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TABLE OF CONTENTS EXECUTIVE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1

ASSESSMENT PROCESS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3

DEMOGRAPHICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3

CHILDREN IN THE HOUSEHOLD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6

EDUCATION & EMPLOYMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7

POVERTY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8

MISCELLANEOUS DEMOGRAPHCS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10

GOVERNMENT ASSISTANCE AND ESSENTIALS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11

HOUSING SITUATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13

TRANSPORTATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15

PHYSICAL HEALTH CHARACTERISTICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17

HEALTHCARE VISITS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

20

HEALTH SCREENINGS AND PREVENTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

21

FEMALE HEALTH SCREENINGS AND PREVENTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

23

MEDICAL HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26

MEDICAL TREATMENT & HEALTHCARE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

27

EYE CARE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

30

MENTAL HEALTH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

31

DENTAL CARE AND CONDITION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

35

FRUITS AND VEGETABLES INTAKE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

38

TOBACCO AND ALCOHOL USE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

40

HEALTH INSURANCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

42

COMMUNITY HEALTH ISSUES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45

COMMUNITY PERCEPTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

49

AGING IN WASHINGTON COUNTY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

56

FAMILY ISSUES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

58

WASHINGTON COUNTY WELLNESS INITIATIVE AND INFORMATION SOURCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

59

SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

61

INDEX OF CHARTS AND TABLES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Index 1

INDEX OF WORKGROUPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Index 4

“This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number P10RH26875, Rural Health Network Development Planning Grant Program for $85,000. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.”


EXECUTIVE SUMMARY All Executive Summary Facts are described in more detail in the Community Assessment Narrative. Conclusions were based ONLY on data and outside research. The results represent the perceptions of the respondents and not necessarily the Washington County Wellness Initiative.

DEMOGRAPHICS 1009 Respondents Included in Results Respondent Pool mirrored 2000 U.S. Census 19.5% Resided outside Bartlesville Unemployed and Looking for a Job? 8% People with bachelor degrees are more likely to be fully employed People without a car rely on Friends & Family first and then CityRide Circuit (Quarter Bus)

COMMUNITY PERCEPTIONS HIGH RISK SUBSTANCES: Meth, Alcohol, and Prescription Drugs FEEL EXTREMELY SAFE? Only 12% WHAT SERVICES DO WE NEED: Transportation, Affordable Housing, Substance Abuse Treatment, and Safe Programs for Children NEIGHBORHOODS NEED: Road Maintenance & Repair, Lack of Public Transportation, and Crime Patrols & Neighborhood Watches TOP 4 COMMUNITY ISSUES that need more attention: Clean Water & Clean Air

FINANCIAL FINDINGS 31% Live Below Poverty Line 45% Receive Some Government Assistance NOT ENOUGH MONEY FOR ESSENTIALS? 44% LACK OF MONEY = LACK OF SERVICES 655 TIMES (Healthcare, Dental Care, and Mental Health Care) TOP 3 BARRIERS TO HEALTHCARE: Insurance/Ability to Pay, Transportation, and Hours of Available Service

Drug/Alcohol Abuse is the TOP Community Health Danger 91 People HAD a STRONG Sense of Community 74% of Respondents believe Government is at least moderately effective at problem solving

HOMELESS WITHIN THE LAST 10 YEARS? 13%

TOP FAMILY ISSUE: Economics, Financial, and Budgeting

SKIPPED EYE CARE because of NO Money: 32%

IT'S NOT EASY for the DISABLED TO GET AROUND: 49%

SKIPPED MENTAL HEALTH CARE because of NO Money: 17%

People MAINLY RELY on People for Information - Internet is Secondary Source

SKIPPED DENTAL CARE because of NO Money: 38%

NO Personal Car? 167 Respondents

SKIPPED DOCTOR because NO Money: 33%

Good Place to Grow Old? 80% of Seniors (65+) say YES

Washington County Wellness Initiative

Community Assessment 2014-2015

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HEALTH ISSUES 5 TOP PERSONAL HEALTH ISSUES: Stress/Depression, High Blood Pressure, Arthritis, Obesity, and Dental Problems NO Personal Doctor? 25% TOP 5 HEALTH ISSUES: Child Abuse/Neglect, Domestic Violence, Aging, Mental Health, and Teenage Pregnancy TRYING TO LOSE WEIGHT? 63% 20% feel only Moderately or Slightly Healthy PAIN kept 160 respondents from USUAL activities for 10 or MORE DAYS LAST MONTH 42 Respondents were in the Emergency Room 4 or more times Last Year

NEVER HAD Blood Pressure Checked: 47

DO NOT Have a Doctor: 224

NEVER HAD a Clinical Breast Exam (Only Women): 148

165 People Travel MORE THAN 30 Miles for Healthcare

NEVER HAD a Pap Test (Only Women): 96

165 People Used the ER Last Year

NEVER HAD a Mammogram (Only Women 44 and Older): 51

PREVENTATIVE HEALTH NEVER HAD a Check-Up: 100

NEVER HAD Blood Sugar Checked: 220

POOR Teeth & Gums: 11% NO Fruits Each Day: 145 NO Veggies Each Day: 45 Started Smoking between age 7 and 52: 193 Respondents HAVE NOT Heard of "Medical Home": 697 OKLAHOMA RANKS 46th in OVERALL HEALTH OUTCOMES NO Health Insurance in Last Year: 25% 271 People PAY for their HEALTH INSURANCE

WCWI 28% of Respondents KNEW about WCWI Most Well Known WCWI workgroup? Casa Hispana

www.wcwiok.org || info@wcwiok.org

2


ASSESSMENT PROCESS As part of the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant P10RH26875, Rural Health Network Development Planning Grant, the Washington County Wellness Initiative (WCWI) developed and conducted a county-wide community assessment. Prior to developing the assessment, the WCWI team met with members of the community to determine if their data gathering needs could be met using the same assessment. Additionally, WCWI reviewed the 2012 County Health Improvement Plan to ensure questions were included to address the four public health strategic issues: Health Care, Lifestyle Prevention, Mental Health, and Poverty. As such, the length of the assessment was expanded to incorporate questions designed to meet the most needs for each workgroup and community partner. The assessment was available to all Washington County residents to complete online or on a paper form beginning November 2014. After 1000 assessments were completed, the data gathering period concluded in May 2015. All data was gathered in a HIPAA compliant method and has been aggregated in this report for analysis and summarization. Surveys were provided throughout the county via multiple distribution points. Ninety-five percent of all assessments were completed without assistance.

DEMOGRAPHICS A pool of 1009 respondents completed the community assessment with approximately three-fourths of the assessments completed by females over the age of 18. Within the pool, the age distribution of respondents was very balanced.

77% of respondents were between the ages of 25 and 64.

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The ethnicity of the respondents and the residences mirrored the ethnicity and populations represented in the 2010 U.S. Census as well as the 2012 survey conducted by the Washington County Health Department as part of its Community Health Improvement Plan. Casa Hispana was established in 2004 as a grass roots Hispanic resources committee and has evolved to facilitate the positive integration of Hispanics into our community by networking and creating opportunities for full participation in all available benefits and services. Casa Hispana is a member of WCWI and is a co-sponsor of the upcoming mobile dental van event designed to provide free dental care to many members of our marginalized residents.

RESPONDENT ETHNICITY COHORT COMPARISON CHART

2012 CHIP REPORT (Washington County Health Department) Race White Persons Black Persons American Indian Asian Persons Reporting >=2 races Hispanic/Latino White -not Hispanic

County Oklahoma 79.60% 75.80% 3.00% 7.70% 10.40% 8.90% 1.20% 1.80% 5.70% 5.70% 5.40% 9.20% 75.30% 68.20%

Washington County Wellness Initiative Community Assessment 2014-2015 (1001 Ethnicity Responses)

2010 CENSUS (Source: U.S. Census Bureau, 2010 Census)

WCWI Community Assessment 82.06% 3.96% 16.65% 0.89% 10.60% 4.06% 81.02%

County

WCWI Respondent Pool Mirrors the CHIP and Census

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78.30% 2.40% 10.30% 1.10% 6.10% 5.00% 75.90%


Respondents were primarily from Bartlesville, but residents from seven other geographic areas participated in the assessment. In addition to basic demographic information, WCWI also gathered tribal affiliation, relationship status, education level, and employment status. This data will be used for cross-analysis of results.

Tribal Affiliation 119 120 100 80 60 40 20 0

8

13

11

15

16

9

28 1

Fifty-five (55%) percent of respondents were married. Single, never married and divorced were the second highest response categories within the pool.

Over 16% of respondents reported a tribal affiliation. Most tribal affiliations were self-reported as Cherokee. Other tribal affiliations included Apache, Beau master, Blackfoot, Kaw, Kickapoo, Navajo, Peoria, Ponca, Sac and Fox, Seminole, Seneca, Shawnee, and Tonkawa.

It is unclear if more than one married person per household responded to the assessment. Several questions within the survey were based on personal perceptions, so multiple responses were allowed within a residence. The survey did not require respondents to report if additional surveys were submitted by other household members.

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CHILDREN IN THE HOUSEHOLD Number of Children 700

634

NOTE: The entry for 38 children is more likely an error than an actual data point. The entries for 9 and 11 did include the ages of these children so their entries are more likely to be accurate responses.

600 500 400 300

167

200

113

100

64

13

8

3

4

1

1

1

4

5

6

7

9

11

38

0 0

1

2

3

Dependent Children: Currently Have Health Insurance

Yes, they do

63

425

No, they do not

Adequate Child Care Available Yes, 213

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No, 61

According to the Bartlesville Regional United Way (BRUW) 2015 Community Profile, prepared by the Community Service Council, with support from the Metropolitan Human Services Commission in Tulsa, Washington County is experiencing the same demographic shift in age of the population as the rest of the state, nation, and world. Older age groups have captured a greater relative share of the population over the past several decades, while the share represented by children has declined. Since 1970, 65 and over has increased to 18.4% of the population. The under 18 age group has dropped to 23.4% of the population since 1970. The Community Profile also showed the under 5 population is becoming more culturally diverse with Hispanic (8.4%), American Indian & Alaska Native (13%), and 2 or more races (12.4%) beginning to represent greater proportions of the population than in previous generations. “Native American, Asian, two or more race, and Hispanic young children all occupy greater shares than in the population as a whole. The WCWI assessment did not request ethnicity of the children.


