MONTEREY COUNTY — After months of data collection and tremendous input from the community, the Monterey County Health Needs Collaborative last week released the results of a comprehensive assessment of population health and health needs in Monterey County.
The Community Health Needs Assessment (CHNA) highlights known health needs in the community, such as diabetes, nutrition and heart disease. The report also demonstrates the need to address access to care issues, as well as calls attention to the need for resources and increased awareness around behavioral health and substance use.
For the first time, six organizations combined efforts to work together on identifying the county’s greatest health needs. The Collaborative partners are Community Hospital of the Monterey Peninsula, Salinas Valley Memorial Healthcare System, Mee Memorial Healthcare System, Natividad, Monterey County Health Department and United Way Monterey County.
The Hospital Council of Northern and Central California, along with Professional Research Consultants, a public opinion research consultant, were instrumental in conducting the CHNA.
“The Hospital Council of Northern and Central California is proud to be part of this collaborative,” said Jo Coffaro, regional vice president of the Hospital Council. “The Community Health Needs Assessment is another tool in the tool box for hospitals, the county and our community partners to use in efforts to improve the health of all the residents of Monterey County.”
The CHNA relied on key stakeholder input, phone interviews, online surveys and secondary data, such as census data and vital statistics. The assessment considered more than 200 indicators in six domains, including region, age, gender, race/ethnicity, income levels and sexual orientation.
From March to May, responses in English and Spanish were derived from 3,149 surveys, including 801 phone-based surveys and 2,348 community outreach online surveys.
On Sept. 15, the partners of the Monterey County Health Needs Collaborative convened an online meeting attended by 136 community leaders representing a cross-section of community-based providers, agencies and organizations. During the meeting, these stakeholders helped evaluate, discuss and prioritize health issues for the community based on the findings of the CHNA.
Professional Research Consultants began the meeting by presenting key findings from the CHNA, highlighting the significant health issues identified from the research. Following the presentation of results, meeting participants were asked to rank the health issues by severity and scope, as well as by the organizations’ ability to address the health issues.
The following issues were organized in order of priority:
- Mental Health
- Access to Health Care Services
- Nutrition, Physical Activity and Weight
- Heart Disease and Stroke
- Substance Use
- Infant Health and Family Planning
- Injury and Violence
- Potentially Disabling Conditions.
In addition to a comprehensive report for Monterey County, the Collaborative partners receive reports focused on specific geographic regions of primary and focus service areas, all of which are available for public viewing and use. It is noted that priorities of health needs may differ among organizational service areas.
Sampling of findings
The self-reported health status for the Monterey County population reflects 10% who identify themselves in excellent health, 71% in very good or good health and 19% as fair or poor health.
The prevalence of diabetes is highest in the Salinas area (15% of the population), exceeding both the state prevalence (9.8%) and the United States (13.8%). Diabetes is also most notable in the 65-plus age group reaching 20%.
Mental health indicators for Monterey County reflect that 34% of county residents consider themselves to be in fair or poor mental health, 24% report being diagnosed with a depressive disorder and more than half (51%) report having experienced symptoms of chronic depression. Those categories most impacted by symptoms of choric depression include women, persons ages 18-39, very-low and low-income individuals and members of the LGBTQ+ community.
Unintended drug-related deaths climbed in Monterey County over the past four years to reach 15 per 100,000. This is equal to the state rate and below the national average of 21 per 100,000. More women in the county (47%) say their life has been negatively affected by drug use by themselves or someone else than men (33%).
A significantly higher percentage of Monterey County residents report barriers to accessing medical care than reported nationwide. Nearly 53% expressed challenges simply getting a doctor’s appointment (15% nationwide); 36% finding a doctor (9% nationwide), 34% expressed inconvenient office hours are a barrier (13% nationwide) and 30% reported the cost of a doctor’s visit is a barrier (13% nationwide).
While 31% of county residents overall indicated they would be unable to pay cash for a $400 emergency expense, that number was higher in South County (35%) and Salinas (34%) than the Monterey Peninsula (24%).
In addition, 28% of county residents find it very or somewhat difficult to buy affordable fresh produce, with Salinas and South County residents disproportionately impacted.
The leading cause of death in Monterey County during 2020 (most recent county vital statistics) was cancer (18.2%), followed closely by heart disease (17.9%), while Covid-19 placed third (8.5%). The prevalence of cancer was most often detected in those age 65 and older (27.7%).
Last month United Way Monterey County presented each member of the Monterey County Health Needs Collaborative with the Community Impact Award for the partnerships that resulted in the CHNA.
“This Collaborative effort has been years in the making. These results provide us with real data to bolster and initiate meaningful efforts to improve the health of our community,” said Katy Castagna, president and CEO of United Way Monterey County. “Partnerships and engagement are key to measurable change and these entities working together have laid an impressive foundation to build upon.”
Each organization will use the detailed reports to prioritize health needs in geographic regions and put implementation strategies in place by the end of November.
Organization-specific and strategic partnerships have been successful in raising awareness and addressing health needs, such as Covid-19 vaccination, diabetes prevention programs, increasing access to care and serving the health needs of a diverse population. The Collaborative partners stated that they are committed to enhancing and partnering to address and impact community health needs.
To download the full report, go to healthymontereycounty.org.