Joplin Community

---

Population overview

The Commission noted several important demographic and population trends within the Joplin Community. Nearly 24% of residents are minors under the age of 17, while approximately 17.5% are over the age of 60. Meaning, that the population is, on average, older than both the Region and nation. Older residents are more likely to be living with chronic illnesses and require access to more health services. Further, approximately 58% of residents are within the age grouping of 18-64, which drives the workforce in the community. 

Approximately 17% of the total population is living with a disability, which is roughly the same as the Commission region but higher than the national rate of 12.62%. This may contribute to access to care and disparities amongst the disability community members. Considerations to take into account when planning for improvement in rural vs urban areas. 

A few of these factors contribute to the overall vulnerability of the population of the Community. Vulnerable populations, such as people in poverty, minorities and the elderly, often experience higher rates of chronic illness and worse health outcomes. To ensure vulnerable and at-risk populations were considered when identifying and addressing community health needs, the Commission identified them in each Community using the Center for Disease Control and Prevention (CDC) Social Vulnerability Index (SVI). Using U.S. Census and American Community Survey data, the SVI identifies the most vulnerable groups across all comparative census tracts. 

Out of the highest vulnerability score of 1.0, the Joplin Community has an overall SVI score of 0.7, meaning that it is more vulnerable than 70% of the rest of counties in the OHC Region. Scores for Socioeconomic Status (0.6), Household Composition and Disability (0.7), Housing Type and Transportation (0.6), and Minority Status and Language (0.5) demonstrate significant vulnerability of the local population. 

---

Assessed Health Issues

Commission stakeholders began the RHA process with analysis of publicly available health data (secondary data) and participating health systems’ emergency room utilization data (primary data) to identify health issues of greatest concern across the region. The result was a ranked list of eight Ozarks Health Commission Region health issues. A full description of the health issues and indicators used can be found in the OHC Regional Health Assessment. 

To represent diverse views from across the region and population, qualitative data was garnered. Across the OHC Region these viewpoints were solicited via 75 individual interviews, 10 focus groups and 2,638 surveys. Methodologies used for the initial scoring/ranking of the health issues and the full report of the qualitative work can be found in OHC Regional Report. This prioritization information can be used by organizations to develop community health improvement plans, guide decision making, and foster collaboration across initiatives. 

During Sept. and Oct. 2021, 25 individual interviews and three focus groups were conducted in the Joplin Community. Those interviewed represented health and social service organizations, education and community collaboratives. 

Of the 2,628 survey respondents from the Region, 45% indicated they lived in the Joplin Community. Respondents were asked to rank perceived community needs, and the top 10 that emerged were: 

1. Affordable, quality childcare 
2. Adolescent and child mental health counseling services 
3. Adult mental health counseling services 
4. Affordable housing 
5. Emergency mental health services 
6. Substance use treatment 
7. Co-located medical and behavioral services 
8. Prevention, education, and early intervention services for substance use 
9. Care coordination between hospitals, clinics, and other health care settings 
10. Social services for individuals experiencing homelessness 

Those interviewed represented health and social service organizations, education and community collaboratives. Stakeholders participating in individual interviews and focus groups agreed with survey respondents about affordable housing, mental health services and care coordination. However, in contrast to survey respondents, those interviewed ranked food insecurity and transportation as top concerns. Also juxtaposed was a lack of priority for job training by those surveyed, where those interviewed felt free training and education would be a “magic wand” to increase quality of life. 

---

Joplin Community Health Priorities

(click a health priority below to learn more)

Each Commission Community convened stakeholders to assess the feasibility of addressing the health issues identified through primary and secondary data sources, and further illuminated with qualitative community feedback. In the Joplin Community, this was organized by the Joplin Health Department and Jasper County Health Department, which dedicated a meeting of the Jasper-Newton County Community Health Collaborative (CHC) on Nov. 12, 2021, to the process. Effort was made to invite all public health agencies, organizations engaged by Crescendo Consulting, CHC members, and leaders of vulnerable and underrepresented communities in the hybrid in-person/virtual meeting. 

Based on the eight health issues identified by the Commission using publicly available and participating health systems’ data, stakeholders from the Joplin Community were convened to further consider top priorities. 

