Georgia Department of Public Health - District 4

Georgia Department of Public Health - District 4

FAYETTE COUNTY COMMUNITY HEALTH ASSESSMENT

March 2015

Fayette County Health Department

District 4 Public Health

Table of Contents

Vision

What is a Community Health Assessment?

Fayette Leading the Way!

Health Assessments

Data Sharing

Geographic Assessment Area

Services Provided

Community Engagement

Assessments

Major Themes

Forces of Change Assessment

Local Public Health System Assessment

Community Health Status Assessment

Community Themes and Strength Assessment

Community Assets

Improvement Plan

Sources

ContactUs

Vision

We envision a Fayette that places a high value on access to quality physical and mental healthcare, social well-being, the built environment, education, safety and promotes community service and responsibility.

What is a Community Health Assessment?

District 4 Public Health, composed of12 individual counties, is seeking accreditation from theNational PublicHealth Accreditation Board (PHAB). Accreditation will providehealth departments the abilityto improvequality, access, services,value, and accountabilityto stakeholders within the community. This assessment satisfies one of the pre-requisites for the Public Health Accreditation Board. Theintention hereisthat, for accreditation purposes, thehealth department can demonstrate that it systematicallyassesses its jurisdiction’s health status and can describeit.

The Community Health Assessment involves a process of collecting, analyzing, and using data to educate and mobilize communities, develop priorities, garner resources, and plan actions to improve the public’s health. It is one of the core functions of public health, which is why it’s in the accreditation standards. It involves the systematic collection and analysis of data in order to provide the health department and the community it serves with a sound basis for decision-making. This assessment was conducted in partnership with other partners in the community and includes data collection on health status, health needs, community assets, resources, and other community or state determinants of health status.

Fayette Leading the Way!

The Community Health Assessment titled Fayette Leading the Way! (FLTW) focused on Fayette County, GA. The assessment was conducted using NACCHO’s Mobilizing for Action through Planning and Partnerships (MAPP) tool and took place from August, 2013 to December 2014. Data was collected, analyzed, reviewed, and presented to the committee for review.

The FLTW coalition consisted of multiple partners from Fayette County including:

Fayette County Board of Education
Fayette Chamber of Commerce
State and Local Public Health
EMS/Fire
Police
Elected Officials
Women Infant & Children (WIC)[represent high risk populations]
Fayette Care Clinic - (provides free medical care to uninsured Fayette County residents that are living at 200% of the federal poverty level)
FACTOR Fayette Family Connection - (local arm of Georgia Family Connection- mission is to improve quality of life for family and children through collaboration)
Board of Health Members
Department of Family and Children Services
Piedmont Fayette Hospital
Southside Support (parents with children of special needs)[represent high risk populations]
McIntosh Trail Community Service Board - (provides mental health, developmental disabilities, and addictive disease services for the underserved)
Exceptional Ops - (developmental disabilities support)[represent high risk populations]
UGA Cooperative Extension
Fayette County Parks and Recreation
Fayette County HeadStart Pre-K –[represent high risk populations]
Promise Place – (Domestic Violence Shelter)
Healing Bridge Clinic – (free medical care for underserved and uninsured)
The Real Life Center – (food, clothing, and financial training assistance)

The FLTW coalition meetings were conducted monthly and invitations to each meeting were emailed out to all partner organizations. Those who attended the meetings received paper printouts of all presentation materials and the presentation information was also posted on our District 4 Public Health website. Community engagement was performed via surveys to the community, board of health meetings, and collaborative community meetings, and individual surveys.

Health Assessments

The FLTW coalition followed the MAPP process throughout the entire community health assessment. During this process, we completed the following four health assessments: Forces of Change, Local Public Health System, Community Health Status, and Community Themes and Strengths. Data will be sustained for future assessments via semi-annual collaborative meetings including analysis reports and documented via meeting summary notes/minutes.

The following is an explanation of each assessment:

January 2014 - Forces of Change Assessment

This assessment was conducted by assessing FLTW coalition members on forces that include trends, factors and events that affect Fayette County.

March 2014–LocalPublic Health System Assessment

This assessment was conducted by assessing FLTW coalition members and additional community members that were invited to this meeting on the Local Public Health System.

