2016 Community Health Needs Assessment and Wellness Plan

Washington County Hospital and Medical Group

In collaboration with
Washington County Health Department
and the Community IPLAN Team
A Collaborative Approach to Improving Population Health in Washington County

TABLE OF CONTENTS

Process..2
Population..2
Community Demographics..3
Washington County Hospital Statistics 2016..4
2016 County Health Rankings5
Washington County Hospital (WCH) Community Assessment Survey 2016.8
Washington County Health Department (WCHD) Survey 2016.12
2016 Strategies to Decrease Risk and Promote Health and Wellness16

PROCESS
Washington County Hospital and Medical Group (WCH) and the Washington County Health
Department (WCHD) share the same vision of improving the health of our community. The
mission of the hospital is to forge partnerships to improve the health of our community
through service excellence. The mission of the health department is to prevent and control
disease in order to ensure the optimal health status of the community. In the past,
Washington County Hospital and Medical Group has employed many different methods to
assess the health needs of the area it serves and has adjusted its services to meet those
identified needs. As a district hospital, Washington County Hospital and Medical Group
believes that it is important to partner with other local resources to assess community health
issues and work collaboratively to improve the health of our residents. Assessing community
health needs through a review of available health data and discussion with area healthcare
partners, community leaders, and representatives of the many groups served by the hospital
and the health department, give Washington County Hospital and Medical Group and its health
care partners the opportunity to identify and address the areas most pressing health care
needs. WCH, WCHD and the community IPLANteam are working collaboratively to complete
this assessment and plan with hopes of making a greater impact on our population health.
The hospital chose to work collaboratively with local healthcare providers, the WCHD and the
community I-PLAN team to complete the assessment rather than using a consultant as had
been past practice. Once the assessment of county data, state and national statistics was
completed, a health assessment survey was distributed to a wide segment of residents
throughout Washington County to self report their perception of wellness and their personal
health activities. This data, coupled with that acquired by the WCHD thru IPLAN serve to
provide a health risk assessment to aid in the development of a roadmap to wellness for our
community.
POPULATION
For the purposes of this Community Health Assessment and Plan, WCH defined its primary
service area and population as Washington County. The hospitals and health department
populations include all who receive care or services without regard to insurance coverage or
eligibility for assistance.
The Community Health Needs Assessment will serve as a guide for planning and
implementation of health care initiatives that will allow the hospital and its partners to best
serve the emerging health needs of Washington County.

COMMUNITY
The geographic assessment area includes the entire county of Washington, which covers 562
square miles in rural south central Illinois. The county includes the following cities/villages:

Addieville, Ashley, Du Bois, Hoyleton

Irvington, Nashville, New Minden, Oakdale
Okawville, Radom, Richview, Venedy, Wamac

This geographic area definition of community is well-suited to Washington County Hospital and
Medical Group, a designated critical access hospital providing basic, primary care through
inpatient care, ancillary services, clinics, and specialty clinics to residents of a rural area.

2016 WASHINGTON COUNTY HOSPITAL SERVICES & STATISTICS AND ECONOMIC IMPACT

HOSPITAL SERVICES

HOSPITAL STATISTICS

Acute Care/Swing Bed Hospital

Long Term Care Program
Emergency Department 24/7
Medical Group/RHC
Surgery
Laboratory
Imaging
Physical Therapy
Occupational Therapy
Speech Therapy
Cardiac Rehab Therapy
Respiratory Therapy
Outpatient Nursing/Infusion Clinic
Specialty Clinics

Total Acute/Swing Beds: 22

Total Long Term Care Beds: 28
Medical/Swing Admissions: 186
Outpatient Visits: 22,307
Medical Group Visits: 7975
Employees on Staff: 160
Full-time Medical Staff: 7
ED Medical Staff: 5
Specialty Medical Staff: 10
Auxiliary Members: 75

ECONOMIC IMPACT FOR COMMUNITY

Washington County Hospital invests in the health of our community in many ways. We provide
essential medical services 24 hours a day, 365 days a year. We provide a variety of innovative,
preventive and community services that improve the health of our citizens.
An increasingly important way Washington County Hospital keeps our community healthy is by
supporting our local and state economy. We are a vigorous economic engine for our
community and for Illinois. The hospital employs 132.3 full time equivalents (FTEs) and has a
total payroll of $8,586,477. Hospital payroll expenditures serve as an important economic
stimulus, creating and supporting jobs throughout the local and state economies. Dollars
earned by Washington County Hospital employees and spent on groceries, clothing, mortgage
payments, rent, etc., generate more than $19,607,000 in economic activity and create an
additional 187 jobs for the local and state economy. (source: 2016 Illinois Health and Hospital
Association)

2016 County Health Rankings for Illinois

www.countyhealthrankings.org/illinois
Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. County
Health Rankings Health Gaps Report 2015.
Many factors contribute to the health of our community. Washington County ranks 23rd out of 102
counties for healthy outcomes. This graphic demonstrates the different health factors that can
ultimately impact our personal health outcomes.

