Key Informant Meeting JULY 27 TH 2018

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1 Key Informant Meeting JULY 27 TH 2018

2 WHAT IS A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA)? Completed every 3 years, a key component of the Affordable Care Act Required of tax exempt hospitals to get an accurate picture of the health needs of each community Provides an overview of the health needs and priorities associated with our service area (Sauk County and surrounding communities) Guides our hospital in community benefit planning efforts and development of a strategic plan to address evaluated needs Also a way to improve health coordination of hospital community benefits with other efforts through partnerships with Sauk County Health Department

Healthiest Wisconsin 2020: State Health Plan Alcohol and other Drug Use Chronic Disease prevention and management Communicable disease prevention and management Environmental and Occupational Health

4 Healthiest Wisconsin 2020: State Health Plan Alcohol and other Drug Use Chronic Disease prevention and management Communicable disease prevention and management Environmental and Occupational Health Healthy Growth and Development Injury and Violence Mental Health Nutrition Oral Health Physical Activity Reproductive and Sexual Health Tobacco use and Exposure Wisconsin Department of Health Services

5 Demographics

6 Zip Codes from Sauk County 649 Highest Survey turnout came from Reedsburg with 649 surveys completed REEDSBURG MERRIMAC PLAIN PRAIRIE DU SAC SAUK CITY SPRING GREEN BARABOO HILLPOINT LAKE DELTON LA VALLE LIME RIDGE LOGANVILLE NORTH FREEDOM ROCK SPRINGS

7 Zip Codes Surrounding Sauk County The highest survey results out of Sauk County were from Roxbury with 164 surveys completed

8 Birth Years of Respondents

9 72.47% of Respondents Reported that They Believed Sauk County is Somewhat Healthy 72.47% 20.02% 1.27% 3.85% 7.91% Very unhealthy Unhealthy Somewhat healthy Very healthy Not sure

10 47.4% of respondents believed that they were in good health % 31.42% 14.14% 1.44% 5.60% Poor Fair Good Very Good Excellent

11 Race/Ethnicity of our county/state 91.1% 81.7% 6.3% 0.9% 1.5% 1.1% 0.7% 2.8% 0.0% 0.1% 4.9% 6.7% African American American Indian Asian Native Hawaiian/Other Pacific Islander Sauk County Wisconsin Hispanic Non-Hispanic White County Health Rankings 2018

12 SURVEY DATA 97.58% 97.58% of respondents identified as white and 1.59% of that percentage said they were Hispanic 0.31% 0.18% 0.09% 0.57% 0.35% 0.75% 0.18% White Black Asian Native Hawaiian or other Pacific Islander American Indian or Alaska Native Another Race Multiple Races Not Sure

13 REEDSBURG WI STATISTICS AS OF JULY 2017 Reedsburg, WI has a population of 9,487 people median age of 35.5 median household income of $51,378. The population of Reedsburg, WI is 92.8% White, 3.93% Hispanic 5.62% of the people in Reedsburg, WI speak a non-english language, and 98.9% are U.S. citizens. The median property value in Reedsburg, WI is $128,200, and the homeownership rate is 60%.

14 Education of Survey Takers Sauk County's High School Graduation Rate has increased by 2% in the past two years and remains at above state average. Sauk County had an increase by 2% in students attending some college in 2018, but is still below the state average. 95.0% 68.0% 93.0% 91.0% 88.0% 88.0% 88.0% 68.0% 60.0% 62.0% Sauk County 2016 Reedsburg 2018 Sauk County 2018 Wisconsin 2018 Sauk County 2016 Sauk County Wisconsin County Health Rankings 2018

15 Reported Education Levels Not sure 0.09% Advanced or professional degree 20.31% College graduate 32.75% Technical school graduate Some College 15.82% 18.68% Highschool or GED 11.21% Some high school 8th grade or less 0.84% 0.31%

16 Household Income of Survey takers Pefer not to answer 8.68% Not Sure 1.15% $150,000+ (more than $75 per hour) 9.25% $100, ,000 (less than $75 per hour) 17.93% $75, ,000 (less than $50 per hour) $50,000-75,000 (less than 37.5 per hour) $25,000-50,000 (less than 25 per hour) 19.21% 19.25% 20.48% $1-25,000 (lessn per hour) 4.05%

17 School Lunch Children Eligible for Free or Reduced Lunch Sauk County 2015 Wisconsin 2015 Reedsburg 2017 Sauk County 2018 Wisconsin % 35% 46.12% 40% 40% County Healthy Ratings 2018

