Working together to solve health concerns

Ottawa County health organizations have been building partnerships since the first Community Health Needs Assessment in 2011.

That work paid dividends during the COVID-19 pandemic, officials said this month during an unveiling of the 2020 Community Health Needs Assessment.

Health providers from hospital systems to small neighborhood free clinics, governments, and nonprofits have collaborated to maximize their efforts to uncover the health needs and assets in Ottawa County.

“This is something we are really great at in Ottawa County,” says Ottawa County Deputy Health Administrator Marcia Mansaray.

Even among competitors such as Holland Hospital and Spectrum Health, collaboration for the health of the overall community took precedence, officials say.

The crisis of a pandemic, itself, further pulled people and agencies together in cooperation.

“We are more prepared now, I think, than before COVID,” Mansaray says. “A huge silver lining about COVID was the increased collaboration among organizations.”

Every three years, the Ottawa County Health Needs Assessment creates a common set of data that agencies across the county can use to analyze and understand both health problems and assets. Then the health care providers, nonprofits, and government agencies work together to craft solutions. The assessment questions thousands of people from across Ottawa County — from health care providers to underserved residents to randomly sampled adults.

COVID, of course

When the county started its community health needs assessments in 2011, lack of health insurance, mental health and the impact of the then-new Affordable Care Act topped the list of concerns.

In 2020, unsurprisingly, COVID-19 colored every answer. 

“It was the year of COVID. That influenced everything about this project,” says Dr. Marty Hill, president of VIP Research and Evaluation, which administered the assessment. “This is the most challenging CHNA (Community Health Needs Assessment) we have done by far of the four (2011, 2014, 2017, 2020). … For me as a researcher it was challenging, because COVID permeated all aspects of health, health care, and life.”

Those from underserved populations such as people of color and those in poverty were five times more likely to have someone in their household diagnosed with COVID-19 — 5% versus 1% in the overall population, according to the report. 

At the same time, fewer of those from those underserved populations said they would be extremely likely or very likely to vaccinate against COVID-19 given the opportunity — 30% versus 48% overall.

“This can have implications for all of our work for preventing COVID-19 in our community,” says Derel Glashower, the county’s top epidemiologist.

In 2020, Ottawa County saw 18,584 documented cases of COVID-19, resulting in 586 hospitalizations and 282 deaths.

And mental health

Mental health and Adverse Childhood Experiences (ACEs) were also a top concern in 2020. Those with four or more ACES, such as abuse, neglect, or family dysfunction, are much more likely to experience adversity in adult life. They are more likely to engage in risky health behaviors, have chronic health conditions such as diabetes and obesity, and have a reduced life expectancy.

“Mental health and access to care is a huge issue and this was magnified during the pandemic” Mansaray says.

The number of adults who reported mental health problems in the two weeks before they took the survey remained constant over the years, hovering around 8% — until 2020 when it nearly doubled.

Almost every person surveyed agreed that treatment helps people with mental illness lead normal lives. And yet half who report poor mental health and anxiety said they did not get treatment.

A lack of mental health care providers, providers who accept all forms of insurance, especially Medicaid, and a perceived lack of empathy may get in the way of accessing care.

Access

Something called social determinants of health can also stand in the way: Available resources; quality of schooling; quality of food, water, and air; employment and safe workplaces; housing costs.

When a family is paying more than it can afford for housing, for example, Hill says, “One of the first things they are going to forego is health care.”

Access to affordable housing is the biggest social determinant — something that West Michigan lacks, officials said.

Additionally, traumatic times such as a pandemic can help people recall other traumatic times in their lives, according to clinicians cited in the report.

“For some people these experiences can open the floodgates,” Hill says.

Next

The Ottawa County Community Health Needs Assessment and subsequent Community Health Improvement Plans have resulted in everything from additional health personnel in the county to exercise programs to new nonprofit collaborations focused on specific health issues.

“This data really leads to a lot of incredible work,” says Patrick Cisler of Community SPOKE and the Lakeshore Nonprofit Alliance.

Ottawa Food, Ottawa Pathways to Better Health, and Thrive Ottawa County are all collaborative efforts to come out of the triennial report. Now, the overarching effort to bring together health partners has been rebranded with a new website, healthyottawa.org, and planning has begun for the Healthy Ottawa Community Health Improvement Plan. 

Mental health, access to care, and encouraging healthy behaviors will be top priorities.

Read more articles by Andrea Goodell.

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