EDUCATION & EMPLOYMENT As part of the analysis, WCWI looked for trends between education and employment status. Approximately 53% of respondents reported at least an associate degree with the highest response rate of 26% representing bachelor degrees. It is also important to note that 10% more respondents obtained a graduate degree than had achieved less than a high school degree.

The data shows respondents with less than an associate degree are more likely to be disabled and not able to work. The data also shows respondents with less than a high school degree are more likely to be looking for work or only working parttime. The data seems to support the theme throughout Washington County that the more educated you are, the more likely you are to be working or retired (which implies former employment).

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The impact of these findings is best reported in the BRUW Community Profile 2015, “As a general rule, the higher the educational attainment, the higher average earnings. Only college and advanced degree holders have seen increase in wages since 1973 nationally. A person with an advanced degree earns an average of over 200% more than a person with less than a high school education.

Higher levels of parental education are strongly associated with better outcomes for children. Children with parents without a high school diploma are at greater risk of low birth weight and other health issues, of poorer levels of school readiness and overall school success, and smoking and binge drinking in adulthood. “

POVERTY According to the Bartlesville Regional United Way 2015 Community Profile, prepared by the Community Service Council, with support from the Metropolitan Human Services Commission in Tulsa, many families struggle to be self-sufficient, even while holding down jobs. As such, WCWI also included a poverty level indicator for a household. WCWI received 812 assessments that included sufficient data to determine if theHow household was living in poverty *27. many people currently live in based on household income and household size (including ages and disabilities of household members).

NOTE: The household sizes greater than 10 were most likely errors in data entry or unclear instructions. Extremely large household sizes were not considered in the poverty calculations.

The WCWI Community Assessment showed 247 respondents were living in households that were below the poverty level based on the current federal guidelines* for calculating poverty levels. The data also showed that respondents living in poverty are distributed across various employment statuses. The fewest households living below poverty level are supported by full-time employment.

Household Income Prefer not to answer

93 39

$150,000 to $174,999

22 34

$100,000 to $124,999

61 92

$60,000 to $74,999

66 84

$35,000 to $44,999

71 77

$15,000 to $24,999

92 68

$0 to $9,999

106 0

20

40

60

80

* The poverty guidelines updated periodically in the Federal Register by the U.S. Department of Health and Human Services under the authority of 42 U.S.C. 9902(2).

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100

120

It should also be noted that the “… shares of Washington County residents living below poverty, below 185% of poverty, and below 200% of poverty have all grown substantially over the past couple of decades. The share living in poverty has risen from 10.9% in 1989 to 14.8% based on the most recent survey.” BRUW Community Profile 2015


LIVING IN POVERTY EMPLOYMENT STATUS No Yes Disabled, not able to work 17 62 Employed, working full-time 353 56 Employed, working part-time 48 37 Not employed, looking for work 19 45 Not employed, NOT looking for work 26 27 Retired 89 20 Grand Total 552 247

% In Poverty 8% 7% 5% 6% 3% 3%

31% of Respondents Live Below the Poverty Level

31%

Wage Comparison: Self-Sufficiency, Welfare, Minimum, Poverty and 185% of Poverty, and Median Family Income: Family of Three, Washington County 2015

This chart and the next chart are included for reference purposes only as the County Benchmark. Self Sufficiency Standard is another method for determining a household’s poverty level. * Reported in the BRUW Community Profile 2015

Notes: For self-sufficiency wage, family of three consists of one adult, one preschooler and one school-age child. Hourly wages given assume full-time, year-round employment. Welfare wage is the combined value of TANF, SNAP, & WIC. Median family income represents families with children under age 18. Values shown for median family income are midpoint estimates within a 90% confidence range, which can be very wide. Source: Oklahoma Association of Community Action Agencies and the Oklahoma Asset Building Coalition, December 2009, The Self-Sufficiency Standard for Oklahoma 2009; Federal Register Notice, 01/22/2015, Annual Update of the HHS Poverty Guidelines; Bureau of Labor Statistics, Feb. 2015; Oklahoma State Dept. of Human Services; US Census Bureau, 2009-13 American Community Survey.

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“The Self Sufficiency Standard is a new approach to express the income levels of families. It is a more sensitive measurement of the financial needs of a family to be self-sufficient from public and private support than is the traditional indicator known as the federal poverty level (FPL). The FPL has been a national standard since the Roosevelt Administration to determine family income levels to qualify for public support. The FPL is generated annually based on the family composition and the family income. It is the same across the United States. The Self Sufficiency Standard is based on family composition, family income, geographic location, and is updated annually using the consumer price index.” “In examining the comparison of wages, it is necessary to look at the enormity of the gap between attained income and self-sufficiency. The bar graph demonstrates the comparison of welfare wage (TANF support and food stamps), minimum wage, poverty wage, 185% of poverty which is the most generous federal program (Medicaid), and the “gap” between these supports and the self-sufficiency wage for a three person family in Washington County. This “gap” has been growing since 1976. The median family income for different family types are also displayed to illustrate how average Washington County families fare in terms of the self-sufficiency wage.” “Over 7,000 Washington County residents live below the federal poverty level. An additional 10,000 are between 100 and 200% of the federal poverty level. Self-sufficiency level in Washington County falls between 150 and 175% of poverty, depending on family size and composition.”

According to the BRUW Community Profile 2015 report, about 17,000 Washington County residents earn a level of income which makes economic self-sufficiency a struggle.

MISCELLANEOUS DEMOGRAPHICS

86 Respondents Reported Military Service

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A cross-analysis was performed to determine if the respondent’s age affects the likelihood of being a registered voter. The data shows a higher percentage of voter registration for the 25 – 64 year old age group. Respondents who were reportedly uncertain about their registration status appeared to be primarily 18 – 34 years old.

Age

N o t a R e g is te re d Vo te r

U ns ure / D o n’t k no w

R e g is te re d V o te r

Gra nd T o ta l

18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 or older Grand Total

24 33 24 40 15 9 2 147

8 9 4 1 1 2 0 25

35 127 131 156 170 80 43 742

67 169 159 197 186 91 45 914

GOVERNMENT ASSISTANCE AND ESSENTIALS Respondent Receives Government Assistance No Assistance 55%

Receives Assistance 45%

NOTE: The “Check all that apply” option was only available on the paper copies of the survey. The online version did not allow multiple selections. As a result, our higher “Receives Assistance” percentage may reflect retired individuals drawing Social Security retirement. Forms of Assistance Included: Disability, Food Stamps, Social Security, SSI, and WIC

“Many Oklahoma families are unable to make ends meet with their current earnings. Fortunately, many programs exist to help fill the gap between what families can afford and what they need to survive. Nearly a quarter of Washington County residents – 12,021 people -- received benefits from SoonerCare in FY2014. Nearly half of children – 5,873 – are on SoonerCare. A third of the county’s infants receive WIC benefits, and over 3,000 residents receive SNAP (formerly Food

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Stamps). Half of the county’s elementary school students participate in the school free lunch program, and an additional 10% qualify for reduced price lunches. Many Washington County families, children, and individuals rely on public assistance programs to meet their basic needs.� BRUW Community Profile 2015; Originally determined by the Oklahoma Dept. of Human Services, Fiscal Year 2013 Annual Report Tables; Oklahoma State Dept. of Education, Low Income Report for 2013-14; US Census Bureau, 2013 Population Estimates; Oklahoma State Dept of Health-WIC service, Caseload Report, Jan. 2015; Oklahoma Health Care Authority, Fast Facts, Feb. 2015, and 2014 Annual Report.

44% of the WCWI Community Assessment respondents do not always have enough money for essentials. What did you do because it was too expensive?

No money means going without healthcare for our residents.

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350

313 262

300

239

250 173

200 150

103

100 31

50 0 Put Off Going to the Dentist

Put Off Buying Glasses, Hearing Aids, etc.

Put off Going Skipped to Health Medication Care or Provider Treatment

Put Off Going to Mental Health Provider

Put Off Buying Assistive Devices (Crutches, Walkers, Wheelchairs, etc.)


The data gathered from the completed community assessments proved the “feeling” people had about our residents lacking dental care is in fact true for our pool of respondents. The most health related service our respondents did not pursue due to the expense was “going to the dentist”. The WCWI Access to Healthcare workgroup (Dental Van Subcommittee), with support from the Bartlesville Regional United Way Venture Grant, Phillips 66 and ConocoPhillips employee team grants, Tri-county Tech’s OU Dental Hygiene program, Bartlesville Community Foundation, and Casa Hispana, is hosting the free dental van for eight days in January 2016 to address this need. The goal is to have the mobile dental van in Washington County four times per year. WCWI leadership and the Access to Healthcare workgroup also provide the Free and Low-Cost Healthcare Resource Guide for under/uninsured residents.

According to the Henry J. Kaiser Family Foundation, health care disparity and health disparities refer to the “differences in health and health care between population groups. ‘Health disparity,’ generally refers to a higher burden of illness, injury, disability, or mortality experienced by one population group relative to another group. A ‘health care disparity’ typically refers to differences between groups in health coverage, access to care, and quality of care. While disparities are commonly viewed through the lens of race and ethnicity, they occur across many dimensions, including socioeconomic status, age, location, gender, disability status, and sexual orientation.” Unfortunately, as was exhibited through the WCWI assessment responses, Washington County does have indications of health and health care disparities. “Disparities in health and health care limit continued improvement in overall quality of care and population health and result in unnecessary costs. Recent analysis estimates that 30% of direct medical costs for Blacks, Hispanics, and Asian Americans are excess costs due to health inequities and that the economy loses an estimated $309 billion per year due to the direct and indirect costs of disparities. As the population becomes more diverse, with people of color projected to account for over half of the population by 2050, it is increasingly important to address health disparities.” WCWI will continue to work toward reducing the affects of health and health care disparities in Washington County. See http://kff.org/disparities-policy/issue-brief/disparities-in-health-andhealth-care-five-key-questions-and-answers/

HOUSING SITUATION

According to the BRUW Community Profile, owners occupy 68% of homes and 32% are rented. The WCWI Community Assessment results support this finding with a slight variance attributable to the “Neither” category.

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The vast majority of respondents reside in singlefamilyhouses.

Type of Housing Military housing

1

Condominium

8

Duplex

17

Townhouse

19

Other (please specify)

28

Mobile home

49

Apartment

89

Single-family house

750 0

200

400

600

13% of respondents reside with friends or family, are homeless or have been homeless within the last ten or five years.

