The Ozarks Health Commission Steering Committee elected to utilize consultative services to acquire reliable and representative input from the 30-county OHC Region. To that end, a consulting firm was hired to gather both quantitative and qualitative data through 3 avenues: community surveys, focus groups and interviews.
The community survey, which collected quantitative data, saw broad participation across all 7 Communities. The community focus groups and interviews which collected qualitative data, consisted of key community stakeholders, policymakers and residents. Across the OHC Region, significant engagement was seen from health systems, non-profits, government, schools, libraries, tribal communities, vulnerable populations and diverse communities, health focused organizations and faith-based organizations.
The full Crescendo Community Report can be found in Appendix D.
Through the analysis of the qualitative data, themes emerged in the region for identified needs and possible interventions. The needs and possible interventions identified through community input are important factors to consider when planning approaches for community improvement. This included needs and interventions in the areas of mental health, substance use and recovery, COVID-19, access to care, housing/homelessness/poverty and neighborhood and built environment.
Our area has high percentage of people on drugs. Meth is big. If you have a record, it’s hard to get housing, so people live in extended stay hotels and drugs are prevalent – people can’t get out of the cycle.Branson Community, Taney County
Through the analysis of quantitative data themes also emerged, including mental health, substance use and recovery, housing and access to affordable childcare.For analysis purposes the themes that emerged will be discussed in relationship to AHIs and/or social determinants of health.
- The COVID-19 pandemic, specifically stemming from low vaccination rates in the area, will have long-lasting effects on many health and social aspects of the population.
- Healthcare has become highly and increasingly politicized, and this has affected both medical and mental health needs of residents across the region.
- Recruiting and retaining the necessary number of and types of providers exacerbates the already challenging health issues (as illustrated by the chart to the right).
- Many shared the hope for their children’s futures, but isolation due to poverty and the risk of COVID-19 is creating what they feel are permanent educational and behavioral health challenges for many. The complete impact of the pandemic will not be known for years.
Overlapping needs mental health and substance use and recovery services were identified through interviews and focus groups. Mental health and substance misuse have always plagued the area, but the COVID-19 pandemic has greatly increased the problem and not nearly enough treatment options exist.
- Survey respondents identified the following needs in relation to Mental Health:
- Counseling services for mental health issues for children & adolescents
- Counseling services for mental health issues for adults
- Emergency mental health services
Regarding the AHI Substance Use and Recovery, 62.97% of the respondents identified drug and substance use treatment and rehab services (including detox) were needed in the region. Further, 60.54% of the respondents identified that drug and other substance use education, prevention and early intervention services are widely needed.
Homeless teens and homeless in general are a major problem. We have a lot of couch surfers or multifamily homes, not enough homes for growing community in Durham. The number of people without a permanent address is extremely staggering for kids in schools.
Lebanon Community, Dallas County
Social determinant of health factors are found as underlying or contributing issues to improving chronic disease and other health issues. Whether due to transportation, insurance or cost considerations, avoidance of healthcare, unhealthy lifestyles or other factors, the difficulty of accessing healthcare, mental health and substance use and recovery providers leads to a large number of people who indicated that chronic conditions are a major issue in the region. Diabetes, heart disease, obesity, Chronic Obstructive Pulmonary Disease (COPD), and hypertension were consistently cited.
Transportation remains a barrier for individuals and families trying to get the healthcare they need, and travel for regular employment.
Another overlapping theme emerges with access, broadband and COVID-19. As delivery options have expanded during the pandemic, not all residents have perceived this as a viable option for services.
Telehealth comes with its own challenges and barriers to solving rural health care needs due to the lack of broadband infrastructure, as well as costs of hardware, consistent internet access, and knowledge gaps.
Housing, homelessness and poverty were identified as themes that are underlying factors that affect the health, well-being and progress of community members.
As we assess the underlying factors, two themes rise to the top from the community survey results. Access to affordable childcare and access to affordable housing. Access to affordable childcare rose to the top of identified needs with 70.37% of the respondents identifying this as a need. This need was identified by all age groups and genders that participated in the survey.