The feasibility of changing each issue and readiness to address each issue was assessed. Feasibility rankings were influenced by stakeholders’ perceptions of the readiness of the community to address an issue, existing initiatives or momentum, whether leadership was established around the condition, perceived feasibility to change, complexity of the issue and the time frame to improve the issue (within 2-3 years or more than 2-3 years). The higher the score, the more significant the impact of the condition on the community, and the more difficult the condition was to address. 

Feasibility was assessed by participants using a short survey, which was opened one week before the meeting to accommodate those unable to attend the live session. A total of 37 stakeholders completed the survey. Survey responses equaled roughly 50% of the total weighted ranking for each health issue. 

Rank	Initial Ranking Primary & Secondary Data		Final Ranking Primary, Secondary & Feasibility Data		Rank change
1	Lung Disease	3.18	Lung Disease	2.94	no change
2	COVID-19	3.17	Heart Disease	2.78	+1
3	Heart Disease	2.91	Oral Health	2.66	+2
4	Mental Health	2.75	Cancer	2.58	+3
5	Oral Health	2.67	Mental Health	2.52	-1
6	Diabetes	2.47	Diabetes	2.47	no change
7	Cancer	2.35	COVID-19	2.42	-5
8	Substance Use & Recovery	1.85	Substance Use & Recovery	2.15	no change

The table above shows Joplin Community health issue rankings based on primary and secondary data (left) and the change after feasibility rankings were included (right). The higher the score, the more significant the impact of the condition on the community, and also the more difficult the condition was to address. It should be noted that feasibility was assessed using a 5-point scale, and the difference between the highest and lowest scores shrank considerably with the introduction of the feasibility rankings, moving from a range of 1.85 to 3.18 to 2.15 to 2.94. 

Special Health Issue: COVID-19

The onset of the COVID-19 pandemic in March 2020 greatly impacted all aspects of the health care industry, as is evident in its high ranking as an assessed health issue. Compared to nationwide data, the Joplin Community had a roughly 25% higher case rate and a 17% lower vaccination rate. When compared to Missouri statewide data, the 10-county region fared 25% worse in all indicators for COVID-19. When feasibility and readiness to change were factored in, COVID-19 dropped five places, with stakeholder consensus being that there were robust systems in place to continue to address screening, testing, contact tracing, vaccination, and treatment. The ongoing efforts and the lack of confidence that the virus would continue to be a dominating issue over the next several years resulted in the determination that COVID-19 is not a priority health issue. 

In qualitative feedback, 56% of survey respondents stated that COVID-19 had affected either their mental health or that of someone who lives with them, and 69% indicated they had children at home impacted by the pandemic. 

Feedback from individual interviews and focus groups about the impact of the COVID-19 pandemic on the Joplin Community emphasized healthcare provider burnout leading to workforce shortages, as well as a rise in respiratory complications and mental health disorders. 

At the end of 2021, both the short- and long-term health impacts of COVID-19 are unknown at a population level. Mortality and morbidity factors in chronic disease secondary data will become evident by the next CHNA cycle, as vaccination and treatment efficacy, breakthrough infection trends, and “long-COVID” impacts are tracked and analyzed. The appearance of the Delta variant, which hit the OHC Region very hard in summer 2021, and the Omicron variant identified as present in Missouri as of Dec. 2021, are examples of the unpredictable nature of viral mutations. Having reliable data sources will continue to be critical to understand how COVID-19 may impact individuals with chronic diseases and conditions that are known co-morbidities. 

---

Social Determinants of Health

(click a Social Determinant of Health below to learn more)

Additional data critical to understanding the health of the population and the vulnerability of the Community was discerned by examining six groupings classified as social determinants of health: Economic Stability, Education Access and Quality, Healthcare Access and Quality, Neighborhood and Built Environment, Social and Community Context and Health Behaviors. The social determinants of health play a significant role in the impact the assessed health issues have on the Joplin Community. For instance, smoking tobacco can lead to lung disease and the Joplin Community has an above average rate of current smokers. This would lead to the outcomes illustrated by the primary and secondary data: above average rates of emergency visits and mortality due to lung disease and heart disease. 

Key Findings

---

Health Services Available

In addition to the websites of participating health systems and public health agencies, there are several robust resource directories available to assist consumers in locating care. These include: