Community Health Needs Assessment

The mission of Katherine Shaw Bethea Hospital is to restore, maintain, and enhance health by providing superior care now and in the future.

But how do we define health? What can we do to restore, maintain, and enhance it? And what health needs can we meet for our community?

The Community Health Needs Assessment is a tool we use to better understand the people we serve. We listen to the needs of people throughout our community, and we look for ways KSB Hospital can play a role in meeting those needs.

This year, we conducted our Community Health Needs Assessment in collaboration with the Lee County Health Department. We identified Diabetes, Obesity & Physical Inactivity, and Food Insecurity as the three key health needs of our community that KSB can best address. Read on to find out how we came to that conclusion, and what we’re going to do about it.

Definition of Community & Demographics

For purposes of this assessment, we defined our community as Lee County, Illinois. Lee County is comprised of 34,584 residents living across 725 square miles, according to a 2015 US Census Bureau estimate, of which 91.8% are white and 5.6% are black or African-American. Additionally, 6.0% are Hispanic or Latino.

Education levels in Lee County show that 88.0% of adults have completed high school, but just 17.3% have a bachelor’s degree or higher. While 58.5% of those over the age of 16 are active in the labor force, 12.7% of residents live below the poverty line.

Existing Health Care Facilities & Resources

Lee County residents are served primarily by KSB Hospital and the KSB Medical Group for medical needs. KSB Hospital is an 80-bed acute care hospital offering emergency medicine, labor & delivery, inpatient psychiatry, multi-disciplinary surgery, and a comprehensive set of diagnostic imaging and laboratory services. The KSB Medical Group is a multi-specialty physician practice offering services in 10 locations across six local communities in Lee and Ogle Counties. In addition to the physician practices, KSB also offers outpatient and clinic services in physical therapy, behavioral health, home care, respiratory therapy and sleep lab, and wellness, among others.

The mental health needs of Lee County residents are also served by Sinnissippi Centers, a comprehensive provider of behavioral health and substance abuse counseling services. Local residents can receive urgent medical care at KSB/Physician’s Immediate Care or NowCare. Many providers offer dental and orthodontic services, and several local stores offer pharmacy and optometry services.

Obtaining the Data

For this needs assessment, we gathered information from a variety of sources in order to get a comprehensive picture of the health and needs of our community. First, we reviewed a report from Community Commons that gave us tremendous insight into various health risk factors for Lee County residents (Appendix 1). The report included information on population, demographics, social economic factors, physical environment, access to clinical care, health behaviors, and health outcomes. In all, Community Commons provided more than 100 data sets to enable us to look for outlier values that suggest Lee County’s areas for improvement.

We also used data gathered from Lee County 8th grade, 10th grade, and 12th grade students on topics like substance use and bullying. The student data was made available through the Illinois Youth Survey, a survey in which a majority of Lee County students participated (Appendix 2).

To supplement our available data, we also created and disseminated a community survey to the general population. This survey asked respondents to rate the quality and availability of several health-related services. It also asked for incidence of various health conditions among the respondents and their households. Finally, it offered respondents a chance for free-text responses to questions on how we could improve. In all, we collected responses from 241 members of the general public, from six different communities within Lee County, and with 7.5% of the responses coming from households which received financial assistance such as Medicaid, Food Stamps, Township Assistance, and others during the past year (Appendix 3).

Data from the Community Commons and Illinois Youth Survey helped drive our conversations on the CHNA/IPLAN Committee that was co-founded by KSB Hospital and the Lee County Health Department for purposes of identifying community health needs. The CHNA/IPLAN Committee was comprised of 23 members representing 17 different organizations who serve Lee County. (Appendix 4) Members represented local health care providers, government agencies, schools, law enforcement, advocacy groups, and not-for-profits.

Further, the data and initial findings were reviewed and commented on by members of the KSB Hospital Patient & Family Advisory Council, a panel of members of the community who provide feedback and guidance for patient-centered decisions, and the KSB Hospital senior executive team.

Health Needs of the Community

Based on the data, input from diverse community members, and expertise from organizational leaders, the following are the primary health needs of our community in which KSB Hospital can best make an impact: Diabetes, Obesity & Physical Inactivity, and Food Insecurity.

