand and utilization of services.

As a result, the number of current consumers of mental health services may seriously undercount

aggregate community need as those on waiting lists and those yet to be identified are not

properly accounted.

The major mental health issues facing Stark County revolve around reducing the prevalence of

untreated mental illness by increasing the capacity for mental health service delivery primarily

through reducing fragmentation and increasing system-level coordination and collaboration.

Increasing awareness of the mental health service availability among potential system users and

non-mental health providers are also important, especially in school and primary care settings.

These strategies will expand treatment options for a variety of at-risk population groups,

including adolescents; this is consistent with the objectives reported in Healthy People 2020.

Risk Factors

For many, lifelong mental disorders may start in childhood or adolescence. For many other

children, normal development is disrupted by biological, environmental, and psychosocial

factors, which impair their mental health, interfere with education and social interactions, and

prevent them from achieving their full potential as adults. Over a period of time, these

undiagnosed and untreated mental illnesses compound as thoughts of suicide prevail.

Contributing Factors

Direct Indirect

Lack of affordable and early assessment

services and screenings

Increased cost of psychotropic drugs

Moderate willingness to address mental

health issues

Inadequate rate of reimbursement

Lack of knowledge of mental health

resources

Primary care practices

Lack of available specialists/psychiatrists Inadequate physical activity

Lack of coordination among service

providers

Uninsured or underinsured

Undeveloped coping skills Lack of inpatient care facilities

Denial of mental illness Negative social stigmas

Improper use of medication Behavioral health treatment funding cuts

Lack of community support systems Policymakers failure to comprehend scope

of problem

37

Barriers Resources for Programming

Cost, inability to afford care or medication Healthcare providers

Lack of or high deductible health insurance Schools and colleges

Transportation A variety of services for children and

adolescents

Lack of understanding of long-term

benefits

Faith community

Lack of coordination among service

providers

Civic and business organizations

Lack of available specialists/psychiatrists Existing mental health organizations and

service providers in the region

Public stigmas and perceptions Local media

Socioeconomic status and cultural

differences


Illinois Department of Public Health

National Council for Behavioral Health

Care

Community Health Improvement Goal(s)

Improve mental health through prevention and by ensuring access to appropriate, quality mental

health services.

Outcome Objective

By 2022, reduce the suicide rate to 10.2 suicides per 100,000. Currently, Stark County is at 16

per 100,000 population. (The Healthy People 2020 goal is 10.2 per 100,000 population.)

Impact Objectives

0. By 2018, new community programming partnerships will be established as a result of

planning and educational campaigns.

1. By 2019, suicide education programs will be promoted among all Stark County

communities.

Intervention Strategies

Establish partnerships among service agencies, professional associations, and families

and caregivers to facilitate the transfer of knowledge, research, practice, and policy

related to mental health.

Engage professional organizations in educating new frontline providers in various

systems (e.g., teachers, physicians, nurses, hospital emergency personnel, daycare

providers, probation officers, and other healthcare providers) in mental health; equip

them with skills to address and enhance mental health; and train them to recognize early

symptoms of emotional and behavioral problems for proactive intervention.

Conduct educational campaign to promote public awareness of mental health issues and

reduce stigma associated with mental illness, working in partnerships with the media,

youth, public health systems, communities, health professionals, employers, and

advocacy groups. Target Human Resource directors and office managers.

38

Identify a comprehensive and quality suicide education program (and funding) which will

appropriately raise awareness of suicide and direct employees in need of mental health

services.

Evaluation

Establish baseline information on current utilization of mental health services in Stark

County.

Document educational program participation, monitoring the knowledge gained through

programming and the diversity of frontline providers who participate.

Conduct process evaluation, document program implementation strategies for the

comprehensive suicide education program to ensure consistency of program delivery and

quality assurance.

Stark County Death Certificates.

Potential Funding Resources

The Substance Abuse and Mental Health Services Administration (SAMHSA)

Stark County Citizens Mental Health Task Force

Private foundations

Employers and school districts

39


Issues

Heart disease is the leading cause of death in the United States and Stark County. Together,

heart disease and stroke are among the most widespread and costly health problems, but also

they are among the most preventable. The leading controllable risk factors for heart disease and

stroke are:

high blood pressure

high cholesterol

cigarette smoking

diabetes

poor diet and physical inactivity

overweight and obesity

The earlier the health intervention, the greater the chance in preventing potentially devastating

complications. In addition to cardiovascular disease, diabetes, and many forms of cancer share

common risk factors such as aging, high blood pressure, high blood cholesterol, inactivity, poor

nutrition, and obesity.

