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Elko County, Nevada
Community Health Needs Survey
Office of Statewide Initiatives
University of Nevada School of Medicine
Reno, Nevada
1
Overview of Community Health Needs Survey
• Questionnaire
– 33 total questions: 12 multiple choice, 5 fill-in-the-blank, 5 Likertscale, 5 yes/no, 6 open-ended
– Survey assessed self-reported health status, access to medical services, knowledge of public health and demographic information
• Survey and Questionnaire Distribution
– Survey was conducted from December 3, 2013 to January 10, 2014
– Surveys were distributed via convenience and snowball sampling methods
– 458 total questionnaires were completed: 72 paper copies were received and 391 were completed online
2
60.0%
0.7%
29.5%
4.9%0.2% 0.7% 1.4% 1.6% 0.9%
89801Elko
89803Elko
89815SpringCreek
89822Carlin
89823Deeth
89825Jackpot
89828Lamoille
89835Wells
89883West
Wendover
What is the zip code of your current residence? (Q30)
3N = 425
What about living in Elko County contributes to people’s health and well-being in a positive
way? (Q1)
4
Positive Factor Percent
Access to the outdoors, wide open spaces 35.0%
Clean air and water, lack of pollution 31.6%
Community relations, culture, family ties 16.4%
Rural lifestyle, 'small town feel' 15.1%
Availability and effectiveness of services 10.4%
Strong economy, availability of jobs 5.7%
Overall safety 2.1%
Other 4.2%
N=378
What are the top health problems people in our community face? (Q2)
5N=458
Health Concern Percent
Access to healthcare services 46.7%
Access to Medicaid and Medicare providers 43.0%
Cost of healthcare 36.7%
Drug abuse 26.3%
Mental illness 23.8%
Alcohol abuse 19.4%
Health Concern Percent
Obesity 14.0%
Inadequate services for seniors 13.8%
Cancers 10.8%
Domestic violence 7.3%
Teenage pregnancy 6.0%
Suicide 5.4%
6
What are the top health problems people in our community face? (Q2, continued)
N=458
What about living in Elko County contributes to health and well-being in a negative way?
(Q4)
7
Negative Factor Percent
Availability of or access to medical care 21.4%
Poor lifestyle choices, alcohol and drug abuse 18.7%
Casinos, gambling, bars and 24-hr lifestyle 11.1%
Mining shift work, job accidents, job difficulties 9.4%
Remoteness, distance to needed services 6.2%
High cost of healthcare, transportation 5.7%
N=407
8
Negative Factor Percent
Poor quality healthcare, lack of concern by providers 4.9%
Environmental problems 4.7%
Lack of Medicare and Medicaid providers 4.5%
High cost of living and housing, homelessness 4.5%
Problems with the local hospital 3.3%
Smoking, tobacco use 2.7%
Other 2.9%
What about living in Elko County contributes to health and well-being in a negative way?
(Q4, continued)
N=407
Important factors for a healthy community and improved quality of life? (Q5)
9
Contributing Factor Percent
Access to healthcare 46.7%
Good jobs and a healthy economy 39.5%
More affordable medical care 31.5%
Strong family life 27.1%
Affordable housing 26.1%
N=458
Contributing Factor Percent
Low crime and safe neighborhoods 19.9%
Good place to raise children 15.3%
More affordable health insurance 15.3%
Good schools 14.7%
Parks and recreation 10.8%
Religious or spiritual values 10.8%
10N=458
Important factors for a healthy community and improved quality of life? (Q5)
How would you rate the overall health of our community? (Q3)
11N=456
0.2%
13.2%
67.9%
16.9% 17.0%
Very Healthy Healthy SomewhatHealthy
Unhealthy Very Unhealthy
19%
62%
16%
3%
Excellent Good Fair Poor
12
How would you rate your personal health? (Q6)
N=438
18.7%
62.3%
16.0%
2.9%
17.8%
50.8%
24.0%
7.2%
26.1%
59.5%
11.9%
2.5%
Excellent Good Fair Poor
Elko County Humboldt County Douglas County
How would you rate your personal health?
13N=438 (Elko County)
How many days during the past 30 days was your physical health not good? (Q7)
14N=438
45% 47%
5% 3%
Zero 10 or Less 11 to 20 20 or more
15
45% 47%
5% 3%
63%
21%
7% 9%
Zero 10 or Less 11 to 20 20 or more
Elko County Humboldt County
N=438 (Elko County)
How many days during the past 30 days was your physical health not good?
51%
39%
5% 5%
Zero 10 or Less 11 to 20 20 or more
How many days during the past 30 days was your mental health not good? (Q8)
16N= 435
17
51%
39%
5% 5%
68%
18%
7% 8%
Zero 10 or Less 11 to 20 21 or more
Elko County Humboldt County
How many days during the past 30 days was your mental health not good?
N= 435 (Elko County)
18
74%
13%
1% 3%7%
A doctor'soffice
Another type ofclinic
A hospital An emergencyroom
Other
Where do you go most often to receive medical care? (Q9)
N=439
Where do you go most often to receive medical care?
19N=439 (Elko County)
74%
13%
1% 3%7%
66%
20%
5% 5% 4%
78%
14%
1% 1%5%
A doctor'soffice
Another type ofclinic
A hospital An emergencyroom
Other
Elko County Humboldt County Douglas County
20N=438
78%
22%
Yes No
Do you have at least one person you think of as your healthcare provider? (Q10)
21
Was there a time in the past 12 months when you could not see a doctor due to
cost? (Q15)
24%
76%
Yes No
N=439
22N=436
26.8%
73.2%
Yes No
In the past 12 months, have you used an emergency room? (Q11)
If yes, how many times did you go to the emergency room? (Q11, continued)
55.8%
25.0%
6.7% 4.8% 4.8% 1.9%
1 2 3 4 5 6
23N=102
24
27%
73%
24%
76%
Yes No
Elko County Humboldt County
In the past 12 months, have you used an emergency room?
N=436 (Elko County)
In the past 12 months did you visit a dentist or dental clinic for dental care?
(Q12)
71.9%
28.1%
Yes No
25N=437
If yes, how many times did you go to the dentist? (Q12, continued)
28.0%
42.9%
17.9%
7.1%
0.7%3.4%
1 2 3 4 5 More than 6
26N=264
Which town or city do you mostly go to for your non-emergency healthcare? (Q13)
2.7% 0.5%
57.0%
0.7%
10.0%
20.1%
0.2%
8.8%
Carlin CarsonCity
Elko Las Vegas Reno Salt LakeCity
WestWendover
Other
27N=437
75.1%
0.5% 2.9%
15.6%
5.7%
Elko Las Vegas Reno Salt Lake City Other
28N=404
Which town or city do you mostly go to for your emergency healthcare? (Q14)
How long has it been since your last routine check-up? (Q16)
29N=440
56%
24%
16%
5%
Within the pastyear
Within the past 1to 3 years
More than 3 Years Never
How long has it been since your last routine checkup?
30N=440 (Elko County)
56%
24%16%
5%
71%
16%10%
4%
54%
27%
15%
4%
Within the pastyear
Within the past 1to 3 years
More than 3 Years Never
Elko Humboldt County Douglas County
How difficult is it to obtain medical information? (Q18)
31
9.6%
19.4%
32.8%
25.7%
12.5%
Very Easy Easy Moderate Difficult Very Difficult
N=439
What is your primary source for medical information? (Q17)
32
2.5%
35.7%
7.3%
43.6%
10.9%
Books Family Doctor Friends andrelatives
Internet Other
N=435
33
36%
44%
39%35%
Family Doctor Internet
Elko County Humboldt County
What is your primary source for medical information?
N=435 (Elko County)
What are the main barriers you face in accessing health care in our community?
(Q19)
34N=458
Barrier Percent
Inability to get an appointment 30.7%
Finding low cost services 16.5%
Finding a place open when I am not working 15.1%
Finding a place that takes my insurance 11.9%
Barrier Percent
Finding obstetrical or gynecological care 4.1%
My ability to take of work without losing pay 2.3%
Lack of transportation to my doctor or provider 1.1%
Finding child care when I need to see a doctor or provider
0.9%
Finding a place where they speak my language 0.5%
Other 16.9%
35
What are the main barriers you face in accessing health care in our community?