18 Access to High Quality Health Services Sauk County is ranked 26 th out of 72 counties for Clinical Care by the 2018 County Health Ratings

19 Health Care Facilities Reedsburg Area Medical Center Reedsburg, WI Sauk Prairie Healthcare Sauk Prairie, WI SSM Health St. Clare Hospital Baraboo, WI

20 ACCESS TO PRIMARY CARE Sauk County 2015 Wisconsin 2015 Sauk County 2018 Wisconsin 2018 Primary Care Physicians 963 to 1 1,215 to to 1 1,250 to 1 Other Primary Care Providers 1,662 to 1 1,343 to 1 1,543 to 1 1,055 to 1

21 ACCESS TO HEALTH CARE 98.1% of residents reported that they had some type of insurance 83% shared it comes from an employer sponsored plan Out of 17 choices, access to healthcare was ranked #1 as the most important factor for a community to be healthy 11.98% of respondents reported not taking a prescription due to the cost

22 Access to Medical Care 82% reported that they felt that they received the appropriate and needed medical care 15.5% reported that they did not receive the needed medical care 91% of parents reported that their child got the appropriate and needed medical care within the last year. 1.39% 12.53% 6.96% 11.42% 16.71% Uninsured Poor medical care insurance did not cover it Not enough time Other with a response 6.96% 14.76% 18.66% 10.58% Could not afford to pay Co-payments too high Unable to get an appointment Other

23 Access to Dental Care In Sauk County, there is one dentist for every 1,560 people Percentage of Those Who Have Not Seen a Dentist Recently 27% 24% 33% 26% County Health Rankings Sauk County 2015 Wisconsin 2015 Sauk County 2018 Wisconsin 2018

24 Oral Health 78.9% reported they have seen a dentist within the last year In 2015, 76% of respondents reported having seen a dentist in the last year % reported that they did receive the dental care that they thought they needed Reasons for Not Receiving Dental Care 18.84% 6.69% 18.24% 34.35% 10.33% 0.30% 9.73% 91% of parents reported that their child received the appropriate dental care. 1.52% Uninsured Could not afford to pay poor medical care Co-payments too high insurance did not cover it Unable to get an appointment Not enough time other

25 Mental Health Care Out of 14 choices, Mental Health was ranked to be the #1 health problem in our community with 80.74%. There is only one Mental Health Care Provider for every 760 people in Sauk County, compared to the State average of 1 to every 560 people 27.31% Reports of Feeling sad, blue or depressed in the last 30 days % 27.40% 2.94% 0.93% 0.70% Never Seldom Sometimes Nearly always Always Not sure

26 Mental Health Access 89.43% of respondents reported they had received the needed Mental Health Care within the last year In 2015, 93% of respondents reported that they received the Mental Health Care needed in the past year. 8.8% reported that they did not get the Mental Health Care they thought they needed

27 Suicide According to Vital Records, there are 3 suicides to date in Sauk County 2018 Contemplation of Suicide 1.36% 4.44% suicide deaths suicide deaths suicide deaths 94.20% Yes No Not sure Suicide Rates CDC

Foot Clinics 8 different locations Serve anywhere from 15 to 30 people at each clinic Needs/Concerns: Transportation for Older Adults Affordable Housing and Healthy

28 Foot Clinics 8 different locations Serve anywhere from 15 to 30 people at each clinic Needs/Concerns: Transportation for Older Adults Affordable Housing and Healthy Foods Difficulty getting appointments and keeping them Believe that Mental Health, Drugs and Alcohol, Diabetes, Respiratory Problems and Obesity are major health concerns

29 Emergency Preparedness, Response & Recovery

30 Resiliency Factors 85.74% reported voting in the last Presidential Election 54.65% reported regularly attending a church or place or worship 20% reported being part of a neighborhood association or other civic group 79.22% reported knowing how to contact their elected officials 8.13% reported being a part of a PTO (Parent Teacher Organization) (if it applied to them) 58.59% reported that they regularly volunteer 95.91% reported that they have internet access in their home

31 Emergency Preparedness 97% 94.64% 76% 75.63% 43% 40.64% Has a 3 day suppy of water Has a 3 day supply of food Has a flashlight in their home

32 Health Literacy

33 Health Information Most commonly reported sources of health information came from: Doctor with 43% Internet with 22.95% Person/Family working in Health care with 15.94% Other with Response Other Not sure Health Newsletter Work TV Myself/family member in the health Family/friends Other Health Professional Internet Doctor 1.71% 0.04% 1.39% 1.17% 3.77% 1.12% 15.94% 3.05% 5.84% 22.95% 43.02%