WASHINGTON COUNTY DEMOGRAPHICS

www.countyhealthrankings.org/illinois 2010 Census

Population
% below 18 years of age
% 65 and older
% Non-Hispanic African American
% American Indian and Alaska Native
% Asian
% Native Hawaiian/Other Pacific
Islander
% Hispanic
% Non-Hispanic White
% not proficient in English
% Female
% Rural

Washington County
14,337
20.7%
18.4%
0.8%
0.1%
0.4%
0.1%

State of Illinois
12,880,580
23.2%
13.9%
14.2%
0.6%
5.3%
0.1%

1.6%
96.2%
0%
49.9%
73.6%

16.7%
62.3%
5%
50.9%
11.5%

Washington County
83%
71%
4.9%
13%

State of Illinois
83%
67%
7.1%
20%

4.1

4.9

27%

32%

25.6

9.9

319

430

64

50

SOCIAL & ECONOMIC FACTORS: STATE RANK 7/102

www.countyhealthrankings.org/illinois

High school graduation

Some College
Unemployment
Children in poverty
Income inequality: Ratio of income at
the 80th percentile to income at the
20th percentile
Children in single-parent households
Social associations: includes civic
organizations, sports groups, political
and professional organizations.
Number of associations per 10,000
population
Violent crime: number of reported
violent crime offenses per 100,000
population
Injury deaths: deaths due to injury per
100,000 population

HEALTH BEHAVIORS: STATE RANK 26/102

www.countyhealthrankings.org/illinois

Adult smoking
Adult obesity
Food Environment index: an index of
factors that contribute to a healthy
food environment, 0 (worst) to 10
(best)
Physical inactivity
Access to exercise opportunities
Excessive drinking
Alcohol-impaired driving deaths

Washington County
15%
31%

State of Illinois
17%
27%

8.3

7.8

27%
46%
21%
33%

22%
89%
21%
36%

HEALTH OUTCOMES/QUALITY OF LIFE: STATE RANK 14/102

www.countyhealthrankings.org/illinois

Poor or fair health

Poor physical health days
Poor mental health days
Low birth weight

Washington County
12%
3.2
3.3
7%

State of Illinois
17%
3.8
3.6
8%

Washington County
10%
3610:1
3580:1
1590:1
67%
83%

State of Illinois
15%
1240:1
1410:1
560:1
65%
86%

CLINICAL CARE: STATE RANK 38/102

www.countyhealthrankings.org/illinois

Uninsured
Primary care physicians
Dentists
Mental health providers
Mammography screening
Diabetic monitoring

2016 WCH COMMUNITY ASSESSMENT SURVEY RESULTS

Surveys were returned by 225 individuals from a variety of local groups including churches and
civic groups within our county. The surveys addressed some basic demographic statistics,
wellness activities, health-related prevention activities and included a section for the
communitys assessment of health and healthcare access within Washington County. The 225
individuals are within these demographic categories and the data provided was self-reported by
them.

EMPLOYMENT

EDUCATION

91

75

120

107
20
Full-time

Part-time

Retired

Unemployed

College
High School
Some High School

GENDER

AGE
15

39

84
106

17-30

30-64

186

Male

65+

Female

WELLNESS ACTIVITIES: SELF REPORTED

250
198

200

162
150
100
52
50
10
0

Smoker

Drink Alcohol
regularly
YES

NO

WELLNESS ACTIVITIES: SELF REPORTED

160

146
131

140
120

108

108

100
80
60

67
45

40
20
0

Eat fast foods 2 or more

times per week

Drink 5 or more sugary

drinks per week
YES

NO

More than 25 pounds

overweight

WELLNESS ACTIVITIES: SELF REPORTED

200
180
160
140
120
100
80
60
40
20
0

181

169

58

47

Exercise 4 or
more times per
week

Eat 5 or more
servings of
fruit/vegetables
daily
YES

NO

HEALTH RELATED PREVENTION ACTIVITIES

IN LAST 12 MONTHS: SELF REPORTED
160

149

140

132

140
109

120
100

82

80

74

65

60

48

40
20
0

Flu shot

Mammogram
(females)
YES

Cholesteral
NO
10

Colonoscopy within
10 yrs

The 225 WCH survey respondents ranked their perception of the top health problems in our
county and the top 5 health care service needs of our community.

