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Lower 8 Community Health Assessment: Regional Overview

Introduction

During the summer of 2012, the Community Health Center of Southeast Kansas administered a survey for residents of the Lower 8 region of Southeast Kansas. The survey’s main focus was the health needs and concerns in these counties. Public health employees asked area residents to complete this survey, which consisted of three multiple-choice questions and three write-in questions. The survey was available in both English and Spanish and in scannable paper and electronic formats. The counties that participated were Chautauqua, Cherokee, Crawford, Elk, Labette, Montgomery, Neosho, and Wilson. The following report is based on the responses of the 3,112 participants.

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Note: A number of surveys from Elk County were received too late for inclusion in this report. However, the county-level report for Elk County does include the data from these surveys.

The chart above shows the distribution of responses by county. The three counties with the most responses were Crawford (28%), Montgomery (21%), and Labette (19%), while Elk and Wilson had the fewest.

The chart above shows the age ranges of those that completed the survey. Almost half (42%) of respondents in all eight counties were in the age range of 41-62. The survey was not administered to anyone under the age of 18.

Chautauqua 6% Cherokee

8%

Crawford 28%

Elk 4%

Labette 19%

Montgomery 21%

Neosho 10%

Wilson 4%

County of Residence

18-25 13%

26-40 31%

41-62 42%

62 & above 14%

Age

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Presented first are results from the three multiple-choice questions. It is important to remember that respondents were asked to choose three answers for each of the multiple-choice questions, which is why the number of responses will add up to far more than the number of respondents.

Question 1 “In the following list, what do you think are the three most important factors for a ‘Healthy Community?’ (Those factors that would most improve the quality of life in your community.)”

The following chart represents the most popular choices of the respondents:

Considering the total number of participants (3,112), 46% agreed that being a “Good place to raise children” is an important factor for a “healthy community,” 44% selected “Good schools,” and 42% chose “Good jobs & healthy economy.”

22

56

56

71

74

165

344

371

669

673

688

750

762

1031

1305

1360

1441

Other

Low adult death and disease rates

Low infant deaths

Arts & cultural events

Excellent race relations

Low level of child abuse

Parks & recreation

Affordale housing

Clean environment

Religious or spiritual values

Healthy behaviors and lifestyles

Strong family life

Access to health care (e.g., family doctors)

Low crime/safe neighborhood

Good jobs & healthy economy

Good schools

Good place to raise children

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Question 2 “In the following list, what do you think are the three most important ‘health problems’ in your community? (Those problems that have the greatest impact on overall community health.)”

Based on the responses of the 3,112 participants, “Cancers” (51%), “Diabetes” (30%), and “Heart disease and stroke” (29%) are the most important “health problems” in their communities as reported by Lower 8 residents. “Cancers” was the single most prevalent choice by a wide margin.

27

39 42

47

78

94

95 184

208

220 235

450

495

678 761

794

830

846

908

928

1582

Homicide

Firearm-related injuries

Infant death

HIV/AIDS

Rape/sexual assault

Farming related injuries

Infectious disease

Other

Sexually transmitted diseases

Motor vehicle crash injuries Respiratory/lung disease

Dental problems Domestic violence

High blood pressure

Mental health problems

Aging problems

Child abuse/neglect

Teenage pregnancy

Heart disease and stroke

Diabetes

Cancers

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Question 3 “In the following list, what do you think are the three most important ‘risky behaviors’ in your community? (Those behaviors that have the greatest impact on overall community health.)”

Among the 3,112 participants, “Drug abuse” was chosen most often (70%), followed by “Alcohol Abuse” at 56%, and “Being overweight” at 49%. There was a wide gap between these top three choices and the fourth-most-prevalent choice, which was “Poor eating habits.” It is also notable that the third, fourth and fifth-place choices (“Being overweight,” “Poor eating habits” and “Lack of exercise,” respectively) were closely related.

Open-ended questions Questions 4-6 were open-ended in nature. In order to perform analysis, the handwritten responses to each question were transcribed into typed text. These typed responses, in addition to those from the online surveys, were then loaded into qualitative data analysis software. This software helped to identify commonly occurring themes and ideas.

More than 2,000 write-in responses to each question were categorized into one or more distinct categories. Note that sometimes these responses contained multiple themes or ideas; for example, the response “Lack of good pay jobs so adults can afford to raise their children without assistance” was interpreted as referring to both the job market (categorized as “Jobs/Economy”) and to government assistance (categorized as “Dependence on government”). This response was tagged as containing both of those themes.

41

129

186

231

411

443

470

666

724

802

1517

1747

2187

Other

Not getting "shots' to prevent disease

Racism

Not using seat belts/child safety seats

Unsafe sex

Dropping out of school

Not using birth control

Tobacco use

Lack of exercise

Poor eating habits

Being overweight

Alcohol abuse

Drug abuse

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Question 4 “What is your biggest concern about your community?”