Page 14

800


WCWI has two organizations focusing on affordable housing solutions: Washington County Affordable Housing Coalition (WCAHC) and Family Promise of Washington County, Inc. (FPWC). The Affordable Housing Coalition assesses housing gaps and barriers, and maintains a housing advocacy group designed to pull community partners together to increase and preserve the supply of decent, affordable, accessible housing for low- and moderate-income households in Washington County. The mission is to mobilize community partners to increase access to affordable housing through committed action. Family Promise is a nonprofit and non-denominational organization for families in transition. The program provides temporary housing hosted by host congregations. The mission is to help low-income children and their families achieve sustainability or self-sufficiency. See www.wcwiok.org

TRANSPORTATION

Does a respondent’s employment status affect their means of transportation? Approximately one-third of respondents who did not drive their personal cars appear to rely on the CityRide Circuit (“the quarter bus”). While some of these respondents are disabled, nearly half of them are working or searching for work. The CityRide Circuit is currently under analysis by the Washington County Transportation Coalition (WCTC). The WCTC has been involved in developing a flexible, fixed-route bus system for the past four years. The WCTC also received consultation and analysis from the Community Transportation Association of America to develop potential viable expansion possibilities to meet the unmet transportation needs. Additionally, Jane Phillips Medical Center (JPMC) established their top three goals to address health issues identified during their Community Health Needs Assessment process conducted in 2013. JPMC listed TRANSPORTATION as their third priority. See https://www.stjohnhealthsystem.com/media/file/1107/Community_Health_Needs_Assessment_JPMC.pdf EMPLOYMENT STATUS

CityRide Circuit

CityRide (Door-to-Door)

Sooner Ride

Friends & Family

Disabled, not able to work Employed, working full-time Employed, working part-time Not employed, looking for work Not employed, NOT looking for work Retired

14 5 4 6 1 0

9 2 2 1 0 3

5 1 1 1 0 2

35 19 13 24 9 10

TOTAL

30

17

10

110

Washington County Wellness Initiative || Community Assessment 2014-2015

Page 15


Transportation Totals

# of Responses

% of Responses

Personal Vehicle Family Members Friends Sooner Ride CityRide Circuit (Bus route) CityRide Door-to-Door Borrow Car Bicycle Company vehicle Walk Transportation at Lighthouse Taxi Motorcycle Semi-truck

813 67 44 12

88.08%

28 13 4 7 1 19

3.03%

1 3 1 1

0.11%

7.26%

According to the Oklahoma Health Equity Campaign, transportation is a Public Health

4.77% 1.30%

1.41% 0.43% 0.76% 0.11% 2.06%

0.33% 0.11% 0.11%

For a few of our residents living in poverty who have a personal car, they often face the challenges of an unreliable car that needs repairs. These residents do without healthcare, food, and often shelter. A WCWI workgroup was organized in 2006 to address automobile challenges. Church Women United Car Repair Project was formed to assist low-income individuals with transportation needs such as car repairs, car insurance and car tags. The assessment responses showed nearly 22% of our respondents DO NOT have a car.

49% of responses showed it is only slightly easy or not at all easy for the disabled to get around in our county. According to the Oklahoma Health Equity Campaign, “Public transportation is linked to many aspects of good health – access to food, safety, exercise, lower stress levels, healthcare access and employment. The public transportation system is especially important to households without automobiles, the elderly, and those unable to drive. The public transportation system is especially important to households without automobiles, the elderly, and those unable to drive. For these people, transit is the lifeline to medical care, grocery stores, employment, recreation, and everyday activities that others take for granted. Many suffer negative health consequences from lack of access to these basic necessities because public transportation isn’t affordable or available. “ See http://digitalprairie.ok.gov/cdm/ref/collection/stgovpub/id/191286

Page 16


PHYSICAL HEALTH CHARACTERISTICS 902 respondents completed the question regarding whether they were currently trying to lose weight. 572 people said they are currently trying to lose weight but only 107 (8%) reported they were obese. The data seems to raise the question of why people are trying to lose weight if they do not believe they are obese.

Currently Trying to Lose Weight No, 330, 37% Yes, 572, 63%

The three MOST REPORTED personal health issues were: Stress/Depression, High Blood Pressure, and Arthritis. NOTE: The respondents only included 18 years and older so teen pregnancy had a small sample of potential respondents.

292 300 250 200 150 100 50 0

Personal Health Issues 246 259 190 197 187 177 163 158 114 67

Highest Frequency Health Issues Stress/Depression Arthritis High blood pressure Dental problems Obesity Hearing/Vision Loss

# of Respondents 292 246 259 190 197 187

% of Total Responses 12% 10% 11% 8% 8% 8%

Lack of Physical Activity Tobacco Use Cholesterol Diabetes

177 163 158 114

7% 7% 7% 5%

69

65

55

48

28

26

Health Issue Poor Nutrition Mental Illness Aging Problems Lung/Respiratory Disease Heart Disease Suicidal Thoughts Motor Vehicle Crash Injuries Cancer Stroke Drug/Alcohol Abuse Teen Pregnancy

Washington County Wellness Initiative || Community Assessment 2014-2015

27

15

14

1

# of % of Total Respondent Responses 67 3% 69 3% 65 3% 55 2% 48 2% 28 1% 26 27 15 14 1

1% 1% 1% 1% 0%

Page 17


80% of respondents felt at least moderately healthy or better. However, 53% reported they had at least 1 – 2 days last month that PAIN made it hard for them to perform their usual activities. On the extreme end of the spectrum, there were 160 respondents (17.8%) with pain for more than 10 days last month.

The BRUW Community Profile 2015 emphasized that “Oklahoma is ranked number 46 in the US in total health outcomes. Some of the states’ strengths include low prevalence of binge drinking, low incidence of pertussis, and low prevalence of low birthweight. Some of our challenges include high prevalence of physical inactivity, low immunization coverage among children, and limited availability of primary care physicians. Of the indicators shown on this graph, Oklahoma appears to be doing better in the area of disparity in health status based on education than we are in other indicator areas. For all other indicators, Oklahoma ranks in the worst 10 states.” See more at: Jane Phillips Medical Center (JPMC) http://www.americashealthrankings.org/OK#sthash.Wc6RWcQI.dpuf also completed a community health needs assessment in 2013 to develop new and enhance established Oklahoma’s Rankings in Health Outcomes, 2013 community benefit programs and services. JPMC established three priority areas to address during 20132015: 1. Primary Care Access 2. Community Wellness 3. Transportation See Jane Phillips Medical Center, Community Health Needs Assessment, FY2013https://www.stjohnhealthsyste m.com/media/file/1107/Community_ Health_Needs_Assessment_JPMC.pdf

Page 18


Number of Days in Pain Days in Pain During Last Month

#

%

1 to 2 3 to 4 5 to 6 7 to 10 More than 10 None Grand Total

131 58 44 45 160 463 1009

13% 6% 4% 4% 16% 46%

# of Days in the Last Month that PAIN Made it Hard for You to do Usual Activities 500

Less than half our respondents experienced no pain in the last month.

463

400 300

160

131

200 100

58

44

3 to 4

5 to 6

45

0 None

1 to 2

7 to 10

Take Prescription Drugs (Except Birth Control) Yes, 545 No, 356

More than 10

According to the WCWI Access to Healthcare Committee and the Physician’s Advisory Board, our residents experiencing chronic pain, may have more challenges finding a “Medical Home” due to many clinics in our county not providing chronic pain management services.

Washington County Wellness Initiative || Community Assessment 2014-2015

Page 19


HEALTHCARE VISITS Jane Phillips Medical Center reports the following number of Emergency Room Visits over the last three years:

# of Emergency Room Visits 598 600 500 400 300 200 100 0

151 69

None 1 time

Page 20

2

30

23

3

4

13 5 to 9

6 10 or more times

2012 - 39,975 2013 - 35,557 2014 - 35,255 Although the number of Emergency Room visits is on the decline, when more residents establish a medical home, the ER visit total should be reduced by an even larger percentage.


HEALTH SCREENINGS AND PREVENTION Last Flu Shot

Bartlesville

Copan

Dewey

Never Within the past year 1 to 2 years 3 to 5 years More than 5 years I don't know Grand Total

154 354 79 40 50 18 695

1 11 2 3 0 1 18

15 31 4 3 5 1 59

Had a Routine Check Bartlesville Up Never Within the past year 1 to 2 years 3 to 5 yeas More than 5 years I don't know Grand Total

79 460 71 36 28 21 695

Copan

Dewey

2 11 2 1 0 1 17

3 40 6 3 5 2 59

I do not live in a town or Ochelata city. 15 4 31 8 6 0 1 1 2 0 2 0 57 13

I do not live in a town or city. 6 48 1 0 4 0 59

Owen

Ramona

1

1 4 0 1 2

0 0 0 0 1

8

Vera

0

Blank Residence

Grand Total

4 6 1 2 4 0 17

195 445 92 51 63 22 868

Ochelata

Owen

Ramona

Grand Total

4 8 0 0 0 0 12

1 0 0 0 0 0 1

1 4 1 0 1 1 8

96 571 81 40 38 25 851

“Regular check-ups are important to maintain a relationship with your doctor and to receive individualized counseling based on your family health history and your lifestyle.� See https://www.dukemedicine.org/blog/should-you-get-annual-physical

Washington County Wellness Initiative || Community Assessment 2014-2015

Page 21


Had Your Blood Pressure Checked

Bartlesville

Never Within the past year 1 to 2 years 3 to 5 yeas More than 5 years I don't know Grand Total

38 594 45 10 6 8 701

Copan

1 49 6 3 1

17 1

18

Bartlesville

Copan

Dewey

Never Within the past year 1 to 2 years 3 to 5 yeas More than 5 years I don't know Grand Total

183 401 53 26 12 19 694

6 10 1 1

10 37 8 2 2 2 61

Owen

Ramona

5 43 3 1 4 56

44 728 55 13 10 8 858

6 1 1

57

I do not live in a town or city.

