Mental health ranks as a top concern in Henry County

MT. PLEASANT — Four Henry County organizations came together to complete the required Community Health Assessments and create a plan to build on strengths and work on weaknesses to improve the county’s overall health.

“Community Health Assessments are an essential part of providing quality health care and implementing community health programs,” Henry County Public Health Outreach Coordinator Kelly Carr states. “This communitywide process identifies the most important factors affecting health in the community in order to develop a plan to build on strengths and work on gaps.”

According to Carr, local public health departments must complete a community assessment at least once every five years and nonprofit hospitals are required to complete one every three years.

Henry County Public Health worked with Henry County Health Center, Iowa State University Extension Office and Outreach, and Healthy Henry County Communities to create the county’s 2023 health assessment and 2024-2026 Community Health Improvement Plan.

These organizations worked together to gather primary data from a community survey and secondary data from a variety of state and national organization sources.

“Several meetings were held to review and analyze the survey results and data, identify common themes, and prioritize those themes,” Carr said.

“The Community Health Assessment allowed us to get public input as well as local data to identify the top needs in Henry County, which really didn’t surprise us,” Carr said. “We now have a nine-page plan of strategies to address those needs and help improve the health of Henry County. Public Health is engaging many community partners to make this a success.”

Through their assessment the team identified eight priorities and created an outline of strategies to address them.

The following priority areas identified “to make Henry County a healthier place to live and work,” are included in the Community Health Improvement plan:

• Behavioral Health

• Cancer

• Healthy Food Access and Awareness

• Active Living

• Older Adult Health and Aging Issues

• Access to Care

Economic concerns and heart disease, stroke, and high blood pressure were not included in the Improvement Plan but identified as priorities.

According to Carr, the Improvement Plan will be used to guide community health activities in the county for the next three years through the efforts of the organizations that created it and “many other community partners.”

The Plan

Kelly Carr, Mandi Morin, Robin Poole, and Shelley Van Dorin of Henry County Public Health, Chris Kempker of ISU Extension and Outreach, and Michelle Rosell of Henry County Health Center took point as the leadership team for Healthy Henry County Communities which analyzed the data to make the Community Health Improvement Plan.

Behavioral Health

According to Carr, Behavioral Health includes the top identified health concern of mental health and substance abuse.

“We grouped mental health and substance misuse together into Behavioral Health since that is the terminology that HHS [Department of Health and Human Services] has started to use,” Carr clarified. “The survey wording was kept the same as the 2020 survey so we could compare apples to apples.”

According to the Health Assessment, “Henry County is located in a mental health provider shortage area as defined by the Health Resources and Services Administration.”

“Mental health care appointments are so hard to get and are booked way out,” One participant commented on the survey.

“Mental health care is non-existent in the area,” another said. “It's near impossible to find play therapy that doesn't involve a 6 month+ waitlist.”

“Mental health is a huge concern in this community, there are not enough resources,” another commented. “All ages are effected, we have had numerous suicides or attempts due to lack of mental health options.”

One survey participant said they have to travel to Iowa City to receive mental health services.

The health assessment report states while the United States suicide age-adjusted death rate per 100,000 population is 13.8, Iowa’s is 16 and Henry County’s is 19.9.

Goals to address this area include the following:

Goal 1: Improve Access to Behavioral Health Services

• Expand Behavioral Health Services within HCHC Rural Health Clinics (counselors and APPs)

• Recruit mental health professionals to work in expanded clinic

• Expand Senior Life Solutions (group therapy for seniors) by adding 1 additional group

• Develop a public awareness campaign of expanded HCHC services

• Promote existing transportation services

Goal 2: Improve Awareness of Behavioral Health Services/Resources

• Promote awareness of 988, Your Life Iowa, mobile crisis response, and ADDS treatment programs around the county

• Implement a campaign about how to talk to a loved one about substance use/misuse

• Educate school personnel and parents about Narcan and its use for unintentional overdoses

• Update as needed and distribute local mental health resource guides

Goal 3: Increase Prevention Strategies

• Implement a campaign to remind all ages about the dangers of alcohol, marijuana, and meth

• Educate about the importance of proper pill disposal and promote area drug take-back boxes and drug disposal pouches

• Implement a campaign to educate all ages about how easy it is to misuse opioids

Goal 4: Strengthen Mental Health and Resilience

• Plan and implement quarterly kindness campaigns

• Implement a process to do PHQ and GAD screenings for mothers of newborns during WIC and newborn home visits

• Develop a handout for new moms educating about postpartum depression, supports, and resources

• Develop and integrate one mental health screen and intervene process into a community event or outreach activity

• Provide mental health education in schools regarding stressors, feelings, coping, etc.

