2024-2026 COMMUNITY HEALTH NEEDS ASSESSMENT
What is a Community Health Needs Assessment:
Our Community Health Needs Assessment (CHNA) is a comprehensive study examining the health status and needs of our community, building upon the Robert Wood Johnson Foundation’s Health Rankings Model. By analyzing factors such as health outcomes, health behaviors, clinical care, social and economic factors, and physical environment measures, we aim to identify areas for improvement and develop strategies to enhance the overall well-being of our community. This assessment, based on both primary and secondary data, provides valuable insights to address the unique health challenges and opportunities in our district and county.
Highlights:
Please note that the full report offers significant detail, rich in data. The following highlights are here to offer the most basic understanding of what is in the full 39 page report.
Introduction/Overview
Grays Harbor County Public Hospital District No. 2, dba Harbor Regional Health (HRH), is a regional healthcare network providing a broad range of services, including inpatient hospital, emergency, primary care, and specialty services. HRH is licensed for 140 beds on its main campus in Aberdeen, the largest city in the mostly rural Grays Harbor County. It is designated by Medicare as a Sole Community Hospital (SCH), a program created by Congress to support smaller, rural hospitals. The SCH program was created by Congress to support small rural hospitals which "by reason of factors such as isolated location, weather conditions, travel conditions, or absence of other hospitals, is the sole source of inpatient hospital services reasonably available in a geographic area to Medicare beneficiaries”.
2021-23 CHNA and Accomplishments
Healthcare Access:
The report noted efforts to increase primary care access, reduce unnecessary emergency department usage, and minimize outmigration for healthcare services.
Key accomplishments include the establishment of a Nurse Practitioner Fellowship program in collaboration with the University of Washington and Premera, recruitment of family medicine nurse practitioners, the transition of the Prompt Care Clinic to a walk-in clinic, and the expansion of specialty care, including cardiology, into primary care settings.
Behavioral/Mental Health:
Strategies were implemented to evaluate telemedicine opportunities to expand access to behavioral health and substance use disorder services.
Accomplishments in this area include regular tele-psychiatry services, de-escalation training for healthcare personnel, and continued evidence-based MAT programs and naloxone kit distributions.
Prevention and Management of Chronic Diseases:
This focus area included implementing care coordination services for individuals with complex needs, and efforts to support early detection and patient self-management.
Notable achievements include the adoption of chronic disease self-management classes, implementation of the Chronic Care Model in primary care settings, and the integration of social determinants of health screening tools.
Economic Development:
Efforts were made to commit leadership time and resources to enhance community infrastructure, aiming to create more family-wage jobs, affordable housing, and better transportation.
HRH collaborated with local chambers of commerce and educational institutions to train the next generation of healthcare workers.
These highlights show a comprehensive approach to addressing healthcare needs in the community by improving access to medical services, integrating behavioral health into primary care, managing chronic diseases proactively, and supporting economic development to enhance community health infrastructure. This summary could be used to showcase the main achievements and strategic approaches on the webpage dedicated to the report.
Demographics
The full report offers considerable detail, however, these summarized data points underscore the complex interplay between demographic factors and social determinants like education, income, and health insurance coverage, all of which can significantly influence community health outcomes. Highlighting these aspects can help the community understand the challenges and needs within their region, supporting targeted interventions and policies.
Population Growth:
Between 2024 and 2029, the population of the district and Grays Harbor County is expected to grow at a slower rate than the state of Washington.
Aging Population:
A significant portion of the population is aged 65 and older, which is higher than the state average. This demographic is expected to continue to grow, increasing the need for healthcare services tailored to older adults.
Social Determinants of Health: The conditions under which people are born, grow, live, work and play—greatly influence the health of a community and its residents. Graduation rates, housing affordability, income/poverty and race are all social determinants.
The area has higher rates of poverty compared to the state average, with a substantial percentage of residents living below the Federal Poverty Level.
Educational attainment in the area is lower, particularly the percentage of adults who have completed some form of post-secondary education.
Income Disparities:
Median household incomes in the district are lower than the state average, highlighting economic challenges that can impact health.
Ethnic and Racial Disparities:
There are significant income disparities within different racial and ethnic groups in the district. For instance, the American Indian/Alaska Native and Hispanic/Latino populations have lower median incomes compared to Non-Hispanic Whites.
Health Insurance Coverage:
The district has a higher uninsured rate than the county and state. Additionally, there's a higher reliance on public health insurance coverage, suggesting socioeconomic challenges in accessing private health insurance.
The District’s Health Status
This section highlights the urgent health challenges facing the district, underscoring the need for focused healthcare interventions and lifestyle health promotion activities to address these pressing health concerns. Such a summary on your webpage could help in raising awareness and rallying community and health policymakers’ support for targeted health programs.
Mortality Rates:
Grays Harbor County has higher death rates compared to the state average, indicating a greater prevalence of serious health issues in the community.
Leading Causes of Death:
The primary causes of death in the area include cancer and heart disease, both of which occur at higher rates than the state average.
Chronic Disease Prevalence:
The district sees a higher prevalence of chronic diseases such as diabetes and obesity compared to the state. The rates of diabetes and obesity are notably higher, which are major risk factors for other health complications.
Behavioral Health Issues:
Behavioral health concerns, including the use of opioids and rates of suicide, are more pronounced in the district than in other parts of the state. The section likely discusses the impact of these issues on community health and the need for targeted behavioral health services.