Grand Total

1

2

60

Had Blood Sugar Checked

18

I do not live in a town or Ochelata city. 1 3 52 10 2

Dewey

13

1

8

Ochelata

Owen

Ramona

5 5

1

3 4

1 1 12

1

1 8

Grand Total 213 500 65 30 19 23 850

“Being overweight also influences how often you get a physical because it increases one’s risk for high blood pressure, high cholesterol and diabetes. For these individuals, the annual physical is an opportunity to reinforce healthy lifestyle choices.” See https://www.dukemedicine.org/blog/should-you-get-annual-physical

Page 22


FEMALE HEALTH SCREENINGS AND PREVENTION 140

Last Mammogram

120 100 80 60 40 20 0

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 or older

Never

50

115

58

23

19

7

2

Within the past year

7

8

36

67

60

40

18

5

6

32

25

10

4

6

6

12

11

6

1

1

12

12

13

4

1

1

5

3

2

1

1

1 to 2 years 3 to 5 yeas

1

More than 5 years I don't know

1

At age 40, women should start scheduling annual mammograms, though your doctor may recommend screening earlier if you have a family history. See http://www.womenshealthmag.com/health/health-checks-how-often

49% of respondents over the age of 44 had a mammogram within the last year but 14% reported never having a mammogram. http://www.womenshealthmag.com/files/wh6_uploads/wp_import/health-checks2.png

Washington County Wellness Initiative || Community Assessment 2014-2015

Page 23


140 120 Hysterectomy

100 80 60 40 20 0 18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

59

130

95

98

84

31

75 or older 14

Within the past year

2

1

5

3

6

1

1 to 2 years

1

3

1

1

1

6

3

5

2

Never

3 to 5 yeas More than 5 years

2

11

32

31

20

10

I don't know

1

5

4

1

2

2

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

Never

35

45

20

19

16

6

75 or older 7

Within the past year

19

60

67

73

54

38

6

1 to 2 years

3

18

14

29

24

9

3

3 to 5 yeas

2

9

9

8

14

5

3

3

7

16

15

5

4

6

3

6

2

4

80 Last Clinical Breast Exam

70 60 50 40 30 20 10 0

More than 5 years I don't know

Page 24

1


70 60

Last Pap Test

50 40 30 20 10 0 18 to 24 21

25 to 34 18

35 to 44 14

45 to 54 17

55 to 64 16

65 to 74 5

75 or older 5

Within the past year

23

65

57

69

32

20

7

1 to 2 years

13

34

19

24

27

8

2

3 to 5 yeas

1

11

12

15

19

12

3

6

13

19

29

13

4

1

7

4

5

5

5

Never

More than 5 years I don't know

1

“If you’ve had three consecutive normal pap smears, are in a mutually monogamous relationship, and have no other risk factors, you could technically go three years between screenings, says Moore. However, most doctors still suggest women see their gynecologist once a year and get a pap smear while they’re there. Your pap tests for any changes or abnormalities in the cells in your cervix, which is a way to screen for cervical cancer, says Alyssa Dweck, MD, co-author of V is For Vagina. For women 21-29, any mild irregularities in the pap test will prompt an HPV test to check for the high-risk strains of the HPV virus, says Dweck. Other than that, you probably won’t get an HPV test until you’re 30.” See http://www.womenshealthmag.com/health/health-checks-how-often

La s t Pa p T e s t Never Within the past year 1 to 2 years 3 to 5 years More than 5 years Unknown

# 96 273 127 73 84 28

% 14% 40% 19% 11% 12% 4%

40% of female respondents had a pap test within the last year.

Washington County Wellness Initiative || Community Assessment 2014-2015

Page 25


MEDICAL HOME Have you heard the term "medical home" and think you understand it? 670 700 600 500 400 300 200 100 0

94

89

53

I have not heard I've heard of it I've heard of and I have heard of a of a "medical but I'm not sure understand a "medical home". home". what it means. "medical home".

A “Medical Home” is the doctor’s office or clinic where your family goes for healthcare.

Page 26

The WCWI Access to Healthcare Committee has defined a “Medical Home” as “the doctor’s office or clinic where your family goes for healthcare.” The Access to Healthcare Committee is currently trying to encourage under/uninsured residents to enroll in a “Medical Home.” These results show education and awareness is the first step to enrollment. A personal doctor is the one you would see if you need a check-up, want advice about a health problem, or get sick or hurt. Do you have a personal doctor? From the data provided, 224 respondents need to establish a medical home under the criteria set forth by the Access to Healthcare Committee.


MEDICAL TREATMENT & HEALTHCARE # of Miles you Travel for Medical Treatment Bartlesville

Copan

Dewey

I do not live in a town or city.

Ochelata

Owen

Ramona

Vera

319 195 126 12 2 3 0 to 5

9

3519

66 6 1 1

6 to 15

8 6 20 3 16 to 30

5 1

1 10

23

3

2

More than 30

Where you live definitely impacts the distance traveled for medical treatment.

Washington County Wellness Initiative || Community Assessment 2014-2015

Page 27


33% of respondents had to do WITHOUT medical treatment because of the expense.

Where did you receive Healthcare last year other than private physician? 165 126

125 80

82 58

Page 28

47

42

31

25

22

17

10

10

10


The majority of the respondents felt like their healthcare was at least good if not better. BIGGEST BARRIERS TO HEALTHCARE - Insurance & Money, Hours of Service, and Transportation

Washington County Wellness Initiative || Community Assessment 2014-2015

Page 29


EYE CARE “Most eye care experts recommend that you have a complete eye exam every one to three years, depending on your age, risk factors and whether you currently wear corrective lenses. Children need regular eye exams to detect vision problems that may interfere with learning.� See www.allaboutvision.com/eyeexam/preparing.htm.

Did you need eye care but were unable to afford the services? No Yes Grand Total

32% of respondents personally needed eye care last year but could not afford it.

Page 30

Total 515 242 757


MENTAL HEALTH

39% of respondents received mental health services last year Mental Health Needed Based on Residence Bartlesville

Copan

Dewey

I do not live in a town or city.

Ochelata

Owen

Ramona

Vera

489 278 4 25 32 10 1 3 Mental Health Assistance Received

14 43 42 6

5 1

No Mental Health Assistance Needed

According to the State of the County’s Health Report for Washington County 2014, suicide was the second leading cause of death for 15-34 year olds. See http://www.ok.gov/health2/documents/Washington%202014.pdf The 2012 County Health Improvement Plan includes a reduction in suicide rates as Mental Health Goal #2. See http://www.ok.gov/health2/documents/CHDS-Washington-CHIP%202012.pdf In response to these reports and the data supporting the public health concerns, the Washington County Suicide Prevention Coalition (WCSPC) was formed to address suicide through awareness, education, and effective prevention, intervention, and postvention. The Washington County Association for Mental Health (WCAMH) was formed to improve behavioral health outcomes and hosts multiple training and education opportunities for mental health providers.

Suicide was the second leading cause of death for 15-34 year olds.

Washington County Wellness Initiative || Community Assessment 2014-2015

Page 31


# of Days in the Last 30 that Mental Health was NOT Good 600

569

500 400 300

116

200

72

100

33

30

77

0 None

1 to 2

3 to 4

WCWI’S Project Prom is a non-profit organization helping youth in our community who would otherwise be unable to afford it, have the experience of prom…a great project to improve the overall emotional health of our high school seniors.

Page 32

5 to 6

7 to 10

8.5% of respondents had bad mental health more than 10 days in the previous month.

More than 10

Teenagers need to know that they are not alone and that they can feel better. If a teen has been feeling sad, hopeless, or irritable for what seems like a long time, he/she might have depression. •

Depression is a real, treatable brain illness, or health problem.

Depression can be caused by big transitions in life, stress, or changes in his/her body’s chemicals that affect thoughts and moods.

Even if the teen feels hopeless, depression gets better with treatment.

There are lots of people who understand and want to help.

The teenager needs to ask for help as early as possible so he/she can get back to being him/herself. See The National Institute of Mental Health at

http://www.nimh.nih.gov/health/publications/teen-depression/index.shtml


17% of respondents had to do WITHOUT mental health care because of the expense.

Mental Health Needs

#

%

Medication Counseling/Therapy Psychiatrist Crisis Care Hospitalization

172 166 63 24 17

39% 38% 14% 5% 4%

The WCWI and the WCSPC received an IMPaCT grant to reduce suicide through a new project in 2013. The goals of the Suicide Prevention in Primary Care Project were to improve depression recognition and management in primary care practices; identify and intervene with patients at risk for suicide; create and/or strengthen connections between the Washington County CHIO, the Department of Mental Health and Substance Abuse Services, and with the University of Oklahoma School of Social Work; and to strengthen the Washington County Wellness Initiative. Participating practices received academic detailing provided by Dr. Lisa Rubenstein and Dr. Ardis Olson in recognizing the signs of depression and suicide ideation. Grant funding also provided an Academic Detailer to aid these physicians in using the Patient Health Questionnaire (PHQ-9). The PHQ-9 is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression and has been called “the 3-component model�.

Washington County Wellness Initiative || Community Assessment 2014-2015

Page 33


IMPaCT GRANT AUDIT RESULTS (2013) Primary Care Charts Reviewed Listed Depression on Problem List Referred for Counseling Treated with Antidepressants Mentioned Suicide Risk

429 30% 18% 23% 24%

According to the American Foundation for Suicide Prevention Key Research Findings, 45% of 40 separate post-mortem studies found that 45% of those who died by suicide had seen a primary care provider within the month before their death, and 77% had such contact within the past year.� See Luoma, et. al., 2002, www.afsp.org/understanding-suicide/keyresearch-findings.

Mental Health Needs by Number of Days in Pain Days in Pain During Last Month 1 to 2 3 to 4 5 to 6 7 to 10 More than 10 None Grand Total

Mental Health No Mental Health Grand Total Assistance Received Assistance Needed 51 25 24 20 86 90 398

80 33 20 25 74 373 611

131 58 44 45 160 463 1009

84% of respondents who needed mental health care had at least 1 or more days of pain in the last month. 16% experienced pain for more than 10 days in the last month.

Page 34


DENTAL CARE AND CONDITION Overall Condition of Teeth & Gums 300

229

250 200

11% of respondents have poor teeth and gums.