To identify and prioritize the needs, the CHNA/IPLAN Committee used the Hanlon Method of health problem priority setting. The Hanlon Method measures the size of the health problem, the impact of the health problem, and the effectiveness of intervention. Collectively, the committee scored mental illness, obesity & physical inactivity, substance abuse, tobacco use, food insecurity, dental access, bullying, and diabetes. The exercise yielded the following priorities, of which KSB Hospital selected three key priorities:

1. Food Insecurity
2. Behavioral Health (Mental Illness, Substance Abuse, Tobacco Use)
3. Diabetes
4. Bullying
5. Obesity & Physical Inactivity

Priorities Not Selected

From this community-wide list, KSB Hospital selected Diabetes, Obesity & Physical Inactivity, and Food Insecurity as three special areas of focus. KSB Hospital did not choose to focus on Behavioral Health because it is a primary focus of Sinnissippi Centers, a community leader in mental health and substance abuse counseling. KSB Hospital will continue to partner with Sinnissippi on these efforts. Additionally, KSB Hospital did not choose bullying as an area of focus because it is an issue that is best dealt with by schools and youth-centered organizations. As a medical center, KSB Hospital did not feel it is best positioned to lead efforts against bullying.

Diabetes

People in Lee County struggle with diabetes more and more each year. According to the Centers for Disease Control and Prevention, the rate of diabetes among Lee County adults has increased from 6.6% in 2004 to 9% in 2012, the most recent year for which we have data. That means that more than 2,700 local adults struggle with diabetes.

To meet the community need for diabetes care, KSB Hospital will offer specially tailored services in the KSB Center for Diabetes Management. The center offers services for those with pre-diabetes, gestational diabetes, and both Type 1 and Type 2 diabetes. Patients who visit the center can complete a screening, consult with a certified diabetes educator, get healthy recipes from a dietitian, and be connected with doctors, physical therapists, and pharmacists all within KSB Hospital.

The KSB Center for Diabetes Management offers free blood glucose screenings to the general public on the first Tuesday of each month.

Additionally, to meet the needs of those with diabetes, KSB Community Wellness will host various outreach activities which may include a diabetes prevention program in association with the YMCA, a diabetic youth camp, school-based education, and the Learning to Live Well community lecture series.

KSB Hospital will evaluate the success of our diabetes care initiatives by the number of people who participate in community programs, the number of patients who visit the KSB Center for Diabetes Management, and reversing or slowing the growth of diabetes incidence in Lee County.

Food Insecurity

Survey data from Feeding America shows that 12.9% of Lee County residents meet the criteria for food insecurity, that is they have limited or uncertain access to adequate food. Further, more than 1 in 5, or 21.5%, of Lee County children are food insecure. Of those children who are food insecure, 30% are ineligible for assistance programs like SNAP or WIC.

These food insecurity facts demonstrate a community health need for stable, nutritious food. Inadequate nutrition can have negative effects on many preexisting health conditions, or may make individuals more likely to suffer adverse health consequences. Because of this, KSB Hospital intends to intervene to help alleviate food insecurity in Lee County.

KSB Hospital is the county’s largest employer with nearly 1,000 employees. In addition, tens of thousands of members of the community visit KSB facilities each year for medical appointments, to visit loved ones, or to attend organizational meetings or events. Making the most of the high traffic locations, KSB Hospital will conduct food drives to solicit charitable contributions from employees, visitors, and guests. These food drives will benefit local food pantries and be available for those who are food insecure.

KSB will participate in the Partnership for a Healthy Lee County (PHLC) along with the Lee County Health Department, the University of Illinois Extension, Master Gardener Program, and local churches to offer a Healthy Harvest Community Garden program in which children learn about growing and eating healthy foods. In addition to the gardening, children participate in educational sessions on topics include plotting, canning, pests, and healthy eating.

Further, KSB Hospital will work in partnership with the United Way, Lee County Health Department, Dixon Family YMCA, and others to offer a summer food program for local children. KSB is well positioned to be a key contributor to the summer food program with a large, productive commercial kitchen, skilled staff, and a wide area of coverage through local clinic locations.

KSB Hospital will evaluate the success of meeting the community need for food security by the number of children served by summer food programs, the number of participants with a community garden plot, and the pounds of food that are collected during food drives.

Obesity & Physical Inactivity

Information from the Centers for Disease Control and Prevention show us that Lee County residents struggle with healthy body weights and are less physically active than average. The data shows that 53.4% of Lee County adults are classified as Overweight, that is they have a BMI between 25 and 30. An additional 31.9% of Lee County adults are Obese, that is they have a BMI in excess of 30. Taken together, we see that 85.3% of Lee County adults are overweight or obese. That compares to a combined rate of 63.4% of Illinois adults and 63.3% of American adults. Further, 27.9% of Lee County adults report no physical activity at all outside work, which is a higher rate of inactivity than either state or national averages.