Health Risk Behaviors:
Health risk behaviors such as insufficient physical activity, poor diet, and tobacco use contribute significantly to chronic disease morbidity and mortality within the district.
Health Risk Behaviors and Outcomes
Insufficient Sleep: A significant portion of the district reports less than 7 hours of sleep per night, contributing to adverse health outcomes and reduced productivity.
Physical Inactivity: The district records higher rates of physical inactivity compared to state averages, increasing the risk of heart disease and other chronic conditions.
Diet and Nutrition: Challenges with food insecurity impact both adults and children, with rates exceeding state averages, affecting overall health and nutrition.
Substance Use: Higher rates of tobacco use in the district are associated with increased health issues such as lung cancer and heart disease.
Behavioral Health
Mental Health Concerns: The community experiences high rates of mental health issues, including depression and anxiety, with a need for expanded mental health services and programs.
Substance Abuse: The section likely addresses the prevalence and impact of substance abuse on the community, including alcohol and drug use.
Adverse Childhood Experiences (ACEs)
Prevalence of ACEs: Discusses the high incidence of adverse childhood experiences within the community and their long-term effects on mental and physical health.
Community Impact: Outlines strategies and programs aimed at mitigating the impact of ACEs through education, support services, and preventive interventions.
Access to Care
Healthcare Personnel Shortages: Highlights a critical shortage of healthcare providers, which contributes to longer wait times and reduced patient care quality.
Medical Underserved Areas: The entire county is designated as a Health Professional Shortage Area, affecting the quality and accessibility of healthcare.
Insurance and Financial Barriers: Many residents lack adequate health insurance, which complicates access to necessary health services.
Community Engagement
To gather an active community voice in the CHNA process, HRH distributed an online survey in collaboration with its community partners, social media, staff, and healthcare personnel. The survey was designed to receive community insights on health needs, gaps, and priorities of the community. With low initial responses from the Hispanic population, on-site surveying was also conducted in Spanish and in English, in addition to the online survey. There were 470 respondents to the 2023 survey.
2024-2026 Priorities
Our 2024-2026 Health Priorities reflect a strategic focus on areas where we can make the most significant impact, improving the well-being of our community members. These priorities are designed to address critical health needs, reduce disparities, and promote equity across all demographics. By detailing our targeted approaches and the specific goals we aim to achieve, we invite our community members to understand and join us in this vital work. Below, we outline the priorities as they are set forth in our comprehensive health needs assessment, committing to transparency and collaboration in our ongoing efforts to serve and uplift our community.
Priorities
The updated data and community input included in this CHNA show an increasing reality and recognition that:
Specific strategies and partnerships to recruit and retain a quality healthcare workforce are key to increasing healthcare access, as are addressing barriers to access, including cost and lack of support services such as transportation.
The Service Area continues to face a significant chronic disease burden, and there needs to be an emphasis on supporting healthy aging and management of chronic conditions, with a specific focus on the AI/AN population.
There needs to be a continued focus to support prevention and treatment of mental health conditions and substance use for all segments of the community.
Poverty, homelessness, and housing affordability continue to impact health equity, access, and outcomes in the community.
Based on the above, the 2024-2026 CHNA priorities will include an overall focus on reducing health disparities and specifically include:
Increase access to healthcare services, with a special emphasis on healthcare workforce recruitment, development, and retention.
Prevention and management of chronic conditions, with an emphasis on services and supports for healthy aging in place.
Partner, advocate, educate, and directly provide services to address the community’s growing behavioral health needs, including substance use.
Collaborate with community partners to focus on economic development of the community, with a renewed focus on addressing housing affordability, homelessness, and supports for those struggling to make ends meet.
2024-2026 CHNA Implementation Plan Overview
Harbor Regional Health is dedicated to making meaningful progress in the health of our community through the implementation of our focused 2024-2026 Community Health Needs Assessment (CHNA) plan. Below, we outline the core strategies we are committed to executing, ensuring targeted improvements and measurable outcomes in community health:
Increase Access to Healthcare Services
Primary Care Expansion: Extend primary care services to underserved areas to ensure comprehensive coverage across our district.
Recruitment and Retention: Enhance efforts to recruit and retain healthcare professionals to maintain high-quality care delivery.
Behavioral and Mental Health Integration
Telehealth Services: Expand telehealth to include more comprehensive behavioral health services.
Community Partnerships: Strengthen collaborations with local organizations to provide integrated health services.
Chronic Disease Management
Education and Prevention Programs: Implement community-based programs focused on disease prevention and management.
Support Groups: Facilitate the creation of support groups for chronic disease patients to improve self-management and quality of life.
Economic and Community Development
Infrastructure Improvement: Work with local governments and organizations to improve healthcare infrastructure and access.
Job Creation Initiatives: Partner with local businesses and educational institutions to create jobs and training opportunities within the healthcare sector.
Health Equity Initiatives
Cultural Competency Training: Provide training for all healthcare personnel to enhance the delivery of culturally competent care.
Outreach Programs: Develop outreach programs that specifically address the needs of underrepresented and marginalized groups in the community.
This implementation plan is a blueprint for action and accountability. By clearly defining our strategies and expected outcomes, we pledge to transparently share progress and continuously seek community input to refine and improve our efforts.