MOST IMPORTANT HEALTH PROBLEMS IN OUR COUNTY

Obesity

Cancer

Heart Disease

Substance Abuse

Alzheimer's

Mental Illness

TOP 5 HEALTH CARE SERVICES IN NEED OF

STRENGTHENING

Substance Abuse

Mental Illness

Cancer Care

Specialty Care

11

Alzheimer's

2016 WASHINGTON COUNTY HEALTH DEPARTMENT SURVEY

66% are overweight/ with 30% being classified as obese

63% report eating fast food at least 1-2 times per week

34% have elevated cholesterol

38% have high blood pressure (hypertension)

9.4% are diabetic

24% are smokers

64% of adults have had a colonoscopy in the past 10 years

24% report exercising 4 or more times per week

28% report eating 5 or more fruits and vegetables daily

20% of adults in the county are at risk for binge drinking

40% of sophomores & 53% of seniors in HS report using substances in the past 30 days
Based on these survey results, the health department has identified four priority health
conditions to focus improvement activities. These same four conditions were also identified in
the top five health concerns on the hospitals community assessment.

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CARDIOVASCULAR DISEASE
Washington County has 1.55 times greater incidence rate for heart disease than the state. The
mortality rate for Washington County was 2 times greater than that of the state.
According to Healthy People 2020, heart disease is the leading cause of death and stroke is the
third leading cause of death in the United States. The major goal is to improve cardiovascular
health and quality of life through prevention, early detection and treatment of risk factors for
heart attack and stroke. The most important risk factors for heart disease and stroke that
people can control are: 1) high blood pressure, 2) high cholesterol, 3) cigarette smoking, 4)
diabetes, 5) poor nutrition and lack of physical activity, and 6) overweight and obesity. While
controlling these risk factors for heart disease and stroke remains a challenge, as any lifestyle
change is difficult, the risk of Americans developing and dying from cardiovascular disease
would be greatly reduced if improvements were made in reducing these risk factors.

CANCER
Overall cancer rates in Washington County are below the state average but some specific
cancers are higher. Colon and rectal cancers are higher for males and females within the
county than the state average. Prostate cancer rates are also higher in the county. Lung cancer
rates are only slightly higher for men than the state average, as are non-Hodkins lymphoma
cases.
According to Healthy People 2020, cancer is the leading cause of death in the United States.
Through cancer research, detection, and treatment progress, there has been a decline in the
incidence of new cases of cancer and in the death rate for all cancers. The major goal for
Healthy People 2020 is to reduce the number of new cancer cases and decrease the illness,
disability, and death caused by cancer. The objectives stress the importance of promoting
evidence-based screening for cervical, colorectal, and breast cancer by measuring the use of
the screening tests available. Risk factors for cancer that can be prevented include: 1) use of
tobacco products, 2) physical inactivity and poor nutrition, 3) obesity, and 4) ultraviolet light
exposure. Cervical cancer can be prevented by getting vaccinated against human
papillomavirus and liver cancer can be prevented by vaccination for the hepatitis B virus.
Screening for early detection include: mammograms for breast cancer, Pap tests for cervical
cancer, and fecal occult blood testing, sigmoidoscopy or colonoscopy for colorectal cancer.

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ALCOHOL AND SUBSTANCE ABUSE (ADULTS AND YOUTH)

Excessive alcohol use is reported at 28% for adults in Washington County vs a state average of
20% and a national average of 17%. But perhaps the more sobering statistic involves our youth.
23% of sophomores and 32% of seniors report binge drinking in the past two weeks (Youth Risk
Behavior Survey 2014)
According to Healthy People 2020, in 2005, it was estimated that 22 million Americans have a
drug or alcohol problem, but approximately 95% of these people are not aware of their
problem. Of those who are aware, attempts to obtain treatment are often unsuccessful. These
facts emphasize the importance of increasing prevention efforts and improving access to
treatment for substance abuse. The effects of substance abuse involve, not only the individual,
but also the family and the community. Many social, physical, mental, and public health
problems relate to substance abuse, including: teenage pregnancy, HIV/AIDS, STDs, domestic
violence, child abuse, motor vehicle crashes, physical fights, crime, homicide, and suicide.
Substance abuse is one of the most complex public health issues due to the social attitudes,
political, and legal responses to the use and abuse of alcohol and drugs.
Additionally, The Centers for Medicare & Medicaid Services (CMS) announced startling figures
in 2016 for Opioid use in the country: Nationally: 5.32%, State of Illinois: 4.64%, Washington
County (zip code 62263): 3.2%.