34 Comments so Far?

35 Adequate, Appropriate & Safe Food, Nutrition, & Physical Activity

36 Obesity Wisconsin Adults 36.20% 35.50% 35.50% Wisconsin Adolescents 31.20% 30.70% 30.50% Wisconsin Adults 2014 Wisconsin Adults 2015 Obese Over Weight Wisconsin Adults 2016 Out of 17 choices, being over weight was ranked the 3 rd most important risky behavior by those taking the survey % 13.00% Wisconsin Adolescents % 15.00% Wisconsin Adolescents 2012 Obese Over Weight 9.30% 13.90% WisconsinAdolescents 2011

37 Height and Weight Average Height in Sauk County is 5'6"

38 Average weight of Sauk County Residents is roughly pounds.

39 Average BMI (Body Mass Index) for Sauk County

40 Sauk County Recreational Assets 5 State Parks 10 County Parks 18 State Nature Centers Ice Age Trail 400 State Recreation Trails Great Sauk Trail

41 REEDSBURG S RECREATIONAL ASSETS

42 Lack of Physical Activity Percentage of the Population that is Physically Inactive 25.00% 23% 21.00% 21% Sauk County 2015 Wisconsin 2015 Sauk County 2018 Wisconsin 2018

43 Physical Activity reported on the survey 20.47% of respondents reported being physically Reasons for Inactivity active for 5 or more days a week 34.87% of respondents reported being physically 0.00% 16.05% 14.81% active for less than one day a week 12.35% 48.20% of respondents who were parents 0.00% 2.47% 7.41% 28.40% reported that their child was active for 5 days or more 7.41% 6.17% 4.94% 8.08% of respondents who were parents reported that their child was active for 1 day or less a week Children do not like to be physically active School/homework/other activities Weather Sick/Ill Work Other with Response Likes to play video games or on the computer Pefers to watch TV Lack of time Neighborhood not safe to be outside Other

44 Food Security 87.47% reported it was never true to having ran out and there wasn't any money to buy more in the past 12 months. 2.28% reported running out of food either often or always true. 13% 13% 11% 11% 5% 5% 2% 2% Sauk County 2015 Wisconsin 2015 Sauk County 2018 Wisconsin 2018 Percentage of Food Insecurity Limited Access to Healthy Foods County Health Rankings

45 Nutrition reported on the survey 80.57% of respondents reported that the availability to get nutritious foods was either good or very good. In 2015, 82% of respondents reported the availability of nutritious foods was either good or very good 1.91% 17.52% 47.53% 33.04% Poor Fair Good Very good

Farmer s Market Focus Group Baraboo Farmers Market: Cooking Demo Want more resources How to cook healthy What are healthy alternative foods How do you read

46 Farmer s Market Focus Group Baraboo Farmers Market: Cooking Demo Want more resources How to cook healthy What are healthy alternative foods How do you read labels More Healthy Recipes *Clients enrolled in WIC and Seniors who are moderate to low incomes are eligible to receive $30 in vouchers to spend at Farmers Markets.

are scared to leave their homes Want education on how to eat healthier

47 Hispanic Focus Groups Two Focus Groups: July 5 th and July 15th Sauk City and Wisconsin Dells Alcohol and Depression are huge concerns Many are scared to leave their homes Want education on how to eat healthier and how to cook healthier Time Only seek healthcare in an emergency setting

Dining Center Focus Groups and WIC Clinics Dining Centers Valuable Resource and Major Food Source Affording Medications Doctor s Appointment Difficulties Transportation Companionship

48 Dining Center Focus Groups and WIC Clinics Dining Centers Valuable Resource and Major Food Source Affording Medications Doctor s Appointment Difficulties Transportation Companionship Obesity, Alcohol and diabetes are major problems WIC Clinic Grateful for service Only way they get good nutritious foods Prices of foods Drugs and Alcohol and Obesity are major problems

49 Alcohol, Drug & Tobacco Use

50 Risky Behaviors reported on the survey 65.16% 71.03% 51.29% 27.92% 21.97% 14.40% 4.16% 3.98% 10.55% 12.60% 4.51% 1.40% 3.76% 3.81% 2.19% 4.11% 2.28%

51 Alcohol Use reported on the survey 38.31% of Respondents Reported to have Binge Drank at Least Once in the Past Month 1.31% 18.57% 19.74% 60.38% None Once Two or more times Not sure

52 Binge Drinking Sauk County has an Excessive Drinking rate of 25% reported by adults State Average Excessive Drinking rate of 26% (range is from 20-29%) County Health Rankings