259

163 136

150

112

100 50 0 Excellent

Very good

Good

Fair

Poor

Overall Health of Teeth and Gums Residence Excellent Bartlesville 131 Copan 3 Dewey 10 I do not live in a town or city 11 Ochelata 3 Owen 1 Ramona 0 Vera 0 No Response 4 Grand Total 163

Fair 99 6 15 10 3 0 1 1 1 136

Good 197 2 12 12 3 0 2 0 1 229

Poor 84 3 10 5 2 0 0 8 112

Very good 205 4 14 24 2 0 5 0 5 259

No Response Grand Total 51 767 0 18 7 68 12 74 3 16 0 1 0 8 0 1 37 56 110 1009

Only 197 of our respondents and their families did not need dental care last year. However, the American Dental Association recommends that you visit your dentist at least once a year to get a routine examination and cleaning. If you have a history of periodontal disease, you should get your teeth cleaned more often in order to prevent the recurrence of infections or disease. You should also have your teeth cleaned more often if you suffer from chronic conditions such as diabetes or heart disease due to their link to dental problems. See https://www.humana.com/learning-center/health-and-wellbeing/healthy-living/teeth-cleaning According to the American Dental Association recommends that “even if you don’t have any symptoms, you can still have dental health problems that only a dentist can diagnose. Regular dental visits will also help prevent problems from developing. Continuity of care is an important part of any health plan and dental health is no exception. Keeping your mouth healthy is an essential piece of your overall health. It’s also important to keep your dentist informed of any changes in your overall health since many medical conditions can affect your dental health too.” See http://www.mouthhealthy.org/en/dental-care-concerns/questions-about-going-to-the-dentist/ Washington County Wellness Initiative || Community Assessment 2014-2015

Page 35


# of Times You or Your Family Needed Dental Care

500 450 400 350 300 250 200 150 100 50 0

451

197

158 69

None

1-2 Times

3-4 Times

5 or More

Number of Times Dental Care Needed in the Last 12 Months Residence 1-2 Times 3-4 Times 5 or More Bartlesville 352 126 50 Copan 9 3 2 Dewey 37 12 3 I do not live in a town or city 32 9 7 Ochelata 6 3 2 Owen 0 0 1 Ramona 4 1 2 Vera 0 1 0 No Response Provided 11 3 2 Grand Total 451 158 69

Zero 168 3 9 12 1 0 1 0 3 197

Grand Total 696 17 61 60 12 1 8 1 19 875

38% of respondents needed dental care but could NOT afford it.

Page 36


No Residence Provided

Bartlesville

Copan

Dewey

# of Dental 1-2 3-4 5 or 1-2 3-4 5 or 1-2 3-4 5 or 1-2 3-4 5 or None None None Visits Times Times More Times Times More Times Times More Times Times More # of Responses

11

3

2

352

126

50

I do not live in a town or city

168

9

3

Ochelata

2

3

37

12

3

Ramona

Owen

9

Vera

# of Dental 1-2 3-4 5 or 1-2 3-4 5 or 5 or 1-2 3-4 5 or 3-4 None None None Visits Times Times More Times Times More More Times Times More Times # of Responses

32

9

7

12

6

3

2

1

1

4

1

2

1

1

Last Time You Had Your Teeth Cleaned Last Time?

Bartlesville

Copan

Dewey

I do not live in a town or city

Never Within the past year 1 to 2 years 3 to 5 yeas More than 5 years I don't know Total

54 408 87 52 64 33 698

3 10 1 2 2 0 18

5 30 4 6 11 3 59

2 37 9 3 4 2 57

Washington County Wellness Initiative || Community Assessment 2014-2015

Ochelata

Owen

Ramona

Total

2 5 2 1 1 1 12

1 0 0 0 0 0 1

0 3 2 1 2 0 8

67 493 105 65 84 39 853

Page 37


FRUITS AND VEGETABLES INTAKE

8 respondents entered more than 4 meals or snacks a day.

The Washington County Preventative Health Partnership (WCPHP) was formed to promote safe and healthy Lifestyles. Its primary goals include creating Safe Routes to School, creating a bicycle friendly community and working with the Certified Healthy Community Programs. During the spring of 2015, the partnership collaborated with the Bartlesville Farmer’s Market as the market began accepting SNAP for purchases of healthy foods. Additionally, WCPHP members are working with the Bartlesville Chamber of Commerce in efforts to obtain Certified Healthy Business status for local businesses and ways to encourage companies to promote healthy food selections in the work place.

Thank you Bartlesville Farmer’s Market for accepting SNAP! Page 38


14 respondents entered more than 4 meals or snacks a day.

The Dietary Guidelines for Americans recommend three to five servings from various vegetables and vegetable juices and two to four servings from various fruits and fruit juices, depending on calorie needs. The Dietary Guidelines for Americans recommend that persons choose dark green leafy vegetables, orange vegetables and fruits, and dry beans and peas often. See Healthy People 2020, http://www.healthypeople.gov/2010/Document/HTML/Volume2/19Nutrition.htm#_Toc490383124 A healthful diet helps Americans reduce their risks for many health conditions, including: Overweight and obesity

Dyslipidemia (poor lipid

Constipation

Malnutrition

profiles)

Diverticular disease

Iron-deficiency anemia

Type 2 diabetes

Some cancers

Heart disease

Osteoporosis

High blood pressure

Oral disease

See Healthy People 2020, http://www.healthypeople.gov/2020/topics-objectives/topic/nutrition-and-weight-status Washington County Wellness Initiative || Community Assessment 2014-2015

Page 39


TOBACCO AND ALCOHOL USE

Approximately 25% of our assessments showed 258 respondents either use tobacco or vapor/electronic cigarettes.

Page 40


Smoking started as early as age 7 and as late as age 52.

“Among adults who smoke, 68 percent began smoking regularly at age 18 or younger, and 85 percent started when they were 21 or younger. Cigarette smoking during childhood and adolescence produces significant health problems among young people, including an increase in the number and severity of respiratory illnesses, decreased physical fitness and potential effects on the rate of lung growth and maximum lung function.” See The American Lung Association, http://www.lung.org/stop-smoking/about-smoking/factsfigures/children-teens-andtobacco.html?referrer=https://www.google.com/

How much alcohol is too much? It could mean drinking too much at one time, drinking too often, or both. It’s important to be aware of how much you are drinking, whether your drinking pattern is risky, the harm that some drinking patterns can cause, and ways to reduce your risks. See http://rethinkingdrinking.niaaa.nih.gov/how-much-is-too-much/

Washington County Wellness Initiative || Community Assessment 2014-2015

Page 41


HEALTH INSURANCE

6% of respondents who had no insurance in the last year now have obtained coverage.

“Health insurance status by age reveals a large proportion of Washington County residents who were uninsured in 2009-13. Nine percent of people under age 18, and 23.7% of those age 18 to 64 self-reported as uninsured. According to the US Census Bureau’s Small Area Health Insurance Estimates (SAHIE), Washington County’s under 18 uninsured population (9.0%) is slightly higher than the state average (10.6%). … Washington County and Oklahoma as a state have higher percentages of uninsured compared to the United States (14.9%). The lack of health insurance correlates with the lack of preventative and acute health care intervention leading to more significant health problems. The lack of health insurance is a factor in Oklahoma’s high premature death rate. “ See the BRUW Community Profile 2015

Page 42


Percent of Population Uninsured, by Age Group: Washington County, 2009-13

Source: US Census Bureau, Small Area Health Insurance Estimates as reported in the BRUW Community Profile 2015

Who Pays for Your Health Insurance 342 350 300

271

250 200 150 100

134

123

108 78

50

43 13

0

Washington County Wellness Initiative || Community Assessment 2014-2015

Page 43


63% of respondents without insurance could not afford health coverage.

Page 44


COMMUNITY HEALTH ISSUES Community Health Issues 340 305 253

233 189

171

164

154

126 86

248

103 62 30

53

Aging is an increasing trend throughout the world. “In developed countries, where acute care and institutional long-term care services are widely available, the use of medical care services by adults rises with age, and per capita expenditures on health care are relatively high among older age groups. Accordingly, the rising proportion of older people is placing upward pressure on overall health care spending in the developed world, although other factors such as income growth and advances in the technological capabilities of medicine generally play a much larger role.� See the National Institute on Aging, https://www.nia.nih.gov/research/publication/global -health-and-aging/assessing-costs-aging-and-healthcare

33

96 24

22

According to 731 respondents, interpersonal violence issues (child abuse/neglect, domestic violence, and rape/sexual assault) are the leading community health issue.

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Child Abuse and Neglect: State of Oklahoma, Washington County 2014

Meth was the #1 concern for our respondents. WCWI recently received a grant from the Cherokee Nation to address underage drinking and prescription drug abuse.

Page 46

Notes: An “alleged victim” represents a report of child abuse and/or neglect accepted by OKDHS for investigation or assessment, and may include multiple children. Each “confirmed victim” of child abuse and/or neglect indicates one child. Since a child may be confirmed abused and/or neglected multiple times in a year, “confirmed victims” is not an unduplicated count of children. Source: Oklahoma Department of Human Services, Fiscal Year 2014 Annual Report Tables as reported in the BRUW Community Profile.


Community Behaviors Other

44

Not Getting “Shots� to Prevent Disease

57

Not Using Seat Belts/Child Restraints

69

Racism

116

Unsafe Sex

120

Divorce Rates

135

Not Using Birth Control

166

Lack of Exercise

200

Underage Drinking

213

Poor Eating Habits

223

Dropping out of School

283

Being Overweight

346

Substance Abuse

535 0

100

200

300

400

500

600

Respondents consistently reported substance abuse (drugs and alcohol) among adults and youth as the top community danger.

NOTE: Weighted scores were calculated by multiplying the number of responses by severity ranking values.

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Dangers?