(Q19, continued)
N=458
Main concerns about health care in our community (Q20)
Heathcare Concern Percent
Cost of healthcare, no affordable providers 20.0%
Quality of care and fear of obtaining care 16.6%
Lack of specialty providers and inadequate services 15.6%
Overall shortage of providers, limited access to care 11.9%
Lack of Medicaid and Medicare providers 10.0%
36N=407
37
Healthcare Concern Percent
Concern with quality and cost of the hospital, ER 6.8%
Difficulty in obtaining an appointment 5.6%
No walk in clinics, urgent cares, or poor hours 4.1%
Distance to services, transportation issues 3.8%
Fears concerning the Affordable Care Act 2.4%
Other 3.2%
Main concerns about health care in our community (Q20, continued)
N=407
Types of medical services would like to see that do not currently exist (Q21)
38
• Specialists – 19.5%– Neurologist, Orthopedic Surgeon, Dermatologist, Cardiologist
• Urgent Care – 15.9%– Open extended hours and weekends, preferably 24/7
• Public health nurse or Walk-in clinic – 11.8%– Low costs, sliding fee scale
• Mental health services – 11.2%
• More family medicine doctors, general practitioners, pediatricians – 9.4%– Primarily ones that accept Medicaid and Medicare
N=373
• Better quality doctors and services provided – 8%
• Oncologists and local cancer treatment centers – 6.5%
– Availability of local radiation and chemotherapy services
– Local doctors who can care for cancer patients without requiring extended travel to larger cities
• More OB/GYN care, prenatal care, family planning services – 3.8%
– Especially female doctors and high risk pregnancy specialists
• Home health services, hospice and at home care for seniors and disabled persons – 3.2%
39
Types of medical services would like to see that do not currently exist (Q21, continued)
N=373
Have you ever heard of the term public health? (Q22)
40
89%
11%
Yes No
N=432
In your own words, what do you believe ‘public health’ means? (Q23)
• 6.5% of respondents mentioned at least 33% of the definition in their response, when using the definition provided by whatispublichhealth.org – Public Health is the science of protecting and improving the health of
communities through education, promotion of healthy lifestyles, and research for disease and injury prevention.
• 17% of respondents mentioned at least 20% of what public health professionals do in their response(www.whatispublichealth.org)
• 49% of respondents mentioned healthcare that was funded by the government, free, universal, etc.
41N=383
• “A public health nurse that will only see patients certain times a week and are only in the office part time.”
• “We used to have a public health clinic that would see you and help you and now we have Nevada Health Centers that is so poorly ran it’s a joke!”
• “A place poor people can go.”
• “Inefficiently run government programs that are a tangle of paperwork and lame workers.”
• “Blanket healthcare for everyone.”
• “The community as a whole, …the overall health”
• “Social handout, poor quality.”
• “WE no longer have PUBLIC HEALTH that was a nurse or that was in the area that assisted with medical needs...”
• “Having a public health nurse or a clinic to go to.”42
In your own words, what do you believe ‘public health’ means? (Q23, continued)
N=383
How difficult is it to obtain required immunizations? (Q24)
30% 29%
24%
13%
4%
Very Easy Easy Moderate Difficult Very Difficult
43N=400
Are you aware of where you can obtain restaurant inspection scores? (Q25)
44
52%48%
Yes No
N=403
How likely would you be to report a complaint if you were concerned with a
restaurant? (Q26)
17.5%
21.6% 21.2% 21.9%
17.8%
Very Unlikley Unlikely ModeratelyLikely
Likely Very Likely
45N=434
Additional comments or concerns (Q33)
• “There needs to be more doctors that see patients after 5pm and have walk-ins.”
• “..it would be nice if health care (appointments) were available when needed and we did not have to wait weeks for an appointment or go to the ER where the cost is astronomical.”
• “Just wish more doctors would come and then stay here.”
• “Our hospital has a horrible reputation, some of it is probably undeserved but most people I know are scared to trust them with anything critical.”
• “Healthcare in Elko County is not a priority for our elected officials. Out County Commissioners and City Council people are more concerned about sage grouse, guns and public lands than they are about the health of the people living here…”
46N=335
• “More information on where to report a problem with a restaurant would be nice. A dog park would be wonderful.”
• I worry that there are a lot of individuals who are unable to access affordable healthcare. Therefore, the spread of various illnesses are passed onto the public.
• “Right now, I don’t feel as if I have a doctor, much less one that is familiar with me and my medical history.”
• “Great Basin college has wonderful medical programs, but they could be increased.”
• “West Wendover is a part of Elko County and provides a large amount of tax revenue. We should be treated like those in Elko, NOT discriminated against!”
• “If I had the ability to, I would move out of Elko. “• “Please help with the hospital here.”
47
Additional comments or concerns (Q33)
N=335
Additional Information
48
John Packham, PhD
Director of Health Policy Research
Office of Statewide Initiatives
University of Nevada School of Medicine
(775) 784-1235
www.medicine.nevada.edu/statewide