53 Drunk Driving Deaths 4.2% of respondents reported having been in a car with a driver who had perhaps had too much to drink. 44% of driving deaths in Sauk County had alcohol involved. County Health Rankings

54 Drug Use reported on the survey Problems in the Home Drinking alcohol Marijuana Heroin Other Street Drugs Missue of perscription drugs or over-thecounter drugs Gambling Not Sure No Other

55 Sauk County 2015 Wisconsin 2015 Sauk County 2018 Wisconsin 2018 Drug Over Dose Death (per 100,000 people) County Health Rankings

56 Tobacco Use reported on the survey 6.38% of respondents reported smoking and vaping everyday Of that 6.38%, 56.92% have tried to quit 61.54% of those smokers were advised by a healthcare professional to quit smoking 5.55% of respondents reported having used other tobacco products (cigars, chew, snuffing and pipes) 15% of adults in the county smoke State average is 17% of adults County Health Rankings

59 Second Hand Smoke reported on the survey 84.05% of respondents Smoking Not Allowed in Homes reported riding 0 days in the same vehicle with someone who was smoking (cigarettes or ecigs ) 94% 91.44%

60 Smoking During Pregnancy 19.00% 14.00% 16.00% 13.00% Sauk County 2015 Wisconsin 2015 Sauk County 2018 Wisconsin 2018 County Health Rankings

61 Chronic Disease Prevention & Management

62 Chronic Disease reported on the survey Health Problems in the Community 80.74% 63.01% 38.66% 35.76% 0.39% 1.14% 0.88% 4.52% 16.45% 4.83% 16.19% 5.62% 20.62% 5.88%

63 Prevention reported on the survey 67.37% of respondents reported receiving a routine check up in the last year 58.27% of respondents reported having received cholesterol testing in the last year 52.54% of respondents reported having an eye exam in the last year Preventable Hospital Stays (per 1,000 Medicare enrollees) Sauk County 2015 Wisconsin 2015 Sauk County 2018 Wisconsin 2018 County Health Rankings

64 High Blood Pressure reported on the survey 19.75% of respondents reported being diagnosed with High Blood Pressure within the last three years Of those 19.75%, 93.26% reported their high blood pressure is under control through medication, exercise, or life style change. High Blood Pressure Percentages from Respondents 23.00% 19.75% Sauk County 2015 Sauk County 2018

65 High Cholesterol reported on the survey 20.26% of respondents reported that they had been told by a physician or provider that they had high cholesterol 81.11% of those respondents reported that their high cholesterol under control through medication, exercise and/or lifestyle changes. High Cholesterol Percentages reported by Respondents 27.00% 20.26% Sauk County 2015 Sauk County 2018

66 Stroke 0.50% of respondents reported that they had been told or treated for a stroke within the last 3 years. Strokes Reported by Respondents 0.40% 0.50% Of the 0.50%, 80% of those respondents reported that it is under control through medication, exercise or lifestyle change. Sauk County 2015 Sauk County 2018

67 Heart Disease 4.66% of the respondents reported being treated or diagnosed with heart disease or a heart condition 88.35% of those respondents reported that it is under control through medication, exercise or lifestyle changes. Heart Disease Reported by Respondents 5.00% 4.66% Sauk County 2015 Sauk County 2018

68 Diabetes 6.11% of respondents reported having been treated or diagnosed by a Physician or Provider that they had diabetes Of that 6.11%, 81.6% of respondents reported that their diabetes is under control through medication, exercise or lifestyle change. Diabetes Reported by Respondents 6.11% 6.00% Sauk County 2015 Sauk County 2018

69 Cancer Cancer Rates Reported by Respondents 3.1% of respondents reported that they had been treat or diagnosed by the Physician or Provider with Cancer. 4.00% 3.10% Sauk County 2015 Sauk County 2018

70 Highest Reported Types of Cancer 31.34% 22.39% 4.48% Breast Melanoma/skin Cervical

71 Communicable Disease Prevention & Control

72 Vaccination Rates- Children Year Olds Meeting Vaccine Bench Marks 83.80% 83.80% 72.40% 72.40% 55.00% 66.60% 59.00% 65.70% 22.40% 25.30% 21.70% 21.10% Hep B T dap Meningitis HPV All Vaccines Influenza Sauk County 2015 Sauk County 2016 Vaccine Rates Sauk County County Health Rankings 2018

73 Vaccination Rates Of those who reported they were over 50 years old, 33.96% reported having already received the pneumonia vaccine. Childhood Immunizations 70.00% 73.00% 71.4% reported having a flu shot in the past year In 2015, 52% of respondents got their flu shot for the year 68.00% 66.00% Sauk County 2015 Wisconsin 2015 Sauk County 2018 Wisconsin 2018

74 Environmental and Occupational Health

75 Asthma reported on the survey 9.48% of respondents reported having asthma In 2015, 9% of respondents reported having asthma 12% of respondents who are parents, reported that their child had asthma 44.25% of those 12% respondents with children reported that they have had an asthma attack within the last year In 2015, 46% of children with asthma, parents reported they had an asthma attack within the last year.