Very Serious %

Somewhat Serious %

Serious but Under Control %

Not Serious %

Total %

Drug/Alcohol Abuse – Adults Drug/Alcohol Abuse – Youth Child Abuse Domestic Violence Smoking Teen Pregnancy Bullying Unprotected Sex Underage Smoking Suicide Second-hand Smoke Exposure Unsupervised Children Unsafe Driving Unsafe Roads and Sidewalks School Violence Access to Firearms Not Using Seatbelts/Car Seats Chemical Exposure

2.95% 2.89% 2.97% 2.75% 2.35% 2.21% 2.24% 2.03% 2.14% 2.20% 2.15% 1.93% 1.88% 1.53% 1.52% 1.56% 1.47% 1.10%

1.88% 1.92% 1.68% 1.93% 2.02% 2.06% 1.88% 2.01% 1.85% 1.70% 1.92% 2.01% 1.90% 2.02% 1.56% 1.34% 1.23% 0.86%

0.77% 0.70% 0.69% 0.71% 0.97% 0.75% 1.02% 0.76% 0.99% 0.87% 1.06% 1.15% 1.53% 1.62% 1.64% 1.18% 1.74% 1.36%

0.28% 0.22% 0.21% 0.25% 0.52% 0.31% 0.42% 0.29% 0.46% 0.38% 0.67% 0.66% 0.82% 0.98% 0.80% 1.06% 1.06% 1.44%

5.87% 5.74% 5.55% 5.64% 5.86% 5.33% 5.55% 5.10% 5.44% 5.14% 5.80% 5.75% 6.13% 6.15% 5.53% 5.14% 5.51% 4.76%

The Washington County Wellness Initiative has several workgroups in place to address dangers and needs in the community. For instance, the Washington County Suicide Prevention Coalition serves the community by providing awareness, trainings, and a survivor support group. Another example is the Washington County Anti-Drug Network. Its primary mission is to reduce or eliminate drug abuse while also encouraging youth to be prepared to make nondestructive decisions.

Although respondents reported smoking as the second most serious danger in Washington County, only 23% of our respondents reported that they used tobacco.

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COMMUNITY PERCEPTIONS The WCWI Community Assessment requested perceptions of each respondent to ascertain the current status of the social determinants for Washington County. Questions addressed neighborhoods, whether environments had been built well, and social and community contexts.

Social Determinants of Health

Understanding Social Determinants of Health According to the Healthy People 2020, “Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Conditions (e.g., social, economic, and physical) in these various environments and settings (e.g., school,

church,

workplace,

and

neighborhood) have been referred to as “place.” In addition to the more material attributes of “place,” the patterns of social engagement and sense of security and wellbeing are also affected by where people live. Resources that enhance quality of life can have a significant influence on population health

outcomes.

resources

include

Examples

of

safe

affordable

and

these

housing, access to education, public safety, availability

“The Goal of Healthy People 2020 is to create social and physical environments that promote good health for all.”

of

emergency/health

healthy

foods,

services,

local and

environments free of life-threatening toxins.” See http://www.healthypeople.gov/2020/topicsobjectives/topic/social-determinants-health

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Sense of Community Bartlesville Copan Extremely strong Quite strong Moderately strong Slightly strong Not at all strong Grand Total

78 206 253 91 52 680

2 4 6 3 1 16

Dewey

I do not live in a town or city.

Ochelata

Owen

Ramona

4 22 19 9 4 58

5 16 19 11 5 56

2 4 4 2 0 12

0 1 0 0 0 1

0 2 4 1 1 8

No Residence Grand Total Provided 0 3 10 0 3 16

91 258 315 117 66 847

How Safe do you Feel in County?

Only 12% of our respondents feel extremely safe in Washington County.

422

450 400 350

260

300 250 200 150

106 61

100

19

50 0 Extremely safe

Quite safe

Moderately safe

Overall, how safe do you feel in Washington Bartlesville County? Extremely safe Quite safe Moderately safe Slightly safe Not at all safe Grand Total

Page 50

90 343 208 39 14 694

Slightly safe

Copan

Dewey

2 9 2 3 1 17

4 29 21 5 2 61

Not at all safe

I do not live in a town or city. 5 25 18 8 1 57

Ochelata

Owen

Ramona

Grand Total

3 5 3 2 0 13

0 1 0 0 0 1

2 4 0 2 0 8

106 416 252 59 18 851


14.6% of respondents reported that law enforcement is only slightly or not responsive at all. Overall, how responsive is law enforcement to the Bartlesville needs of Washington County? Extremely responsive 73 Quite responsive 292 Moderately 218 responsive Slightly responsive 77 Not at all responsive 26 Grand Total 686

Law Enforcement Responsiveness 400

363

350 279

300 250 200 150 100

93

90

33

50 0 Extremely responsive

Quite responsive

Moderately responsive

Slightly responsive

Not at all responsive

Copan

Dewey

I do not live in a town or city.

2 7

9 26

3 19

1 8

1 0

0 5

89 357

6

18

25

4

0

1

272

0 2 17

7 1 61

7 2 56

0 0 13

0 0 1

1 1 8

92 32 842

Ochelata

Owen

Ramona

Grand Total

Only 46% of respondents believe people & groups have the opportunity to affect the community’s quality of life.

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Are levels of mutual trust and respect increasing among community partners as they participate in collaborative activities to achieve shared community goals?

55% of respondents do not know how the levels of mutual trust and respect are within Washington County collaborations.

600 478

500 400

292

300 200 100

90

0 No

Yes

74% of respondents believe local government is at least moderately effective at problem solving.

I don't know.

Effectiveness of Local Government at Problem Solving 450 400 350 300 250 200 150 100 50 0

186

Bartlesville

Copan

Extremely effective Quite effective Moderately effective Slightly effective Not at all effective Grand Total

31 153 307 130 57 678

0 4 5 3 4 16

161 76

38 Extremely effective

How effective is the local government at solving problems in Washington County?

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384

Quite effective Moderately effective

Dewey

I do not live in a town or city.

Ochelata

Owen

2 16 23 11 7 59

4 8 24 14 4 54

1 2 7 1 1 12

0 1 0 0 0 1

Slightly effective

No Ramona Residence Provided 0 0 6 1 1 8

0 2 12 1 2 17

Not at all effective

Grand Total

38 186 384 161 76 845


How well are streets maintained? 500

424

400 300

203

200 100

120

100

16

0 Extremely well

Quite well

Moderately Slightly well well

Washington County residents would like to see better maintained streets.

Not at all well

The Washington County Wellness Initiative’s Preventative Health Committee focuses on several neighborhood issues including sidewalks, bikeways, and walking trails. Additionally, WCPHP, in collaboration with Jane Phillips Medical Center, initiated FLOWCo. This is a FREE program for the people of Washington County, Oklahoma. All shapes, sizes, ages (12 & up or babies in strollers), and fitness levels are encouraged to join us. Participants are grouped according to ability, because fitness can't have a "one-size-fits-all" approach. Groups run or walk and their abilities improve each week.

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Need More Services 16.00% 14.00% 12.00% 10.00% 8.00% 6.00% 4.00% 2.00% 0.00%

The top four services requiring more resources according to the WCWI assessment were transportation, affordable housing, substance abuse treatment and safe programs for children. According to the BRUW Community Profile 2015, “Adequate resources, healthy and safe environments, and positive intellectual and emotional development of children are keys to eventual transition into healthy and productive adulthood. Unfortunately, these are not guaranteed and many children in this region of northern Oklahoma do not have the opportunity to benefit from such conditions.”

Weighted Scores for Issues Needing Attention Safe Food at Grocery Stores

1383 1484

Illegal Dumping of Hazardous Waste Clean Childcare Facilities Safe Food at Restaurants Transmittable Diseases From… Chemical Storage and Disposal of… Recyclable Materials in Land Exposure to Secondhand Smoke Clean Water for Recreation Clean Outdoor Air

1927 2043 2460 2594 2705 2733 2858

Clean Indoor Air Clean Water for Drinking

3358 0

Page 54

1507 1511

500 1000 1500 2000 2500 3000 3500 4000

According to respondents, the top four issues needing further attention involve clean air and clean water, both drinking and recreation.


Clean Water from Drinking

Issues Needing Attention

Clean Indoor Air Clean Outdoor Air

6% 7%

6%

5%

5%

13%

11%

Clean Water for Recreation Exposure to Secondhand Smoke

9%

Recyclable Materials in Land

10%

Chemical Storage and Disposal of

8% 10%

10% Chemical Waste

Transmittable Diseases From Animals/Insects Safe Food at Restaurants Clean Childcare Facilities Illegal Dumping of Hazardous Waste Safe Food at Grocery Stores

Although both questions show more jobs are needed in Washington County, the respondents felt more jobs were needed for adults than youth. One issue with these results is that they do not take into account the wage scale for the adult and youth jobs that people believe are available. Many Washington County residents live below the poverty level even when they are employed (i.e. working poor). According to the BRUW Community Profile, “eighty percent of Bartlesville’s 1,951 youth aged 16 to 19 are enrolled in school; some of these students work as well. Twelve percent of youth in Bartlesville are employed and not enrolled in school; many of these kids have already graduated high school. The remaining 7% of youth are neither enrolled in school nor working – 6 of that 7% are not in the labor force at all, and the remaining 1% are unemployed, meaning they are seeking employment.”

According to respondents, Washington County needs more jobs! Washington County Wellness Initiative || Community Assessment 2014-2015

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AGING IN WASHINGTON COUNTY # of People 65 or Older in Household 800

717

600 400

126

200

92

3

1

4

1

3

4

5

6

1

0 0

1

2

12

Over 200 respondents had households with someone aged 65 or older.

12.4% of respondents needed long-term care in the last 12 months

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Living Arrangements for Persons 65 and Older

“While most persons age 65 and older in Washington County … and Bartlesville live with family, many live alone, creating situations that may put them at greater risk of injury or accidents. A smaller share live in group quarters.” Source: US Census Bureau, 2009-13 American Community Survey as reported in the BRUW Community Profile 2015.

80% of respondents age 65 or older feel Washington County is a good place to grow old.

Is Washington County a Good Place to Grow Old? Age 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 or older Grand Total

I don't know. 22 36 27 41 29 9 6 170

No 7 12 26 25 16 8 3 97

Yes 32 106 95 113 125 68 36 575

Grand Total 61 154 148 179 170 85 45 842

Based on elder-friendly housing, transportation to medical services, churches, shopping, elder day care, and social support for the elderly living alone, 68% of respondents believed Washington County is a good place to grow old.

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FAMILY ISSUES Family Issues 450 420 400 350 300

252

250 200 150 100 50

193 185185 183 156 145

125125 120 117

104 92 84 77 72 69 61 59 56 17

0

Economics, budgeting, and finances present the largest issues for families.

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WASHINGTON COUNTY WELLESS INITIATIVE AND INFORMATION SOURCES Have you heard of WCWI? 109 No

238 512

Yes Not Sure

450 400 350 300 250 200 150 100 50 0

WCWI?

People who knew about WCWI were well distributed throughout the county.

WCWI was established in 2004 to transform and strengthen the public health infrastructure through community based action and became legally incorporated as a non-profit, designated as a 501(c)3, in 2014.

Bartlesville

No 406

Yes 197

Not Sure 86

Copan

11

3

4

Dewey

34

16

9

I do not live in a town or city.