DEMENTIA/MENTAL HEALTH
Death certificates from Washington County reviewed over the past 4 years reveal that
dementia is listed as a leading significant health history for the majority of elderly deaths.
According to Healthy People 2020, Dementia was the 6th leading cause of death in 2013
according to death certificate data. In people over 70 years of age, the prevalence of dementia
was 15% in the United States in 2010. Costs related to care of dementia patients are estimated
to range between $159 and $215 billion. Dementia eventually affects the individuals ability to
manage their own medications, take care of financial matters, drive a car, avoid physical injury,
maintain appropriate social relationships, and perform activities of daily living.

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www.countyhealthrankings.org/illinois Illinois Health Gaps Report

15

WCH STRATEGIES TO HELP DECREASE RISK FACTORS AND PROMOTE HEALTH AND WELLNESS

CARDIOVASCULAR DISEASE
Publish a Wellness Resource Booklet to help identify available resources that promote a
healthy lifestyle.
Provide community education via the Brown Bag Luncheon Series, promoting medication
accuracy and understanding the importance of taking medications as prescribed.
Focus on providing specialized chronic care management for patients with 2 or more chronic
diseases
Continue to provide meeting space for Yoga classes and Weight Watchers at the hospital
Promote Cardiac Rehab services including those available to spouses of impacted patients
Encourage healthy eating with the Eat Fit program which is designed to assist participants
with sodium control in their diet. Regular sessions are held to provide education and support in
shopping, meal planning, identification of sources of sodium in the diet and ways to make
substitutions for healthier choices.
ContinueDiabetic Self-Management program led by a nurse practitioner: These insurance
covered education and support meetings are held monthly to provide new information, share
information among participants and provide individual support.
Enforce the Smoke-Free ordinances and expand smoke free areas.
Support the efforts of the WCHD in reducing risk factors for cardiovascular disease.

CANCER
Educate affected patients and their families to the importance of health eating
Provide screening medical services:
Mammograms: including final results for diagnostic mammography before leaving
the hospital
PSA: prostate lab test to provide early detection of cancer
Colonoscopy: recommended every 10 years or more often if family history exists
Promote preventative care
HPV: vaccine that prevents cervical cancers
Support the efforts of the WCHD in reducing risk factors related to cancer
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ALCOHOL AND SUBSTANCE ABUSE (ADULTS AND YOUTH)

Participate in MacKennas Broken Hearts, a bi-annual disaster drill involving high school
students intended to drive home the devastating effects of drug and alcohol use.
Advocate for the Opioid Control Summits (State, region and county)- focuses on ways we can
all Make an Impact in the fight against prescription opioid and heroin abuse.
Address 2014 Youth Risk Behavior Summaries for Washington County
14% of 10th graders and 33% of 12th graders in Washington County have driven under
the influence compared to state percentages of 7% and 18% respectively
Advance the work being performed by the Alcohol and Substance Abuse Coalitionto create
strategic plans for alcohol, tobacco and other drug prevention.
Community Education
Support the efforts of the WCHD to prevent substance use/abuse for adults and youth

DEMENTIA/MENTAL HEALTH
Foster community awareness of prevention, diagnosis, and treatment options for dementia
and other mental health conditions
Promote Telepsych services which are offered weekly at Washington County Hospital. A
board certified psychiatrist provides video face to face visits with patients and their families to
aid in the management of mental health issues.
Encourage use of pediatric and adolescence psychiatric care which is provided by a Nurse
Practitioner within the Rural Health Clinic
Recommend the Human Service Center in Okawville which provides counseling programs for
individuals needing the following:
Psychiatric Services
Counseling Services

Community Support Services

Substance Use Services

DUI Services
Children First

Support the efforts of the WCHD for the prevention and early diagnosis and management of
dementia and other mental health disorders

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