76 Physical Environment Sauk County 2015 Wisconsin 2015 Sauk County 2018 Wisconsin 2018 Severe Housing Problems 14.00% 15.00% 15.00% 15% Drive Alone to Work 80.00% 80.00% 81.00% 81% Long Commute- Driving Alone to work 25.00% 26.00% 26.00% 27%

77 Healthy Growth and Development/Reproductive and Sexual Health

78 Women s Health 21% of Women reported having a bone density scan done 35.20% 30.35% Time since last pap smear 14.21% 6.78% 8.07% 2.46% 2.92% Less than 1 year Less than 2 years Less than 3 years less than 5 years More than 5 years Never Not Sure

79 Mammogram Screening 62.60% 70.20% 65% 72% 65% 72% Sauk County Wisconsin Not Sure Never More than 5 years less than 5 years Less than 3 years Less than 2 years Less than 1 year How long since a women's last mammogram 0.33% 36.33% 4.02% 4.08% 2.65% 16.32% 36.27%

80 Teen Pregnancy Teen Pregnancy Rate Sauk County Wisconsin County Health Rankings 2018

81 Men s Health Prostate Cancer Screening Test 48.21% 20.39% 9.64% 5.79% 4.96% 6.34% 4.68% Less than 1 year Less than 2 years Less than 3 years less than 5 years More than 5 years Never Not Sure

82 Elderly Health 39.22% of respondents reported being over the age of % of those reported having a Blood Stool Test within the last 5 years 55.78% of those over 50 reported having a Colonoscopy within the last 5 years 76.18% reported having a colonoscopy within the last 10 years 15.09% Less than 1 year Colonoscopy Rates Reported by Respondents 13.80% 26.89% Less than 2 Less than 5 years years 20.40% Less than 10 years 3.77% More than 10 years 19.58% Never 0.47% Not sure

83 Children s Health 87.59% of parents reported that their child has a personal doctor or nurse 89.56% of parents reported that their child has regular preventive care checkups In 2015, it was only 88% 9.1% of respondents who are parents said that there was a time in the last year that their child needed to see a specialist but did not see one % Reasons for Child Not Seeing a Specialist 20.27% Unable to Insurance get an did not cover appointment it 12.16% Not enough time 18.92% Speciality physician not in the area 5.41% Didn't know where to go 2.70% Other 21.62% Other: Response

84 Injury and Violence

85 Safety Feeling Afraid for Their Safety Out of 17 choices, low crime/safe neighborhoods was ranked 2 nd most important factor for a community to be healthy 28.47% 2.08% 29.17% 6.93% reported being afraid for their personal safety 62.8% Parent s reported that their perceived safety of their children in the community was nearly always. 2.78% 2.08% 2.08% 6.25% 0.69% 10.42% 6.25% 2.78% 6.94% Stranger Acquauntance Boyfriend/Girlfriend Child Ex-Spouse Friend Spouse Separated Spouse Parent Brother/sister Someone else Not sure

86 Injuries Sauk County 2015 Wisconsin 2015 Sauk County 2018 Wisconsin 2018 Injury Hospitalization Injury Deaths Violent Crime Offenses

87 Abuse and Harm 3.28% of respondents reported being physically abused in the past year In 2015, 1% of respondents reported being physically abused in the past year 29.85% 5.97% 7.46% 2.99% 13.43% 11.94% 10.1% reported being emotionally/verbally abused In 2015, 11% of respondents reported having been verbally/emotionally abused in the last year 1.49% 0.00% 2.99% 11.94% 8.96% 2.99% Stranger Acquaintance Boyfriend/Girlfriend Child Ex-Spouse Friend Spouse Separated Spouse Parent Brother/sister Someone else Not sure

88 LET S DISCUSS What do you think a healthy community looks like? What are the biggest health problems in our community? What does our community do to stay healthy? What keeps our community from being healthy? What would we need to create a more healthy community?

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Walworth County Community Health Survey Summary

Walworth County Community Health Survey Summary This research provides valuable behavioral data, lifestyle habits, and the prevalence of risk factors and disease conditions of Walworth County residents.