The following table shows the number of times each theme or idea occurred within the write-in responses to question 4:

Theme N Percent

Jobs/economy 587 25.7%

Drugs 377 16.5%

Alcohol 108 4.7%

Aging/dwindling population 106 4.6%

Poverty 101 4.4%

Crime 98 4.3%

Dependence on government 91 4.0%

Lack of activities/recreation 83 3.6%

Housing concerns 76 3.3%

Education 73 3.2%

Access to health/dental care 71 3.1%

Obesity/eating habits 61 2.7%

General health 59 2.6%

Child abuse/neglect 54 2.4%

Other 343 15.0%

Total 2287 100.0%

Note: Any theme occurring 50 or fewer times was grouped into the “Other” category.

The top five themes that arose in response to this question were “Jobs/economy,” “Drugs,” “Alcohol,” “Aging/dwindling population,” and “Poverty.” “Crime” followed closely at number six.

“Jobs/economy” and “Drugs” were the most prevalent themes by a wide margin. In fact, none of the other individual themes accounted for even 5% of the total. It is also worth considering the relationship between “Jobs/economy” and “Poverty.” These two themes are closely tied, and if combined, they would be found in more than 30% of all responses.

Because “Jobs/economy” and “Drugs” were broad themes and included many responses, each was divided into sub-categories in order to more specifically describe the respondents’ concerns. The charts below illustrate the make-up of these responses:

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General concern over drug use

81% Meth use

5%

Youth drug use 5%

Drug-related crimes 5% Sale/ manufacture of

drugs 3%

Prescription drug abuse

1%

Drugs

The most common themes seen in both categories were broad – “Lack of jobs” for “Jobs/economy,” and “General concern over drug use” for “Drugs.” Responses were placed in these sub-categories if they did not mention a more specific economy- or drug-related problem. Most often, respondents wrote short answers such as “drugs” or “jobs.”

Lack of jobs 52%

Poor economy 26%

Low-paying jobs 7%

Unemployment rate 6%

Few jobs for young people

4%

Lack of businesses 3%

Jobs leaving area 2%

Jobs/economy

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Question 5 “What one thing would you change about your community? (i.e., what is missing?)”

The following table shows the number of times each theme or idea occurred within the write-in responses to question 5:

Theme N Percent

More jobs/better economy 432 28.1%

More activities/entertainment 274 17.8%

Reduction of drug use 113 7.4%

Exercise/recreation facilities 103 6.7%

Community involvement 103 6.7%

Increased access to health/dental care 81 5.3%

More housing options 75 4.9%

Education improvements 73 4.7%

Family/parenting improvement 46 3.0%

Lower taxes 43 2.8%

Other 194 12.6%

Total 1537 100.0%

Note: Any theme occurring 40 or fewer times was grouped into the “Other” category.

The five most prevalent themes that emerged in response to question 5 were “More jobs/better economy,” “More activities/entertainment,” “Reduction of drug use,” “Exercise/recreation facilities,” and “Community involvement.”

Because jobs and drug use were the two most prominent concerns raised by community members in answer to question 4, their presence in this list is unsurprising. However, this question also brought to light some new concerns. Perhaps most prominent among these was a desire for more activities and entertainment.

Because this category was broad and encompassed many individual themes, it was broken down into sub-categories highlighting more specific concerns. “Activities for youth” was the central theme of 56% of the responses within the “More activities/entertainment” category. Many respondents mentioned that such activities were needed in order to keep youth from participating in risky behaviors.

A breakdown of responses within the “More activities/entertainment” category is shown in the following chart:

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Another theme unique to question 5 was a desire for exercise or recreation facilities. Once again, this category encompassed a range of ideas. Most of the people whose responses fell into this category stated a desire for a physical building at which people could exercise or hold social gatherings, while others wanted more parks or walking trails. The responses within the “Exercise/recreation facilities” category are shown in the following chart:

Activities for youth 56% More activities

in general 27%

Activities for families

9%

Entertainment 8%

More activities/entertainment

Fitness/rec center 62%

Park 19%

Walking/biking trail 16%

Pool 3%

Exercise/recreation facilities

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Question 6 “What do you like most about living in your community?”

The following table shows the number of times each theme or idea occurred within the write-in responses to question 6:

Theme N Percent

Friendliness 848 26.1%

Community size 652 20.1%

Community involvement 416 12.8%

Environment 300 9.2%

Safety 236 7.3%

Closeness to family 210 6.5%

Schools 169 5.2%

Rural life 97 3.0%

Low crime 77 2.4%

Recreation 54 1.7%

Health care 49 1.5%

Economical 48 1.5%

Short commutes 29 0.9%

Supportive community 25 0.8%

Religion 23 0.7%

Location 18 0.6%

Total 3251 100.0%

It could be argued that the responses to questions 4 and 5 showed some of the drawbacks of living in a

small, rural community. The responses to question 6, on the other hand, highlighted many of the

benefits of small-town life. The five most common themes were “Friendliness,” “Community size,”

“Community involvement,” “Environment,” and “Safety.” It is noteworthy that “Community

Involvement” was the third-most-prevalent answer to this question, while it was also the fifth-most-

mentioned theme in response to question 5.