Lifestyle changes can help prevent high blood pressure and reduce cholesterol levels. High

blood pressure interventions include increasing the level of aerobic physical activity; maintaining

a healthy weight; limiting the consumption of alcohol to moderate levels for those who drink;

reducing salt and sodium intake; and eating a reduced-fat diet high in fruits, vegetables, and low-

fat dairy products. A diet low in saturated fat, cholesterol, and total fat, combined with physical

activity and weight control can lower blood cholesterol levels. Healthy People 2020 calls for

successfully reaching the goal of “improving cardiovascular health and quality of life through

prevention, detection, and treatment of risk factors for heart attack and stroke; early

identification and treatment of heart attacks and strokes; and prevention of repeat cardiovascular

events.”

The Healthy People 2020 objectives for cardiovascular disease include the following:

An increase in the proportion of adults who have had their blood pressure measured with

the preceding 2 years and can state whether their blood pressure was normal or high to

92.6% per 100,000 (baseline 90.6 per 100,000 population)

An increase in the proportion of adults who have had their blood cholesterol checked

within the preceding five years to 82.1% per 100,000 population (baseline 74.6% per

100,000 population).

Demographic Study

Residents in Stark County report a higher than State average prevalence of high cholesterol. The

percentage of residents who report they have high cholesterol is higher in Stark County (48.80%)

than the State of Illinois average of 36.6%. With regard to high blood pressure, Stark County has

a higher percentage of residents with high blood pressure than residents in the State of Illinois as

a whole. The percentage of Stark County residents reporting they have high blood pressure from

40

33.9% in 2009 to 53.5% in 2014. In Stark County, the number of people diagnosed with obesity

and being overweight has increased over the years from 2007-2009 to 2010-2014.

Health Problem

Modifying risk factors, such as high blood pressure, high cholesterol, tobacco use, excessive

body weight, and physical inactivity, offers the greatest potential for reducing Cardiovascular

disease (CVD) morbidity, disability, and mortality. These measures will also decreased

individual risk for diabetes and many forms of cancer. Prevention programs have been set up in

states with high rates of CVD to implement policy and environmental strategies to increase

levels of physical activity and the availability of heart-healthy foods, and to decrease rates of

tobacco use among minority populations. Changes have been advocated in schools, worksites,

and other community based organizations, and they have been publicized by the Federal and

State government and the media.

Risk Factors

Overweight or obese

Physical inactivity

Cigarette smoking

Excessive alcohol consumption

Very high-carbohydrate diet (>60% of total energy)

Other diseases (type 2 diabetes, chronic renal failure, chronic nephrotic syndrome)

Certain drugs (corticosteroids, protease inhibitors for HIV, beta-adrenergic blocking

agents, estrogens)

Genetics


Direct Indirect

Obesity Limited availability of tobacco cessation

programs

Dietary choices Tobacco-related marketing and peer

pressure

Heredity Inadequate financial resources

Sedentary Lifestyle Stress

Socioeconomic

Media

Other disease conditions

Smoking (nicotine addiction)


Patient apathy/procrastination/denial of risk

factors

Healthcare providers

Financial resources Stark County Health Department

Lack of motivation and/or willingness Schools and colleges

Lack of understanding of long-term Faith community

41

benefits

Lack of transportation

Lack of time/resources American Heart Association

Public perceptions about risks/benefits Centers for Disease Control & National

Heart, Lung, and Blood Institute

Access to primary and preventative health

care


Accepted social norms University of Illinois Extension

Lack of food preparation skills Civic and business groups

Lack of walkable/bikeable communities Business and labor organizations

Human Service Organizations

Local media outlets

Illinois Institute for Rural Affairs


Community Health Improvement Goal: Reduce the incidence and impact of heart disease,

diabetes, and cancer forms among Stark County residents.

Outcome Objective

By 2022, increase the proportion of adults who have had their blood cholesterol checked within

the preceding 5 years to 98%. Currently, Stark County is at 96% based on the 2014 Illinois

BRFSS. (The Healthy People 2020 goal is 82.1%).

Impact Objectives

1. By 2020, increase to at least 75% the number of worksite wellness program participants

being screened (blood cholesterol)

2. By 2018, cholesterol education and lab screening services will be promoted among all

Stark County residents.


Survey employers regarding existing cardiovascular disease prevention programs.

Initiate worksite cardiovascular related screening and education programs.

o Convene an advisory committee to recruit businesses to participate in the

program.

o Utilize Health Department staff to conduct blood pressure and cholesterol

screenings at employer worksites, as well as teach cardiovascular related

education programs on topics such as lowering blood pressure and cholesterol,

diet, nutrition, and smoking cessation programs.

o Utilize American Heart Association’s My Life Check online assessment to collect

participant data and assist participants in establishing health related goals.

Implement Chronic Disease Management education program in at least two communities.

42

Evaluation

Complete survey of current employee cardiovascular disease prevention programs.

Advisory committee convened.

Implement at least three new screening and educational programs at worksites.

Chronic Disease Management program participant evaluations.

Illinois Behavioral Risk Factor Surveillance System

Potential Funding

Program costs will be shared among participants and organizations. Outside funding support

will be sought from private foundations, state agencies, and local businesses.

43


Issue

In 2005, an estimated 22 million Americans struggled with a drug or alcohol problem. Almost 95

percent of people with substance use problems are considered unaware of their problem. Of

those who recognize their problem, 273,000 have made an unsuccessful effort to obtain

treatment. These estimates highlight the importance of increasing prevention efforts and

improving access to treatment for substance abuse and co-occurring disorders. Alcohol and

tobacco are the substances of highest prevalence and use in rural America.

Emerging trends related to adolescent substance use include the rise in abuse of prescription

drugs over the past 5 years. The 2007 National Institute of Drug Abuse (NIDA) Monitoring the

Future (MTF) survey found high rates of nonmedical use of the prescription pain relievers

Vicodin and OxyContin. It is believed two factors have led to the increase in abuse. First, the

availability of prescription drugs is increasing from many sources, including the family medicine

cabinet, the Internet, and doctors. Second, many adolescents believe that prescription drugs are

safer to take than street drugs.

The Healthy People 2020 objectives for substance abuse include the following:

Reduce the death rate per 100,000 to 11.3 (Baseline 12.6)

Increase the proportion of high school seniors never using substances – alcoholic beverages

to 30.5% per 100,000 (Baseline: 27.7%)

Increase the proportion of high school seniors never using substances – illicit drugs to 60.3%

per 100,000 (Baseline: 54.8%)

Demographic Study

Between the years 2013-2014, the number of patients who suffer from opiate overdose deaths in

Illinois was 3,284. Of all heroin deaths reported, 17% were suffered by new users. And in 2010,

drug overdose deaths outnumbered motor vehicle deaths in 31 states include Illinois.

A new data set from the 2012 IYS, a self reported survey completed in even years by 6th

, 8th

,

10th

, and 12th

grade students at participating schools yielded countywide data related to youth

behaviors.

Among Stark County youth, use of alcohol, cigarettes, marijuana, and illicit drugs increases with

age. Marijuana and illicit drug use is lower than Illinois, but steadily increases with age.

Alcohol, cigarettes and inhalant use is equal or higher than Illinois, but again steadily increases

with age.

Health Problem

The effects of substance abuse are cumulative, contributing to costly social, physical, mental,

and public health problems. These problems include:

Teenage pregnancy

Unplanned pregnancy

Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)

Other sexually transmitted diseases (STDs)

44

Domestic violence

Child abuse

Motor vehicle crashes

Physical fights

Crime

Homicide

Suicide

The abuse of substances, legal and illegal increases the risk for criminal behavior. Individuals

who are convicted of a felony crime limit their employment options as many employers do not

hire applicants who are convicted felons. In addition, failure to pass a drug screening also

eliminates an applicant from a candidate pool of potential employees. In 2015, Stark County

unemployment stood at 4.5%, below the State level of 5.4%, it is simple to infer the rate is

related not to economic factors, but failure to comply with employment hiring standards.

Risk Factors

Economic

Family history

Peer pressure

Social acceptance

Accessibility

Lower self-esteem

Stress

Societal norm


Direct Indirect

Undeveloped coping skills Poor self-esteem

Physical Environment Limited family/parenting skills

Mental Health Rural lifestyle

Easy Access Limited employment opportunities for

convicted felons

Accepted Behavior Family dynamics

Lack of Treatment providers Depression, Bi-Polar, Anxiety

Understaffed law enforcement

Stigma


Cost, inability to afford treatment Healthcare providers

Lack of available treatment providers Schools and colleges

Transportation Youth serving organizations

Public stigmas and perceptions Faith community


differences

Civic and business organizations

Existing treatment providers in the region

Local media

45



Substance Abuse Objectives and Strategies

Community Health Improvement Goal: Reduce substance abuse to protect the health, safety,

and quality of life for all Stark County residents.

Outcome Objective(s)

By 2022, reduce the drug induced death rate to 15.5 deaths per 100,000 population. Currently,

Stark County is at 17.3 per 100,000 population. (This is an improvement of 10 percent. The

Healthy People 2020 goal is 11.3 deaths per 100,000 population)

Impact Objectives

1. By 2018, institute and conduct a Narcan Education, Training, and Kit Distribution

Program for Stark County First Responders and Law Enforcement Officials.


2018: Provide drug overdose prevention training (including use of naloxone) to potential

Stark County responders.

2018: Prescribe to all duration, frequency, and oversight requirements of drug prevention

overdose training.

2018: Promote the importance that drug use is illegal and high dangerous and that

complete abstinence from illegal drug use is the healthiest choice.