37

13

5

Ochelata

9

2

2

Owen

1

Ramona

4

3

Have you heard I do not live in Bartlesville Copan Dewey Ochelata of WCWI? a town or city. No Yes Not Sure

59% 29% 12%

61% 17% 22%

58% 27% 15%

67% 24% 9%

69% 15% 15%

Washington County Wellness Initiative || Community Assessment 2014-2015

1

Owen

Ramona

Grand Total

0% 100% 0%

50% 38% 13%

59% 28% 13%

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*For purposes of this graph, WC is Washington County.

In order to increase awareness of the WCWI workgroups, we need to do a better job infiltrating the mediums used by our respondents for information. Page 60


SUMMARY The respondent pool of the Washington County Wellness Initiative Community Assessment 2014-2015 mirrors the population and demographic data reported in the 2010 United States Census and the overarching data described in the Bartlesville Regional United Way Community Profile 2015. Additionally, as part of the assessment process, the WCWI team also included data and research made available by several state and federal organizations. All the data and research gathered during the community assessment process will be used to strengthen the strategic plans and goals of each WCWI workgroup and will be used to initiate new workgroups to affect positive change based on the reported needs within the county. As recommended by the Community Service Council of Tulsa in the Community Profile 2015, WCWI will continue to strengthen and establish more opportunities for collaboration within Washington County, provide social media marketing, and increase community outreach. The WCWI is also in search of further funding opportunities for transportation, risk reduction education, and case management.

BRUW Community Profile 2015 According to the BRUW Community Profile 2015, “…the most successful community approaches address a continuum of prevention through maintenance. Any plan for community improvement should include addressing the community, family, school and individual. “ The Community Profile included these recommendations: 

Outcome performance  Successful outreach and • Child care measures recruitment • Transportation  Community coalitions  Case management/Care • Translation coordination • Collaborative, public Strong social marketing private partnerships  Risk reduction education • Consumer/client  Access to services and care investments All the WCWI workgroups support the spirit and direction described within the Community Profile recommendations. Based on the results of the assessment, the workgroups will continue to provide their current services and make efforts to grow their capacity to increase their reach.

Healthy People 2020 Healthy People 2020 is a “national health promotion and disease prevention initiative bringing together many individuals and agencies to improve the health of all Americans, eliminate disparities in health, and improve years and quality of healthy life.” Its findings emphasize that “health starts in our homes, schools, workplaces, neighborhoods, and communities” and reminds us that “…taking care of ourselves by eating well and staying active, not smoking, getting the recommended immunizations and screening tests, and seeing a doctor when we are sick all influence our health.” What many people never consider is the correlation between how “our health is also determined in part by access to social and economic opportunities; the resources and supports available in our homes, neighborhoods, and communities; the quality of our schooling; the safety of our workplaces; the cleanliness of our water, food, and air; and the nature of our social interactions and relationships.” This correlation was the impetus for including several of the questions in the WCWI 2014-2015 Community Assessment. Healthy People 2020

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includes the research to support the premise that “the conditions in which we live explain in part why some Americans are healthier than others and why Americans more generally are not as healthy as they could be.” As described by Healthy People 2020, the Social Determinants of Health topic area “is designed to identify ways to create social and physical environments that promote good health for all. All Americans deserve an equal opportunity to make the choices that lead to good health. But to ensure all Americans have that opportunity, advances are needed not only in health care but also in fields such as education, childcare, housing, business, law, media, community planning, transportation, and agriculture. Making these advances involves working together to: •

Explore how programs, practices, and policies in these areas affect the health of individuals, families, and communities.

Establish common goals, complementary roles, and ongoing constructive relationships between the health sector and these areas.

Maximize opportunities for collaboration among Federal-, tribal-, state-, and local-level partners related to social determinants of health.” http://www.healthypeople.gov/

WCWI leadership, volunteer base, and workgroups are constantly searching for ways to improve the overall health of Washington County. Our efforts include maximizing the outcomes and impact of the workgroups to encompass the three highlights of the Social Determinants of Health included within Healthy People 2020. The community assessment confirms the continuing need for the existing workgroups within WCWI. The work groups' efforts are aligned with reported community needs, support the Community Profile 2015 recommendations, and positively impact the social determinants of health.

Oklahoma Health Improvement Plan Oklahoma also has an Oklahoma Health Improvement Plan (OHIP) updated in 2015. The “OHIP 2020 focuses efforts on making improvements in key strategic areas and creating a culture of health. Making improvements in these flagship issues will have the greatest impact on the health of Oklahomans now and for future generations.” OKLAHOMA HEALTH IMPROVEMENT PLAN FLAGSHIP ISSUES: Tobacco Obesity Children’s Health Behavioral Health

Although the WCWI Community Assessment results do not completely align with the OHIP results as far as perceived rankings by our respondents, WCWI does recognize the need to address these concerns and will continue to grow and encourage support for these flagship issues as well as others using the WCWI workgroups. In the personal health issues reported by WCWI respondents, stress/depression, obesity, lack of physical activity, and tobacco use were prioritized within the top seven health conditions – all issues which do align with the flagship issues. One of WCWI’s core values is creating outcomes through collaboration and partnerships. The WCWI assessment results and the OHIP both agree on the need to work together to improve community health. The OHIP specifically states a “key to success in the implementation of the plan is private / public partnerships directed at common goals.” See http://www.okhealthequity.org/

Oklahoma Health Equity Plan and the WCWI Results Lastly, in order to summarize the results of the Washington County Wellness Initiative Community Assessment, the responses will be compared to the Oklahoma Health Equity Campaign (OHEC) findings. The Oklahoma Health Equity Campaign created a forum where state “health organizations and community leaders … joined forces to shine the light on Page 62


the glaring socio-economic and racial inequities in health and to search for ways to fight their effects on Oklahomans. The campaign alerts state and community leaders on socioeconomic and ethnic inequities in health and engages leaders in conversation and action to fight the effects of these inequities on Oklahomans.” See http://www.okhealthequity.org/

HEALTH EQUITY POSITION STATEMENTS HEALTH begins at home in our families, with a loving relationship between parents and their children, where kids can expect to be safe, nurtured and protected. HEALTH begins with healthy communities, with safe streets and sidewalks, freedom from violence and parks where kids can play. HEALTH begins with safe jobs and fair wages, where people derive a sense of personal satisfaction from their work and connection to their co-workers. HEALTH begins with healthy relationships, healthy communities and healthy jobs, which protect us from the stress of everyday life.

HEALTH EQUITY is when everyone has the opportunity to “attain his/her full health potential” and no one is disadvantaged from achieving this potential because of social position or other socially determined circumstance. We can’t eradicate illness, but we can foster health by positively impacting the factors affecting health.

WCWI FUNCTIONS AND WORKGROUPS The Washington County Wellness Initiative is a 501(c)(3) organization dedicated to supporting the numerous organizations, coalitions, initiatives, and projects providing services to our residents with the goal of improving the overall “health” of the communities throughout the county. WCWI Functions Serve as the 501(c)(3) fiscal agent for member organizations, work groups, committees, initiatives, and projects Encourage member engagement and to pool community resources Improve Washington County communities’ capacity to obtain optimum health and social well-being outcomes for our citizens Implement plans and strategies to address gaps Memorialize the institutional memory of the WCWI and all of its partners to aid in sustainability and organizational compliance The WCWI Workgroups are: Access to Healthcare Casa Hispana Hispanic Outreach Center Church Women United Car Repair Project Family Promise of Washington County Preventative Health Partnership Project Prom Washington County Affordable Housing Coalition Washington County Anti-drug Network Washington County Association for Mental Health Washington County Suicide Prevention Coalition Washington County Transportation Coalition We can’t eradicate illness, but we can nurture healthy communities.

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HEALTH EQUITY FINDINGS OF FACT • OKLAHOMANS with lower socioeconomic status die earlier and have more disability.

• •

OKLAHOMA ranks 19th highest in adults without a high school diploma (14.4%). OKLAHOMA ranks 7th highest in the percentage of individuals uninsured (18.7%) among all states (including District of Columbia).

7% of WCWI respondents did not have a high school diploma or GED

25% of WCWI respondents were uninsured in the last year.

• • OKLAHOMA ranks 6th lowest in median household income ($41,664).

OKLAHOMANS suffer more unhealthy days (mentally and physically) than adults nationally with suicide being the most common type of violent death according to the 2008 State of the State’s Health Report.

OKLAHOMA consistently ranks among the lowest states in the consumption of fruits and vegetables.

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COMMUNITY ASSESSMENT RESULTS 88 WCWI respondents reported being disabled as their “employment status” 13% of WCWI respondents have been Homeless within the last 10 years 63% of respondents report Washington County needs More Jobs

• • •

• •

31% of WCWI respondents are currently living Below the Poverty Line 45% of respondents receive some government assistance

17% of respondents had to go without mental health services last year 17.8% of respondents reported more than 10 Bad Physical Health Days in the Last Month 8.5% of respondents reported more than 10 Bad Mental Health Days in the Last Month

57% of respondents had only 0 or 1 serving of fruit a day 39% of respondents had only 0 or 1 serving of vegetables a day


OKLAHOMA is ranked as the 5th most obese state.

OKLAHOMA ranks at the bottom of the national health rankings, according to the United Health Foundation (43rd) and the Commonwealth Fund State Scorecard (50th). OKLAHOMA is 49th in the nation in the limited availability of primary care physicians per 100,000 population.

• •

There were 655 instances of respondents going without healthcare, dental care, and mental health care due to a lack of money.

• •

• OKLAHOMA reports that 65% of infants and toddlers have at least one known risk factor to increase the chance of poor health, school and developmental outcomes.

OKLAHOMA ranks 3rd in incarcerations (655 per 100,000, 32% higher than the national average) among 50 states.

68% of respondents were trying to lose weight Obesity was the fourth most reported health issue for respondents

25% of respondents do not have a Primary Care Physician 161 respondents used the Emergency Room last year for Healthcare

Child Abuse and Child Neglect were identified as the #1 Community Health Issue by Respondents Safe programs for children was identified in the top four issues needing more services

Although no specific data was gathered regarding incarceration and the impact it has on the families and the health of our residents, research proves a correlation between health outcomes and if a parent or caregiver is incarcerated.

Overall, the OHEC positions and findings align very closely with the goals and strategies of WCWI and confirm the needs identified by WCWI are also the needs of our state. The position statements support the work of our workgroups and our continued focus on nurturing a healthy community for all our residents. The OHEC wants to collaborate with public and private organizations, governmental and community partnerships to build public commitment to achieve health equity and decrease the health inequities in Oklahoma. OHEC wants partners to include businesses, advocacy groups, community non-profits, environmental justice organizations, chambers of commerce, faith-based organizations, labor organizations, professional associations and people like you and me that want our families to be healthy and happy. WCWI will continue to reach out to OHEC to establish a stronger partnership.

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Future Plans WCWI Community Assessment results support the perceptions that Washington County has many opportunities to improve and gaps that need to be filled to address community health and health issues. As a first step, WCWI leadership will discuss partnering with the SAFE-NOW organization designed to provide forensic exams to victims of domestic violence and sexual assault in Nowata, Osage and Washington County. Through this workgroup, WCWI can address the community health issues associated with interpersonal violence. WCWI workgroups will use the results of the assessment to update goals and modify impact and evaluation methods. WCWI will continue to take the steps necessary to nurture a healthy Washington County.

According to responses, 72% of respondents have not heard of WCWI. In order to increase organizational reach, raising awareness of workgroup services and WCWI will be a top priority.

Acknowledgements As part of the 2014-2015 Community Assessment, the WCWI team included valuable information and data made available by the Bartlesville Regional United Way Community Profile 2015, the Healthy People 2020 program, the Oklahoma Health Improvement Plan - 2015, the Washington County Health Department’s State of the County, the Jane Phillips Medical Center, Community Health Needs Assessment, and the Oklahoma Health Equity Program. Additionally, this report and the valuable data it contains could not have been accomplished without the support of our many Washington County respondents and volunteers who worked diligently to distribute and enter the assessments.

“I alone cannot change the world, but I can cast a stone across the waters to create many ripples.” Mother Teresa

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INDEX OF CHARTS AND TABLES EXECUTIVE SUMMARY

1

ASSESSMENT PROCESS

3

DEMOGRAPHICS Gender, Age of Respondents Ethnicity, Respondent Ethnicity Cohort Comparison Chart Residency, Tribal Affiliation, Current Relationship Status

3 4 5

CHILDREN IN THE HOUSEHOLD # of Children, Dependent Children: Currently Have Health Insurance, Adequate Child Care Available

6

EDUCATION & EMPLOYMENT Education Level, Employment Status based on Highest School Level Achieved

7

Number of People in the Household, Total Household Income Living in Poverty by Employment Status, Wage Comparison: Self-Sufficiency, Welfare, Minimum, Poverty and 185% of Poverty, and Median Family Income: Family of Three, Washington County 2015* Washington County Income Levels and Percentages of Poverty Levels by Year*

8

POVERTY

9 10

MISCELLANEOUS DEMOGRAPHCS Language Primarily Spoken in Household, Military Service by Branch Voter Registration Percentages, Voter Registration by Age

10 11

GOVERNMENT ASSISTANCE AND ESSENTIALS Respondent Receives Government Assistance Do you have enough money to pay for essentials such as food, clothing, housing…?, What did you do because it was too expensive?

12

Rent or Own Type of Housing, Have You Been Homeless?

13 14

How do you get around every day?, Mode of Transportation by Employment Status (Not in a Personal Car), Other forms of Transportation, How easy is it for the disabled to get around in Washington County?

15

11

HOUSING SITUATION

TRANSPORTATION 16

PHYSICAL HEALTH CHARACTERISTICS Currently Trying to Lose Weight, Personal Health Issues Chart, Health Issue Frequency Chart How physically healthy are you?, Oklahoma’s Rankings in Health Outcomes, 2013* Number of Days in Pain, # of Days in the Last Month that PAIN Made it Hard for You to do Usual Activities, Take Prescription Drugs (Except Birth Control)

17 18 19

HEALTHCARE VISITS # of Emergency Room Visits, Jane Phillips Medical Center Emergency Room Numbers, Made an Appointment for a Check-up, # of Visits to Personal Doctor, # of Clinic Visits

20

HEALTH SCREENINGS AND PREVENTION Last Flu Shot by Town, Last Time You Had a Flu Shot, Last Time You Had a Routine Check Up, Had a Routine Check Up by Town Had Your Blood Pressure Checked by Town, Last Time You Had Blood Pressure Checked, Last Time You Had Blood Sugar Checked, Had Blood Sugar Checked by Town

21 22

FEMALE HEALTH SCREENINGS AND PREVENTION Last Mammogram by Age Hysterectomy by Age, Last Clinical Breast Exam by Age Last Pap Test by Age, Last Pap Test

INDEX OF CHARTS AND TABLES

23 24 25

1 of 3


MEDICAL HOME Have you heard the term “medical home” and think you understand it?, Do you currently have a “medical home”?, Do you have a personal doctor?

26

MEDICAL TREATMENT & HEALTHCARE # of Miles you Travel for Medical Treatment by Town, Number of Miles Traveled (Version 2)

27

Ease of Finding a Doctor Who Participates in Health Plan, Did not Visit Doctor Due to LACK of Money, Where did you receive Healthcare last year other than a private physician?

28

Healthcare Locations You Used, Overall Health Care Rating, Barriers to Healthcare

29

# of Times You or Your Family Needed Eye Care, Did you need eye care but were unable to afford the services? (Table), Personally Needed Eye Care but Could NOT Afford Services (Pie Chart)

30

Mental Health Needed in the Last 12 Months, Mental Health Needed Based on Town # of Days in the Last 30 that Mental Health was NOT Good Overall Mental or Emotional Health, Needed Mental Health Care but Were NOT Able to Afford the Services, Were you able to obtain Mental Health Services in Washington County?, Table of Mental Health Needs, Mental Health Services Needed IMPaCT Grant Audit Results 2013, Mental Health Needs by Number of Days in Pain

31 32

EYE CARE

MENTAL HEALTH

33 34

DENTAL CARE AND CONDITION Overall Condition of Teeth & Gums, Overall Condition of Teeth & Gums by Town # of Times You or Your Family Needed Dental Care, # of Times You or Your Family Needed Dental Care by Town, Did You Need Dental Care but Were UNABLE to Afford the Services When was last Dental Visit?, # of Dental Visits by Town, Last Time You Had Your Teeth Cleaned, Last Time You Had Teeth Cleaned by Town

35 36 37

FRUITS AND VEGETABLES INTAKE # of Meals or Snacks with Fruit, Meals and Snacks Including Fruit # of Meals or Snacks with Vegetables, Meals and Snacks Including Vegetables

38 39

TOBACCO AND ALCOHOL USE Do you currently smoke cigarettes or use tobacco of any form?, Do you use electronic or vapor cigarettes?, Someone else in household uses Tobacco Age When Smokers Started Smoking, Age When Smokers Started Smoking – 18 Years Old/Younger (Pie Chart), Age When Smokers Started Smoking - 26 Years Old/Younger (Pie Chart), # of Alcoholic Beverages Consumed in Last 30 Days

40 41

HEALTH INSURANCE Were you without health insurance during the last 12 months?, Do you currently have health insurance?, Spouse/Significant Other Insurance Percent of Population Uninsured, by Age Group: Washington County, 2009-13*, Who Pays for Your Health Insurance Why no health insurance?, Payment Method for Healthcare

42 43 44

COMMUNITY HEALTH ISSUES

INDEX OF CHARTS AND TABLES

Community Health Issues

45

Child Abuse and Neglect, State of Oklahoma – Washington County*, Community Substance Issues Community Behaviors, Weighted Scores for Community Dangers Community Dangers by Category of Severity Table

47 48

46

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COMMUNITY PERCEPTIONS Social Determinants of Health Diagram, Sense of Community Sense of Community by Town, How Safe do you Feel in County?, Overall, how safe do you feel in Washington County? By Town (Table) Law Enforcement Responsiveness, How responsive is law enforcement to the needs of Washington County? By Town, Individuals and Groups Have the opportunity to contribute/participate in the quality of life? Mutual Trust and Respect in Collaborations, Effectiveness of Local Government at Problem Solving, How effective is the local government at solving problems in Washington County? By Town How well are streets maintained?, Neighborhood Issues Need More Services (Bar Chart), Weighted Scores for Issues Needing Attention Issues Needing Attention (Pie Chart), Enough ADULT Jobs, Enough YOUTH Jobs

49 50 51

52 53 54 55

AGING IN WASHINGTON COUNTY # of People 65 or Older in Household, Long-term Care Placement Needed in the Last 12 Months Persons Age 65 and older By Residence Type*, If you needed long-term care placement, were you able to obtain it in Washington County?, Is Washington County a good place to grow old?, Is Washington County a good place to grow old? By Age of Respondent

FAMILY ISSUES

56 57 58

WASHINGTON COUNTY WELLNESS INITIATIVE AND INFORMATION SOURCES Have you heard of WCWI?, WCWI By Town, WCWI Awareness by Town - Version 2 WCWI Workgroup Awareness, Information Sources

59 60

BRUW Community Profile 2015, Healthy People 2020 Oklahoma Health Improvement Plan Oklahoma Health Equity Plan Oklahoma Health Equity Position Statements & WCWI Functions and Workgroups Oklahoma Health Equity Finding of Facts & WCWI Community Assessment Results Future Plans, Acknowledgements

61 62 62 63 64 66

SUMMARY

* Bartlesville Regional United Way, Community Profile 2015

INDEX OF CHARTS AND TABLES

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INDEX OF WORKGROUPS Access to Healthcare …………………………………………………………………………………………

13, 19, 26, 60

Casa Hispana Hispanic Outreach Center ……………………..…………………….………………

4, 13, 60

Church Women United Car Repair Project ……………………………………………………..…

16, 60

Family Promise of Washington County ……………………………………..………………………

15,60

Preventative Health Partnership ……………………………………….……..………………………

38, 53, 60

Project Prom ………………………………………..…………………………………..………………………

32, 60

Washington County Affordable Housing Coalition ……………………………………………

15, 60

Washington County Anti-drug Network ……………………………...……………………………

48, 60

Washington County Association for Mental Health …………………….……………………

31, 60

Washington County Suicide Prevention Coalition …………….………………………………

31, 33, 34, 48, 60

Washington County Transportation Coalition ……………………..……………………………

15, 60

2014-2015 Community Assessment  
2014-2015 Community Assessment  
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