• Promote campaigns to reduce stigma and increase support around asking for help

Cancer

The Health Assessment states that Cancer made the list for the improvement plan because, “Iowa has the 2nd highest incidence rate for cancer in the U.S., (behind Kentucky), and is the only state with an increasing rate of cancer. Henry County has higher rates than the state average of lung cancer, colorectal cancer, and melanoma of the skin.”

Goals to address this area include the following:

Goal 1: Increase Awareness of Recommended Cancer Screenings

• Promote and support programs that provide free or low-cost recommended screenings to people who are uninsured or underinsured

• Create a flyer listing preventive health screenings by age to hand out during immunization clinics and at community events

• Educate the public about cancer screening recommendations by utilizing agency websites, social media, and waiting rooms

• Work with area primary care providers to ensure preventive health screenings are completed timely

Goal 2: Increase Cancer Prevention Strategies

• Promote and increase tobacco/nicotine cessation

• Educate community members on harms of tobacco and nicotine

• Reduce adult and youth exposure to secondhand smoke

• Implement adolescent reminder mailings to increase the number of kids who initiate and complete the HPV vaccination series

• Encourage providers to strongly recommend the HPV vaccine as a cancer prevention strategy

• Increase public awareness of HPV vaccine recommendations and role in cancer prevention

• Encourage availability of sunscreen at outdoor events

• Increase awareness about skin cancer prevention and screening

• Increase targeted skin cancer education for Iowans who work outside

Healthy Food Access & Awareness

This topic was chosen for the Health Improvement plan due to survey participants indicated obesity and poor nutrition as top health concerns.

“When identifying personal barriers to health, 23% selected access to healthy food,” the report states. “28% of respondents indicated that they are food insecure. In addition, 37% of adults in Henry County are obese, up from 33% in 2022 and 47% of children in Henry County were eligible for free or reduced-price lunch.”

One survey participant commented that access to healthy food is an important factor for a healthy community, “ … but it must also be inexpensive because inflation is really hurting all of us.”

Additionally, the secondary study information considered informed the group that people with healthy eating habits live longer and are at lower risk for serious health problems like heart disease, Type 2 diabetes, and obesity.

Healthy eating habits can also help those with chronic diseases.

Goals to address this topic include the following:

Goal 1: Reduce Food Insecurity

• Support and promote farmers markets and community gardens

• Support and promote Grow Another Row and home-garden produce donations

• Promote food pantries and explore food rescue efforts to increase donations

• Promote food assistance programs such as SNAP, WIC, free and reduced lunch programs, farmers market vouchers, congregate meal sites, and Double Up Food Bucks

Goal 2: Increase Awareness of Healthier Food Choices

• Increase exposure to and education about healthy foods and drinks in schools

• Develop and implement community-based nutrition education classes

• Increase participation levels of HCHC Diabetes Education programs

Active Living

Survey responses about obesity also lead to Active Living making the list for the improvement plan.

“When identifying personal barriers to health, 27% of respondents selected lack of free recreational opportunities. 24% of adults report no leisure time physical activity,” the report states.

When asked what is missing or most needed in the community to improve their personal health, one respondent stated, “activities that are exciting and motivating to people.”

“When I first move here in Iowa particularly in New London I really didn’t know what to expect but now that I've been here for almost four years I am really liking it because it's not like living in the big city where traffic is everywhere,” another commented when given the opportunity to include additional comments overall. “The only downside is there's not much to do for my kids around this area. I want more fun recreational activities for my kids and some more restaurants to dine too. Hopefully they can improve that later on.”

In addition to reducing obesity, regular physical activity can reduce risk for many serious health issues such as cancer, heart disease, stroke, high blood pressure, depression, and diabetes, the report informs.