Evaluation

Stark County MRC (Medical Reserve Corps.) Grant Deliverables and Compliance

Reports

Involvement on Kewanee Community Drug and Alcohol Task Force

Involvement on the Stark County Citizens Mental Health Task Force

Evaluations of “First Responder & Law Enforcement” participants

Stark County Death Certificates

State of Illinois Death Data

Potential Funding

Stark County MRC (Medical Reserve Corps.) Grant

Private Donors

Stark County Citizens Mental Health Task Force

47

Aging Population

Issue

As Americans live longer, growth in the number of older adults is unprecedented. In 2014,

14.5% (46.3 million) of the US population was aged 65 or older and is projected to reach 23.5%

(98 million) by 2060. Aging adults experience higher risk of chronic disease. In 2012, 60% of

older adults managed 2 or more chronic conditions. Common chronic conditions include:

Heart Disease

Cancer

Chronic bronchitis or emphysema

Stroke

Diabetes mellitus

Alzheimer's disease

Chronic conditions can lower quality of life for older adults and contribute to the leading causes

of death among this population.

Health-related quality of life (HRQOL) is a multi-dimensional concept that includes domains

related to physical, mental, emotional, and social functioning. It goes beyond direct measures of

population health, life expectancy, and causes of death, and focuses on the impact health status

has on quality of life. A related concept of HRQOL is well-being, which assesses the positive

aspects of a person’s life, such as positive emotions and life satisfaction. Well-being is a relative

state where one maximizes his or her physical, mental, and social functioning in the context of

supportive environments to live a full, satisfying, and productive life.

Healthy People 2020 emphasizes the importance of health-related quality of life and well-being

by including it as one of the initiative’s overarching goals, “promoting quality of life, healthy

development, and health behaviors across all life stages.

The Healthy People 2020 objectives for health related quality of life and well being include the

following:

Increase the proportion of adults who self report good or better physical health.

(Baseline: 78.8% of adults self-reported good or better physical health in the past 12

months).

Increase the proportion of adults who self report good or better mental health. (Baseline:

78.1% of adults self-reported good or better mental health in the past 12 months).

Demographic Study

The median age in Stark County stands at 45.9 which is markedly older compared to the median

age of Illinois (37.3) and the US (37.8). Looking at the breakdown of age groups in the

48

generation analysis of Stark County; we see the greatest percentage concentrations come in the

50s (14.1%), 60s (14.4%), and 70s (16.3%). Approximately 92% of older adults have at least one

chronic disease, and 77% have at least two. Four chronic diseases—heart disease, cancer, stroke,

and diabetes—cause almost two-thirds of all deaths each year. Chronic diseases account for 75%

of the money our nation spends on health care, yet only 1% of health dollars are spent on public

efforts to improve overall health.

Health Problem

The effects of continued poor physical and mental health are cumulative and often permanent.

They can contribute to costly social, physical, mental and public health problems. These

problems include:

Arthritis

Heart Disease

Cancer

Respiratory Diseases

Alzheimer’s Disease

Osteoporosis

Diabetes

Influenza and Pneumonia

Falls

Substance Abuse

Obesity

Depression

Oral Health

Poverty

Shingles

Risk Factors

Aging

Family history

Minority group

Sedentary lifestyle

Obese

Poor diet

Genetics

Hypertension

Other diseases

Certain Drugs

Depression


Direct Indirect

Lack of family support Lack of transportation

Depression Lack of services

Declining health Pride

49

Lack of medical care access Lack of affordable medications

Poor nutrition Medicaid and Medicare funding cuts

Poor physical conditions Improper medication management

Poor mental conditions Funding cuts


Cost, inability to afford care or medication Healthcare providers

Lack of or high deductible health insurance Schools and colleges

Transportation Faith community

Lack of understanding of long-term

implications

Existing education and service providers in

the region.

Lack of available educators or specialists Local media


differences


Public stigmas and perceptions Illinois Department of Public Health

Aging Population Objectives and Strategies

Community Health Improvement Goal: Improve health-related quality of life and well-being

for adults and older individuals.

Outcome Objective

By 2020, Increase the proportion of adults who self-report good or better physical health

to 70%. Currently, Stark County is at 63.95% based on the 2016 CHNA (The Health

People 2020 goal is 79.8%).

By 2020, Increase the proportion of adults who self-report good or better mental health to

80%. Currently, Stark County is at 76.82% based on the 2016 CHNA (The Health

People 2020 goal is 80.1%).

Impact Objectives

1. By 2018, new community programming partnerships will be established as a result of

planning and educational campaigns.

2. By 2019, physical and mental wellness education programs will be promoted among all

Stark County communities.