May 2014 - Community Health Status Assessment

The survey was distributed by paper version in coalition member organizations and also online via survey monkey. The survey monkey link was sent out to community partners and was placed on the Fayette County Chamber of commerce website and the District 4 Public Health website. WIC, HeadStart, Southside Support, and Exceptional Ops represented high risk populations.

June 2014 - Community Themes and Strengths Assessment

This assessment was conducted by assessing FLTW coalition members on answering questions of Community Themes and Strengths including:

–What is important in Fayette County?

–How is quality of life perceived in our community?

–What assets do we have that can be used to improve community health?

Data Sharing

The data collected from the health assessment and this report will be posted on District 4 Public

Health’swebsite. Each community health assessment involved either community residents or the FLTW coalition members. After each assessment was conducted, the results were presented at the following FLTW coalition meeting. The community health assessment report will be made available to the community via the District 4 Public Health website and paper copies in the Fayette County Health Department. It will also be distributed to all FLTW coalition members to distribute to their clients.

Geographic Assessment Area

The Fayette County Health Department primary service area is defined as thegeographic area encompassing the zip codes of Tyrone, Fayetteville, Peachtree City, Woolsey and Brooks, Georgia.

County-level quantitative data was utilizedthroughout the assessment to providecomparable measures to further define the

health needs of local residents.

Fayette County consists of a mixture of ruraland suburban communities whose health needs are met by one hospital system, a mixture ofprivate practices, the county health department and other social services.

Services Provided

The health department provides a wide range of outpatient services, including:

Community Engagement

We conducted a Community Health System Assessment survey to engage the community via survey monkey and paper copies in community organizations. The Community Strengths and Themes surveys provide qualitativeinformation on how Fayette County residents perceivetheirhealth and qualityoflife concerns aswell as their knowledgeofcommunityresources and assets.

TheCommunityStrengths and Themes Assessment, was determined bytheMobilizing forAction through Planning and Partnerships (MAPP)strategy.TheMAPPprocess was employed to gain insight upon thequalityoflifein FayetteCounty,Georgia. This was done through interviewing collaborative committee members. The results ofthe assessment will provideDistrict 4 Public Health office with a comprehensivesummaryof communityperceived views on the current stateofhealth in Fayette County,Georgia.

Assessments

The FLTW coalition collected 79 paper surveys.Survey participants ranged in ages from 18 - 74. Participants included those from all over Fayette County. There were 79 responses with 58 (79%) female and 15 (20%) male.

Major Themes

Major themes include the following:

The 3 most important health problems in the community:
Aging Problems
Cancers
Heart Disease and Stroke

The 3 most risky behaviors in the community:
Alcohol Abuse
Overweight
Texting while driving

Satisfaction withhealthcare in the community:
50% said no or strongly no
<20% said yes

Forces of Change Assessment

The Forces of Change Assessment is designed to help participants answer the following questions:

What is occurring or might occur that affects the health of our community or the local public health system?
What specific threats or opportunities are generated by these occurrences?

The FLTW collaborative addressed these questions for the following categories: Political, Social, Economic, Environmental, Technology, Scientific, and Legal/Ethical. Our findings are listed below.

Political

Affordable Care Act (ACA) - confusion, increasing costs, access to care
Consolidation of services
Re-districting
Lack of group homes
Annexation
Medicaid experts or lack of
Access to Social Services Information

/ Legal/Ethical

CHINS law
Barrier to Mental Health care at hospital
Proper referrals

Social

Homeless population

Mental Health access to care
Domestic Violence
Pinewood studios
Cultural change
Growing Veteran population with increasing PTSD and mental health disorders
Influx of Katrina population
Lack of access to mental health care
Increasing immigrant population
City exclusivity/Insular
Greater Diversity
Lack of social activity for young people
Think Tanks
Acceptance of drug use and alcohol

Technological

Lack of medical info for 911
Health information exchange
Healthcare provider incentive
Library
Access to social services information

/ Scientific

Lack of specialists
No STEM schools
No aviation schools
Incubator/Think tank/research

Economic

Property taxes
Decreased work force with increased aging population
Cost of Housing/lack of affordable housing
Lack of transportation
Education options
Lack of vocational and tech schools
Pinewood
Sewer system

/ Environmental

Access to highway/interstate
Too much fast food
Snowstorm/Katrina
Lack of sewer system
Golf cart paths
Sidewalks
Air Quality
Bike lanes
Public Transit-Lack

Local Public Health System Assessment

TheNational PublicHealth PerformanceStandards Program (NPHPSP) assessment is a helpful

tool in evaluating the current performance against aset ofoptimal standards. This is apartnership effort to improvethepracticeofpublichealth andtheperformanceofpublichealth systems. This Local PublicHealth System Assessment (LPHS)report is intended to help theDistrict 4 gain agood understanding ofits performanceand moveonto thenext step in strengthening thepublicsystem.