Goals to address this area include the following:

Goal 1: Increase Physical Activity Among All Residents

• Host, participate in, and promote free community activities

• Update wellness resource guide to include free opportunities like tennis and basketball courts

• Encourage regular physical activity for kids and adults using existing campaigns (SWITCH, 5-2-1-0, Play Your Way, Move Your Way)

• Increase usage of activity stencils at public locations

• Promote outdoor facilities such as pools, splash pad, tennis courts, playgrounds, etc.

• Increase participation in existing recreational opportunities

• Explore shared use agreements for school facilities

• Create educational opportunities to learn how to play outdoor sports like pickleball, disc golf, and tennis

• Encourage development of trails, sidewalks, and park enhancements

Older Adult Health and Aging Issues

In consideration of Henry County’s 65 and older population increasing by 16.1% in 2010 to 19.6% in 2021, this topic made the Improvement Plan list.

Higher risk for health concerns such as diabetes, osteoporosis, and Alzheimer’s and more hospitalizations for falls and infectious diseases are also an issue for this population.

Goals to address area include the following:

Goal 1: Increase Awareness and Expand Knowledge Around Fall Risks and Prevention to Reduce Falls and Fall-Related Injuries

• Promote the Henry County Lifeline service and investigate funding opportunities

• Develop a plan to promote fall risks & prevention

• Develop a fall prevention program in Henry County

Goal 2: Provide Health Management Education to Older Adults

• Develop a plan to check blood pressures and provide health education at senior apartment sites

and other community locations around Henry County

• Develop an annual senior health fair

• Promote financial assistance programs that may free up dollars for health management expenses (Affordable Connectivity Program, energy assistance, low-income housing, food assistance, waiver programs, Medicare preventive health services, etc.)

• Increase the number of community members taught to monitor their blood pressure at home

• Explore being trained in or hosting Better Choices Better Health workshops

Access to Care

Results from the survey showed 68% of respondents identified access to health care as one of the most important factors for healthy community and 38% chose specialty physicians and 28% chose affordable health insurance as missing or most needed in the community.

When asked about the most important factors for a healthy community and a good quality of life, one respondent listed, “Health Insurance that actually pays for what the patient needs!”

“Cost of medical care even with insurance is too high,” another comment reads.

Many other comments listed the cost of health insurance as a barrier.

Those in households with income of less than $20,000 specifically identified dental health as a top concern and lack of transportation as a barrier in the survey results.

“Henry County is designated as a health care provider shortage area by the Health Resources and Services Administration and a low income population dental provider shortage area,” the report states.

Among top concerns for the community, one respondent stated that dentist in Mt. Pleasant don’t take state insurance or aren’t taking new patients.

“Not enough places take state dental insurance,” one person said. “We have to go to Iowa City.”

Additionally, survey participants stated transportation made it difficult to access health care and other healthy resources.

“There is no way of getting around unless you have transportation, for anyone whom does not have this access it cost money to use what we have a cab service and it can be expensive to pay when you do not have the means needed,” one participant stated.

“The roads are so bad, it is hard to ride a bike, sidewalks have many crack, very few walking/bike paths,” another commented.

Goals to address this area include the following:

Goal 1: Improve Access to Health Care for All Henry County Residents

• Promote SEIBUS, RSVP, and other public transportation services

• Promote SHIIP (Senior Health Insurance Information Program) to help seniors sign up for appropriate Medicare plans

• Promote available health insurance resources (HHS, Marketplace, etc.) to uninsured individuals

• Promote prescription delivery services as an alternative to finding transportation

• Increase number of trained staff members to provide presumptive eligibility for Medicaid

• HCHC Rural Health Clinics to develop a chronic care management program for Medicare recipients

• Increase number of primary care, mental health, and long-term care specialty providers in Henry County

Goal 2: Help Residents Navigate/Remove Barriers for Better Health

• Educate both the public and new referral sources about the CARE LINKS health navigation program

• Increase number of referrals to CARE LINKS from health care professionals

• Promote and update as needed the Henry County Community Resource Guide to support residents in finding available services

The complete Health Assessment and Health Improvement Plans are both available at www.HealthyHenryCounty.org/PublicHealth

“We welcome your feedback and if you would like to get involved, please reach out to publichealth@henrycountyiowa.us or 319-385-0779,” Carr said.

Comments: AnnaMarie.Ward@southeastiowaunion.com