Establish partnerships among service agencies, professional associations, and families

and caregivers to facilitate the transfer of knowledge, research, practice, and policy

related to mental and physical health interventions.

Conduct educational campaign to promote public awareness of mental and physical

health issues of an aging population.

Reduce stigma associated with mental illness and aging, working in partnerships with the

media, youth, public health systems, communities, health professionals, employers, and

advocacy groups.

50

Evaluation

Complete survey of education programs.

Illinois Behavioral Risk Factor Surveillance System

Involvement on the Stark County Citizens Mental Health Task Force

Participation numbers of community screening and educational events

Program participant evaluations

Potential Funding

Program costs will be shared among participants and organizations. Outside funding support

will be sought from private foundations, state agencies, and local businesses.

51

Appendices

54

Stark County IPLAN Planning Committee Participants

John A. Ballentine, Stark County News

John is a writer/reporter/photographer with the Stark County News. He is a graduate of MacMurray College.

John has worked in various IT fields throughout his career, including Computer Engineer. He also served in the

United States Navy as a Data Systems Technician. John’s involvement with the INPLAN process is a crucial

part of our strategic plan, as the Stark County Newspaper is the only local news outlet in Stark County.

Bill Baumann, Stark County Citizen’s Mental Health Task Force

Bill is a 35 year Stark County resident. He is the proud father of five children. Bill is a founding member of the

Stark County Citizen’s Mental Health Task Force, having served in various capacities. Bill is also a member of

the Stark County Farm Bureau, as well as a member of the Mental Illness Family Support Group. Bill travels

Stark County on a daily basis, having worked as a Rural Mail Carrier since 1988. He has also farmed in Stark

County for nearly 35 years.

Doris Bogner, Stark County Health Board

Doris is a resident of Bradford, Illinois for 40+ years, mother of 6, grandmother of 13 and great grandmother of

5. I am a retired registered nurse, having mostly hospital experience. She is a Co-President of the Stark County

Citizen’s Mental Health Task Force. She is also a member of the Stark County Health Board. Because of

Doris’ involvement in various agencies, committees and parish nurse activities, she realizes the importance of

establishing better health care for our rural areas. She hopes her involvement in the IPLAN committee will aid

this goal.

Maggie Brooks, North Central Behavioral Health System

Maggie is a Licensed Professional Counselor with North Central Behavioral Health System. She has been in

practice for over 21 years and has provided counseling services to clients from ages 4 to 90, but she really

enjoys the challenge of adolescents. She has over 10 years of supervisory experience and enjoy teaching new

clinicians how to better manage their role.

Dorothy David, Stark County Health Department

Dorothy, Director of Environment Health at Stark County Health Department, was first introduced into the

IPLAN process in 1992 when it was first developed and introduced in Illinois. Since then, working in

McDonough County Health Department, she continued to participate representing the Environmental Health

group. Since McDonough County has a very high Radon level and high in lung cancer rate, we managed to

implement Radon awareness to include inspection and mitigation through the Health Department together with

smoke free restaurant program. Later, she joined Peoria County Health Department in 2005. There, we

approached the assessment in a similar process known as Mobilizing for Action through Planning and

Partnership (MAPP). In 2010, when Dorothy joined Stark County Health Department, even though she was not

part of the planning process, she was part of the review team in finalizing the outcome before it is submitted to

the Board of Health and Illinois Department of Public Health.

Chad Grip, Bradford School District #1 Chad is the superintendent of the Bradford School District. He has worked for the district for the past 15 years.

Prior to becoming a school administrator, Chad taught Kindergarten, 5th grade and junior high students in

Bradford. He completed his undergraduate studies as well as his specialist endorsements at Western Illinois

University.

Lee Hager, Stark County Health Board

Lee is a lifelong resident of Stark County and a U.S. Army Veteran. I married Janet Linder on Aug 24, 1969.

We have one daughter, Laura Janine (Sinclair), who attended Valley Grade School and graduated from

Wyoming High School in 1991. He has served as Township Trustee for 12 years, Valley Township Clerk for 2

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years, Valley Grade School Board 9 years, Stark County Farm Bureau 12 years and President for 2 years, Stark

County Board for 8 years where he represented the County in the development and start of the new Stark

County Health Department. He also served on the North Central Behavioral Health Board at the same time. I

also served as Chairman of the USDA Farm Services Agency Board for 9 years. Lee currently serves on the

Stark County Board of Health and the Mental Health Board, the Stark County Farm Bureau Board and the Stark

Planning Commission.

Betty Hoy, Retired Pharmacist & Businesswoman

Betty graduated from the University of Illinois College of Pharmacy in 1961. She then worked for 12 years for

3 Independent Retail Pharmacists. In 1973 Betty and her late husband moved to Bradford and opened and

operated the Bradford Pharmacy until she retired and closed the pharmacy in 2016. Betty was a member of the

Stark County Health Board from 1990 to 2010. Over the years, Betty has been a member of the DuPage County

Pharmaceutical Association, the Central Illinois Pharmaceutical Association and the American Pharmaceutical

Association.

