On Thursday, November 16, Door County Medical Center (DCMC) joined hospitals throughout the country to celebrate National Rural Health Day. Since 2010, the third Thursday of November has been dedicated to promoting the unique health care challenges in rural communities. This year, we are highlighting DCMC's collaboration with partners and stakeholders to address health care disparities through a Community Health Needs Assessment (CHNA).

The purpose of the CHNA process is to identify needs and to develop plans that improve the health status of our residents. The State of Wisconsin requires local health departments to conduct a Community Health Assessment every five years and the IRS requires hospitals to complete a CHNA every three years. The core CHNA Workgroup includes DCMC, Bellin Health, Door County Public Health and United Way of Door County. The CHNA includes collection and analysis of data to identify health issues of primary concern and serves as the basis for the Community Health Improvement Plan (CHIP).

Background & Purpose:

Assess Needs and Resources

• Collect and analyze community health data
• Identify health disparities
• Examine determinants of health
• Conduct key informant interviews to identify assets and resources
• Consider issues and themes identified by stakeholders and community

What Is Important

• Identify priority health issues
• Summarize and disseminate the results to the community

The CHNA consists of three data collection methods including secondary, qualitative and quantitative data. Once the data was collected and analyzed, the top areas of concern were identified and further analyzed. The CHNA Workgroup reviewed the secondary data, stakeholder interviews, and community input surveys and selected three broad areas of primary concern: mental health, substance use, and healthy lifestyles. Each of these encompasses several narrower focus areas.

Priority #1 Mental Health

Mental health is an important part of overall health and well-being. Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make healthy choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.

According to the National Alliance on Mental Illness, 50% of all lifetime mental illness begins by age 14, and 75% by age 24. Mental health was identified as the top area of concern across the community input survey, key informant interviews, and the secondary data. It was the top issue identified in Door County households and the number one issue identified as affecting a child's wellbeing. Further, only 22% of respondents feel there is proper access to mental health resources in this community.

Priority #2 Substance Use

A "substance" is anything that can alter a person's mood or cognition. Substances can range from caffeine and alcohol to cocaine and heroin. Many people only claim to use certain substances recreationally. Alcohol is commonly enjoyed socially, while more states are legalizing recreational marijuana use.

Drug misuse, abuse, and addiction are all serious public health challenges. Drug misuse is generally associated with prescription medicines. Prescription medicines are meant to be taken as directed by doctors. Drug abuse happens when drugs, including alcohol, illicit drugs, or any psychoactive substances, are misused to get high or inflict self-harm. It is also known as substance use disorder (SUD) since people who abuse drugs experience significantly altered thinking, behavior, and body functions. Drug addiction, also known as severe SUD, is a brain disorder that manifests as the uncontrollable use of a substance despite its consequences. People with drug addiction have a physical and/or psychological need to take a substance because they suffer intense or debilitating withdrawal symptoms when they go without that substance.

Priority #3 Healthy Lifestyles

A healthy lifestyle is a way of living that lowers the risk of being seriously ill or dying early. Not all diseases are preventable, but a large proportion of deaths, particularly those from coronary heart disease and lung cancer, can be avoided. Health is not only just about avoiding disease. It is also about physical, mental and social well being. When a healthy lifestyle is adopted, a more positive role model is provided to other people in the family, particularly children.

We recognize that behaviors related to physical activity, nutrition, mental health, substance use, oral health, and early childhood development all play a vital role in the overall wellbeing of an individual.

Supporting the Health of the Door County Community

In the next phase, the CHNA workgroup and community partners will identify effective strategies to address the 3 core health priorities. "By analyzing the conditions, behaviors, and environments that impact our health, we can effectively engage community partners to coordinate evidence-based prevention strategies and multi-level approaches to address the health needs of our community and promote health equity," says Door County Public Health Officer Eric Krawczyk.

"The Community Health Needs Assessment and Community Health Improvement Plan supports Door County Medical Center's vision to deliver compassionate, quality care that inspires a healthy community," says DCMC CEO Brian Stephens. "We look forward to collaborating with our partners and community members to deliver focused and impactful health solutions."