Health survey findings reported

Washington — A countywide survey of public health issues drew 219 responses worth of feedback, according to Washington County Public Health Director Emily Tokheim who presented on initial findings from the data Monday afternoon.

The lion’s share of responses, a little over 120, came from Washington residents, according to Tokheim. The rest scattered across other communities in the county, only one of which — Kalona — had more than 20 participants. A plurality (46%) came from households of two or less, and nearly three quarters of respondents were female.

Their replies had a few recurring themes.

Mental health identified as high priority, but policy approach may be complicated

The countywide survey asked respondents a number of questions with subtly distinct framing to assess local health needs. Whenever the subject came up in multiple-choice responses, it was among the two most-selected answers.

On another question asking about access to services, 34.25% of respondents said access to a mental health provider was “difficult” or “very difficult,” more than any other item listed including child care services, specialty doctors and primary care.

While health officials said that recurring theme was hardly surprising, they said there may be a gap between the perceived barriers to mental health care and reality.

Washington County Mental Health and Disability Services Coordinator Bobbie Wulf said the county may need to prioritize connecting people with providers, rather than simply drawing more providers to the area.

“I’d love to find out how many people who answered the survey have actually tried to access services, and where the barrier is,” she said at the meeting. “Since the last survey, we have more mental health providers in Washington County than we’ve ever had.”

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That contradicts conventional wisdom, given that almost 120 respondents said “access to mental health services” was among the top five barriers to health and well-being for the community. That said, when asked what barriers kept respondents’ family personally from being healthy, less than half as many cited mental health access as a concern, dropping it to the second most common answer.

In a follow-up interview after the meeting, Tokheim said the finding surprised her.

“We have an adequate number of providers with minimal wait lists, but clearly people don’t know about that,” she said. “There was a lot of conversation regarding awareness.”

The number one barrier people cited to their own family’s health, according to the survey, was “personal choice.” With over 60 votes, it came in ahead of access to any type of care, low wages, underlying conditions, unawareness, and a “none of the above” option.

Tokheim said that had big implications for public health’s efforts to encourage well-being on non-mental health fronts. Participants at Monday’s meeting discussed community relationship-building, active living and healthy food as other top community concerns that called for an information-sharing approach.

“It highlighted the need to make some systemic choices, and make sure that healthy choice is the easy choice,” Tokheim said. She said county efforts could focus on helping restaurants coordinate healthy menu sections, mapping out local walking paths, and putting step count information on long stair cases. She said the strategy would put “reminders out there, as a gentle nudge.”

Some concerns fall beyond public health’s control

Tokheim said she aimed to present an action plan based on survey findings at the October Board of Health meeting. Still, she acknowledged that some widespread causes of health concern were too big for local solutions to make a dent.

“While those are certainly important and they came up frequently in our survey results, some of the things we would like to do to address (those) concerns are out of our hands,” she said.

A shortage of child care is a prime example. The issue was listed as the number one “thing out community could improve” with almost 120 votes, and has long been highlighted by local economic development groups as a problem. Tokheim said staff at her own child’s center had recently left due to a lack of benefits packages and wages across the industry.

Des Moines, Henry, Louisa and Washington County Early Childhood Iowa Area Director Tasha Beghtol said the problem was not a shortage of child care centers, but a lack of trained staff to work at them.

“We need to shift the conversation, we need humans to do child care,” she said. “We keep building centers and they can’t hire anybody.”

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Unaffordable housing, low wages and job opportunities were other areas of widespread concern that Tokheim said fell more on private businesses than county decisions.

“Affordability goes along with a lot of these concepts we’ve talked about, but what can we in this room push forward with that?” she said at the presentation. “Thinking about smart objectives, what can we deliver for something like that? I think some of those might be really above and beyond what we are capable of doing.”

Washington County Public Health’s full power point of the initial survey findings can be found in the online version of this article.

Download: PubHealth ChaChip workshop presentation.pdf

Comments: Kalen.McCain@southeastiowaunion.com