Kelli Humphrey, Stark County Health Department Kelli serves as the Financial Services Coordinator for the Henry and Stark County Health Department. Kelli

has been with the Health Department for years. Kelli currently resides in Cambridge, IL.

William Lamb, Stark County School District #100 Bill is the Stark County High School and Junior High principal. He is a former high school math teacher, with

over 15 years as a school administrator. He graduated from Illinois State University a long, long time ago,

when phones were still attached to walls. A long-time Peoria resident, Bill and his wife are now raising their

family in Wyoming, IL. He is a trained NAMI family mental health educator, and has been involved with

adolescent mental health since 1991.

Thomas Marten, Stark County Farm Bureau

Thomas serves as the manager of the Stark County Farm Bureau, the largest membership organization in Stark

County, IL. Thomas is an Agricultural Systems alumnus of SIU. He resides in Wyoming, IL.

Mary Prayne, Central Illinois Area Agency on Aging LPN

Mary is a Stark County citizen, Wife, Mother and Grandmother. Her career in nursing spans 30 years. Mary is

a Children and Family Rights Advocate/Activist, bringing awareness to the child abuse, known as parental

alienation... She is currently working to help rewrite legislature to ensure children have the right to be able to

freely love and spend equal time with both loving parents and sides of their family, without fear of retribution.

Mary is on the Board of Directors for Central Illinois Agency on Aging, (second term) and Illinois Fathers. She

is also a member of the Marshall County Behavioral Health Task Force Committee and the Stark County

Mental Health Task Force Committee

Crystal Rosebecke, Tri County Opportunities Council

Crystal has lived her whole life in Stark County. She grew up in Wyoming, had a business in Toulon for 18

years. She closed the business after the death of her husband. Then at age 40, she decided to go back to school.

Crystal has worked for Tri County Opportunities for 16 + years as a Case Management Specialist. She works

with low income families in a self- sufficiency program. She remarried and lives in Lafayette. She is the

mother of three daughters and six beautiful grandchildren.

Sharon Sager, Stark County Health Board

Sharon is a resident of Stark County, where she attended grade school and high school. She then went on to

pursue a 3 year nursing diploma in Galesburg. She worked primarily at Proctor Hospital, until her husband put

her to work on the farm. She proudly serves President of the Stark County Health Board, as well as Co-

President of the Stark County Citizen’s Mental Health Task Force.

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Beth Smith, Stark County Health Department

Beth is the proud mom of four beautiful children and one darling grandson. She is a graduate of Northern

Illinois University. She is a Community Health Educator for the Stark County Health Department. Beth serves

on Stark County Citizen’s MH Task Force and the Kewanee Community Drug and Alcohol Task Force. She is

a founding member of Henry County Mental Health Alliance, as well as co-founder, along with her children, of

Up with Life Suicide Prevention Initiative. As a suicide loss survivor, she has a passion for mental health

advocacy and building competencies through education. She strives to spare others the heartache of losing a

loved one to the tragedy of suicide. In her spare time, Beth enjoys watching my son play basketball, having fun

with her grandson, and road tripping to University of Illinois to see my twin girls and Colorado to visit my

oldest daughter.

Duane Stevens, Stark County Health Department

Duane serves as the Public Health Administrator of the Stark County Health Department. Duane has been with

the Health Department since 2005. Previous to assuming the duties as the Health Department’s Administrator,

Duane serves for 9 years as the Department’s Director of Financial Services. Duane currently resides in

Kewanee, IL.

RaeAnn Tucker, Stark County Health Department

RaeAnn is the Director of Health Promotion with the Stark County Health Department. She has over 27 years

of experience in the field of Public Health. She is one of only 6 Regional Public Information Officers in the

Illinois Department of Public Health’s Information Distribution infrastructure. RaeAnn is a current or past

officer or board member for the following organizations/associations/etc. Kewanee United Way, Henry County

Human Services Council, and the ABCD After-School Program. Her position with the Health Department has

afforded her a vast knowledge and experience in health education, marketing, media relations, public relations,

event planning and coordination, and graphic design.

Sue VanDeRostyne, Toulon Rehabilitation and Health Care Center

Sue has been the Chief Executive Officer/Nursing Home Administrator at Toulon Rehab since 2007. She was

also employed at Kewanee Hospital for 19 years, holding a position in leadership accountability for all clinical

and administrative patient care departments, including a position on the Board of Directors. Cumulatively, Sue

has over thirty years of healthcare leadership, management and executive experience.