The10 Essential PublicHealth Servicesdescribethepublichealth activities that all communities should undertakeand serve as theframework forNPHPSPinstruments. These include:

1) Monitorhealth status to identifyand solve communityhealth problems.

2) Diagnose and investigatehealth problems and health hazards in the community.

3) Inform, educate, andempowerpeopleabout health issues.

4) Mobilize communitypartnerships and action to identifyand solvehealth problems.

5) Develop policies and plans that support individualand communityhealth efforts.

6) Enforcelaws andregulations that protect health and ensuresafety.

7) Link peopleto needed personal health services and assuretheprovision ofhealth carewhen otherwiseunavailable.

8) Assure competent public and personal health careworkforce.

9) Evaluateeffectiveness, accessibility, and qualityofpersonal andpopulation-based health services.

10)Researchfornew insights and innovativesolutions to health problems.

The following feedback resulted from the Local Public Health System Assessment that focuses on health challenges in the community in relation to the 10 essential public health services:

Essential Public Health Service 1 and 2: Monitor Health Status and Diagnose and Investigate Health Problems

•No Community Health Assessments being performed outside of the hospital

•Health data collected by state and federal agencies is not easily accessible to the public

•Consistently performing drills and exercises to prepare for public health threats and emergencies

•In close proximity to Georgia Public Health Laboratory and CDC Laboratories

Essential Public Health Service 3 and 4: Inform, Educate and Empower and Mobilize Community Partnerships

•A need for greater collaboration and communication among partner organizations

•A need for innovation in public health awareness

•Lacking mental health care for children

•A social service resource guide is needed

•Fayette has a strong Faith Based Emergency Response Network formed by the EMA

Essential Public Health Service 5 and 6: Develop Policies and Plans and Enforce Laws and Regulations

•Local Public Health System (LPHS) does not coordinate with the Local Health Department in provision of services. There are a variety of social serving organizations in the community, but they all working in a collaborative manner.

•LPHS and Local HD do not have a strong relationship with policy makers

•Not currently a regular review of Public Health laws, regulations and ordinances

•Public Health issues are addressed as they arise

Essential Public Health Services 7 and 9: Link to services and Evaluation

•Greatest barrier to care is transportation

•Fayette needs public transportation to provide access to health services

•Fayette does not evaluate how well the LPHS activities meet the needs of the community

Essential Public Health Services 8 and 10: Assure competent workforce and Research for new insights

•No history of a LPHS workforce assessment

•Need a RN at every school

•Need to expand nursing schools to Fayette County

•Increase Tele-health opportunities

•Schools do a good job at collecting data

•Need to partner with colleges and universities to conduct more in depth Public Health research and evaluation

Community Health Status Assessment

The Health Status analysisprovides quantitativedataon abroadarrayofhealth indicators, including qualityoflife,behavioral risk factors,and othermeasures that reflect abroad definition ofhealth.

Demographics Characteristics

Population-108,365
<18-24.3%
>65-14.6%
African American-20.4%
American Indian/Alaskan Native-.4%
Asian-4.1%
Hispanic-6.5%
Non-Hispanic White-67.2%
% Not Proficient in English-1.5%
Female-51.7%
Rural-18.2%

Socioeconomic Characteristics

Education-78% High School Graduation
Education-76.2% Some post-secondary education
Education-Ranked 3rd in GA
Income-Ranked 2nd in GA with Median income of $78,717

Health Resource Availability

15% Uninsured adults
8% Uninsured children
7% of residents could not see doctor due to costs
Primary Care Physician Ratio-905:1
Access to care-Ranked 1st in GA
Quality of Care-Ranked 1st in GA