KSB plans to meet the community health need of improved physical activity and decreased incidence of overweight or obesity by engaging the community in interesting and enjoyable ways. KSB Community Wellness ambassadors will provide healthy recipes and food samples at the Dixon Main Street summer City Market events. To further education on healthy eating choices that affect weight, KSB will be the lead sponsor and organizer of the Learning to Live Well community lecture series with special presentations by multidisciplinary providers.

Physical activity is an important contributor to body weight, and KSB will play an active role in promoting physical activity and fitness. KSB will sponsor the Reagan Run 5K and coordinate the KSB Corporate Challenge during the race to encourage local employers to form teams to enter the competition. KSB will again sponsor a community-wide healthy weight contest named Move For A Change, building on a successful program with hundreds of local participants and teams competing to lose weight in a healthy and sustainable way.

KSB will also sponsor the KSB Wellness Center at the Dixon Family YMCA and underwrite new exercise equipment purchases to increase opportunities for those looking for physical activities. KSB also works with the YMCA on a youth running program that teaches kids how to train for and practice running for exercise. KSB will provide physical therapists and physicians to community races and sporting events to ensure participants have access to professional advice on healthy fitness practices.

To support those who want to begin exercising for the first time, KSB physicians will write prescriptions for a free 30-day membership to the Dixon Family YMCA, where new members receive an educational orientation on how to get started working out individually or in a group or class setting.

Further potential activities to promote healthy lifestyles include an Amazing Race-style contest, walking clubs, educational events with the YMCA or other community partners, a bicycling initiative, and targeted outreach through large local employers.

Primary & Chronic Health Needs of Uninsured Persons, Low-Income Persons, and Minority Groups

The CHNA/IPLAN Committee took into account the unique health needs of uninsured persons, low-income persons, and minority groups. The results of our consideration of those needs were reflected in our scoring of health priorities using the Hanlon Method. For example, we discussed and scored the healthy food challenge that low-income people have that affects all three key health priorities: diabetes, food insecurity, and obesity.

The CHNA/IPLAN Committee included representatives from the Lee County Health Department which regularly provides services and has unique insight into underserved populations. Further, the Dixon Public Schools representative helped add perspective on students from low-income families. The committee membership included representatives from various ethnic and socio-economic groups and those perspectives greatly contributed to the discussion and prioritization exercise.

Limits to Our Data & Assessment

As with any assessment or survey process, we did not have perfect access to all the information that would have been useful. Our health data was collected by various groups, and several sources were 2 or more years old. Further, the information we had gave us first-level understanding of some key issues, but we did not have the financial resources or expertise to conduct statistically-valid surveys of our own on a local scale. We gathered a group of community representatives to help get diverse points of view but as with any focus group, we’re of course limited to those opinions that members shared with the group.

Availability of the Community Health Needs Assessment

The KSB Community Health Needs Assessment 2016 is available to the general public on ksbhospital.com/CHNA and a free printed copy is available to individuals who make a request to KSB Hospital, 403 E. First St, Dixon, IL 61021

Acknowledgements

Special thanks to Cathy Ferguson and the Lee County Health Department for collaborating and sharing resources among the Community Health Needs Assessment and IPLAN projects. Thank you also to all those who served on the CHNA/IPLAN Committee, and to those who completed surveys sharing information about their health needs.

Appendices

Community Commons — Lee County

Illinois Youth Survey — Lee County

Community Health Needs Assessment 2016 Survey

CHNA/IPLAN Committee Members

Cathy Ferguson, Lee County Health Department
Diana Vasquez, Lee County Health Department
Megan Dempsey, Lee County Health Department
Ali Aslam, Lee County Health Department
Linda Wegner, PRISM of Lee County
Mary Brokaw, National Alliance on Mental Illness — Sauk Area
Karla Belzer, University of Illinois Extension
Janet Lynch, Sauk Valley Community College
Teresa Strum, KSB Hospital
Nancy Varga, KSB Hospital
Terry Shroyer, Dixon Park District
Jennifer Wenzel-Wamhoff, KSB Center for Diabetes Management
Andrew McFarlane, Dixon Family YMCA
Kevin Lalley, Lee County Emergency Management Agency
Tom Demmer, KSB Hospital
Saad Blaney, MD, Lee County Board of Health & KSB Hospital
Stacie Kemp, Sinnissippi Centers
Danny Langloss, Dixon Police Department
Dave Glessner, Lee County Sheriff’s Department
Jim Walters, YMCA of the Sauk Valley
Staci Stewart, Lee County Probation Department
Bob Olson, Lee County Board & Lee County Board of Health
Dave Blackburn, Dixon Public Schools