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Orientation Session - August 31, 2016

Introduction to the IPLAN Process

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Session II – October 26, 2016


A comprehensive Community Overview data analysis of Stark County was presented on October 26, 2016.

Committee members were encouraged to share data they found relevant to the needs assessment within their

personal and professional spheres of influence. A key component of the needs assessment was community

perception. Committee members were encouraged to contribute and collect perceived health issues of interest

to county residents.

The community health assessment began in August 2016 with a review of the IPLAN process. Examples of

problem identification and analysis were provided. The procedure used in this process was also outlined in the

guidelines for IPLAN recertification. The APEX/PH manual was used as a reference. A data analysis was

conducted of secondary sources of information. Topics include population size, race/ethnicity, age, gender,

income, employment, crime, births, deaths, health behaviors, morbidity, hospitalization, and health care

utilization. Two major sources of information for the Community Overview are the U.S. Census Bureau and

Illinois Department of Public Health. Much of the detailed Census information comes from the 2010 actual

population counts and the 2010-2014 American Community Survey five-year estimates.

Other data sources include the Illinois Department of Public Health, the Illinois Behavioral Risk Factor

Surveillance System, the Illinois County Health Rankings, the National Institutes of Health, the National Cancer

Institute, the Centers for Disease Control and Prevention, the US Department of Health and Human Services,

the Illinois Youth Survey, the Illinois Department of Children and Family Services, Illinois Hospital

Association’s COMP data, and several other state and local agencies.

Additionally, survey data from 238 respondents in the community were assessed with a special focus on the at-

risk or economically disadvantaged population. Areas of investigation included perceptions of the community

health issues, unhealthy behaviors, issues with quality of life, healthy behaviors, and access to medical care,

dental care, prescription medications and mental-health counseling. Additionally, demographic characteristics

of respondents were utilized to provide insights into why certain segments of the population responded

differently.

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Session II – October 26, 2016

Continued…

Participants were provided with an overview of key findings from the Stark County Community

Health Needs Assessment.

.

The following list is a summary of the 10 main health issues that were distilled through the analysis

of the Community Health Needs Assessment data study.

Aging Issues

Cancer

Mental Health

Heart Disease

Obesity

Diabetes

Early Sexual Activity

Chronic Pain

Infectious Disease

Lung Disease

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Session III – December 14, 2016

In this session, participants reviewed the ranking of health issues identified through an electronically

mailed survey to community health planning committee members. Utilizing local knowledge of the

community and information provided by Healthy People 2020 reports on specific health issues,

participants created the following hypothesis about why a particular health problem exists.

The following terms were explained and utilized in this practice exercise:

Risk Factors – Scientifically established factors (determinants) that relate directly to the level of a

health problem. A health problem may have may have any number of risk factors identified for it.

For example, low birth weight is a risk factor for the health problem of infant mortality. It is a

scientific fact that a higher percentage of babies who weigh less than 2,500 grams at birth die in the

first year than babies who weigh 2,500 grams or more at birth.

Direct Contributing Factors – Scientifically established factors that directly affect the level of a risk

factor. For example, teen pregnancy is one factor that contributes directly to the birth of low birth

weight babies.

Indirect Contributing Factors – Community-specific factors that directly affect the level of the

direct contributing factors. For example, low self-esteem may be one indirect contributing factor

promoting teen pregnancy, thus generating low birth weight babies, and ultimately elevating infant

mortality rates. These factors can vary considerably from community to community. During our

final session, we discussed programming intervention strategies for each of the three health priorities

identified for the county.

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DESCRIPTION OF COMMUNITY RESOURCES

Recreational Facilities (3)

YMCA of Kewanee

YMCA of Kewanee strives to be a safe place where all people feel welcomed regardless of background. They

bring people of all ages and ethnicities together to help them make meaningful connections, improve health and

well-being, to teach and reinforce positive values and find a sense of respect, belonging and engagement. The Y

will strengthen our entire community through youth development, healthy living and social responsibility.

Kewanee Park District

The Kewanee Park District exists to provide care for public lands and opportunities for personal growth. They

work with citizens of Kewanee to provide a broad spectrum of opportunities to renew, restore and recreate,

balancing often stressful lifestyle. The Park District encourages participation of individuals and families to

develop the highest possible level of physical and mental well-being with the intent of creating a well-balanced

and healthy community.

Toulon, Wyoming and Bradford Public Library Districts

These three Stark County public library districts are active centers for resource, education and community

events serving residents of all ages.

Health Departments (1)

Henry-Stark County Health Department

The Henry County Health Department offers clinic services, Women’s Health, Family Planning, Physicals,

Well-child, Immunization, STD, WIC/Breastfeeding, Community and Group Presentations, Home Health

skilled nursing and homecare services, and Environmental Health Services in the Henry County area.