Quality of Life

Poor or Fair Health Days-9%
Physically Unhealthy Days-2.6%
Mentally Unhealthy Days-2.9%

Behavioral Risk Factors

Adult Smokers-12%
Physically inactive-22%
Excessive Drinking-13%
Alcohol impaired driving deaths-29%
Limited access to healthy foods-7%
Alcohol and Drug Use-Ranked 93rd in GA

Environmental Health Indicators

Air and Water Quality-Ranked 157th in GA
Housing and Transit-Ranked 69th in GA
Drinking water violations-40% of population in violation
Severe Housing Problems-13%

Social and Mental Health

Social/Emotional Support-16% with no social/emotional support

Maternal and Child Health

Low-Birth Rate-7%
Teen birth rate-13%
Children in poverty-11%
Children in single-parent households-22%
Infant mortality rate-4.8% (per 100,000)
Child mortality rate-33.6

Death, Illness and Injury

Injury death rate-40
Homicide Rate-3
Leading causes of Age-adjusted death:
Ischemic heart and vascular disease
Cancer
Cerebrovascular disease
All other mental and behavioral disorders
Alzheimer’s disease

Leading causes of premature death:
Ischemic heart and vascular disease
Motor vehicle crashes
Suicide
Cancer of the trachea, bronchus and lung
Accidental poisoning

Community Themes and Strength Assessment

The “CommunityStrengths and Themes Assessment,”ofphasethreein theMAPPprocess was employed to gain insight upon thequalityoflifein FayetteCounty,Georgia. This was done through surveying collaborative members. The results ofthe assessment will provideDistrict 4 with a comprehensivesummaryof communityperceived views on the current stateofhealth in FayetteCounty,Georgia.

In the following list, what do you think are the three most important factors for a “Healthy Community?”
Answer Options / Response Percent
Low crime/safe neighborhoods / 67.10%
Good schools / 45.60%
Clean environment / 34.20%
Access to health care (e.g., family doctor) / 32.90%
Good jobs and healthy economy / 30.40%
Healthy behaviors and lifestyles / 27.80%
Strong family life / 22.80%
Good place to raise children / 20.30%
Parks and recreation / 12.70%
Religious or spiritual values / 12.70%
Low level of child abuse / 7.60%
Affordable housing / 7.60%
Excellent race/ethnic relations / 7.60%
Emergency preparedness / 6.30%
Low adult death and disease rates / 5.10%
Low infant deaths / 5.10%
Arts and cultural events / 2.50%

In the following list, what do you think are the three most important “health problems” in our community? (Those problems which have the greatest impact on overall community health.)
Answer Options / Response Percent
Heart disease and stroke / 47.30%
Aging problems (e.g., arthritis, hearing/vision loss, etc.) / 45.90%
Cancers / 39.20%
Mental health problems / 32.40%
High blood pressure / 29.70%
Diabetes / 27.00%
Motor vehicle crash injuries / 20.30%
Domestic Violence / 18.90%
Child abuse / neglect / 14.90%
Teenage pregnancy / 8.10%
Dental problems / 6.80%
Infectious Diseases (e.g., hepatitis, TB, etc.) / 5.40%
Firearm-related injuries / 4.10%
Respiratory / lung disease / 4.10%
Rape / sexual assault / 2.70%
Sexually Transmitted Diseases (STDs) / 2.70%
Suicide / 2.70%
Terrorist activities / 0.00%

In the following list, what do you think are the three most important “risky behaviors” in our community? (Those behaviors which have the greatest impact on overall community health.)
Answer Options / Response Percent / Response Count
Texting while driving / 50.60% / 40
Being overweight / 48.10% / 38
Alcohol abuse / 44.30% / 35
Drug abuse / 36.70% / 29
Poor eating habits / 29.10% / 23
Lack of exercise / 24.10% / 19
Tobacco use / 16.50% / 13
Not using seat belts / child safety seats / 12.70% / 10
Unsafe sex / 11.40% / 9
Unsecured firearms / 7.60% / 6
Dropping out of school / 5.10% / 4
Racism / 5.10% / 4
Not getting “shots” to prevent disease / 2.50% / 2
Not using birth control / 1.30% / 1
Lack of maternity care / 0.00% / 0