Community Agencies/Private Practices (7)

Alcoholics Anonymous

Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with

each other that they may solve their common problem and help others to recover from alcoholism. Alcoholic’s

Anonymous meetings are offered in the Henry County area.

North Central Behavioral Health Systems North Central Behavioral Health Systems serves clients through eight locations in Central and North Central

Illinois with a broad range of mental health and addictions services for individuals and families. Their service

continuum includes brief solution-focused counseling for those experiencing common issues such as

depression, anxiety and stress, to those individuals needing more extensive services such as intensive mental

health or substance use programs, medication management, psycho-social rehabilitation, community and home

support, or a variety of other specialized services.

Henry County Youth Services Bureau

The mission of the Henry County Youth Services Bureau is to empower youth to succeed by serving them in

their home, school and community. Founded in 1972, they are dedicated to providing free counseling services

to youth ages 3 to 21. YSB Counselors provide a wide array of services, including: Individual counseling,

Diversion Program for youth involved with Henry County Court Services, Assessments, Referral Services, and

Group Counseling. YSB Staff provide counseling services at a location that is convenient to the client and their

family. Counseling sessions are offered year round, and can be held at a client’s school, home, community

center, or the YSB office.

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Kewanee Drug and Alcohol Task Force

The Kewanee Community Drug and Alcohol Task Force was established in 1984. A Drug Free Community

Grant was awarded to the KCDATF in 2011. The DFC grant provides $125,000 per year for 5 years with an

opportunity to apply for another 5 years! The Mission of the Kewanee Community Drug and Alcohol Task

Force is to decrease the use and abuse of alcohol and other drugs among youth in the Kewanee area. The vision

that unites our efforts is: to decrease the use and abuse of alcohol and other drugs among youth in the Kewanee

area so that the entire community will work toward common goals to change the culture of alcohol and drug

use.

Toulon, Wyoming and Bradford Food Pantries

These Stark County food banks are dedicated to providing for the needs of hungry people by collecting and

distributing food and grocery products and educating the community about Nutrition.

Bureau-Henry and Stark Regional Office of Education The mission of the Bureau, Henry and Stark County Regional Office of Education is to support and enhance

educational growth through advocacy and leadership. The vision of the Bureau, Henry and Stark County

Regional Office of Education is to be a proactive intermediate educational agency serving the learning

community through innovative and collaborative leadership.

University of Illinois Extension

University of Illinois Extension is the flagship outreach effort of the University of Illinois at Urbana-

Champaign, offering educational programs to residents of all of Illinois' 102 counties — and far beyond.

Extension provides practical education you can trust to help people, businesses, and communities solve

problems, develop skills, and build a better future. U of I Extension offers educational programs in five broad

areas: Energy and environmental stewardship, Food safety and security, Economic development and workforce

preparedness, Family health, financial security, and wellness, and Youth development.

Hospitals/Clinics (8)

OSF Saint Luke Medical Center

OSF Saint Luke Medical Center, a 25-bed Critical Access Hospital located in Kewanee, Illinois and provides

Inpatient services, a broad range of Outpatient services, Emergency services and primary care services. For over

95 years, OSF Saint Luke has kept pace with many innovations in health care, including a new hospital that

opened in 2008. OSF Saint Luke Medical Center has a long history of "friends and neighbors taking care of

friends and neighbors" while providing an excellent patient experience.

OSF Multi-Specialty Group

OSF Multi-Specialty Group offers a wide range of medical and surgical care, as well as other specialty services,

through provider offices located at OSF Saint Luke Medical Center.

OSF Home Care and Hospice

OSF Home Care and Hospice offer health care and services to home bound individuals as well as services at

end of life through Hospice.

Aunt Martha’s – Great River Community Health Center

Is a medical clinic located in Toulon. Aunt Martha’s provides adult primary care, pediatrics, mental health

(telepsychiatry) and dental care services.

Kewanee Medical Clinic

The Kewanee Medical Clinic is a medical practice providing a wide range of medical services.

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Ahearn & Associates Medical Center, Inc.

Ahearn & Associates Medical Center, Inc. provides office care for acute and chronic illnesses as well as

wellness exams and preventive healthcare services.

Regional Family Health Center

Regional Family Health Center is a medical practice providing a wide range of medical services.

Preferred Home Healthcare & Hospice Preferred Home Health Care offers a full range of health care services including home health, hospice, private

duty nursing, medical equipment and supplies, seating and mobility products, a retail show floor, and retail and

compounding pharmacy services.

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Resources for Planning

Illinois Department of Public Health – IPLAN

http://app.idph.state.il.us/

Healthy People 2020 Information Access Project

http://phpartners.org/hp2020/index.html

Illinois Project for Local Assessment of Needs

Documents

Transcript of Illinois Project for Local Assessment of Needs