Georgia Department of Public Health District 4 fayette county community health assessment

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Vision 2

What is a Community Health Assessment? 2

Fayette Leading the Way! 3

Health Assessments 4

Data Sharing 5

Geographic Assessment Area 5

Services Provided 5

Community Engagement 6

Assessments 6

Major Themes 6

Forces of Change Assessment 7

Local Public Health System Assessment 9

Community Health Status Assessment 11

Community Themes and Strength Assessment 13

Community Assets 28

Improvement Plan 28

Sources 29

Vision

We envision a Fayette that places a high value on access to quality physical and mental healthcare, social well-being, the built environment, education, safety and promotes community service and responsibility.

What is a Community Health Assessment?

District 4 Public Health, composed of 12 individual counties, is seeking accreditation from the National Public Health Accreditation Board (PHAB). Accreditation will provide health departments the ability to improve quality, access, services, value, and accountability to stake holders within the community. This assessment satisfies one of the pre-requisites for the Public Health Accreditation Board. The intention here is that, for accreditation purposes, the health department can demonstrate that it systematically assesses its jurisdiction’s health status and can describe it.

The Community Health Assessment involves a process of collecting, analyzing, and using data to educate and mobilize communities, develop priorities, garner resources, and plan actions to improve the public’s health. It is one of the core functions of public health, which is why it’s in the accreditation standards. It involves the systematic collection and analysis of data in order to provide the health department and the community it serves with a sound basis for decision-making. This assessment was conducted in partnership with other partners in the community and includes data collection on health status, health needs, community assets, resources, and other community or state determinants of health status.

Fayette Leading the Way!

The Community Health Assessment titled Fayette Leading the Way! (FLTW) focused on Fayette County, GA. The assessment was conducted using NACCHO’s Mobilizing for Action through Planning and Partnerships (MAPP) tool and took place from August, 2013 to December 2014. Data was collected, analyzed, reviewed, and presented to the committee for review.
The FLTW coalition consisted of multiple partners from Fayette County including:

Fayette County Board of Education
Fayette Chamber of Commerce
State and Local Public Health
EMS/Fire
Police
Elected Officials
Women Infant & Children (WIC) [represent high risk populations]
Fayette Care Clinic - (provides free medical care to uninsured Fayette County residents that are living at 200% of the federal poverty level)
FACTOR Fayette Family Connection - (local arm of Georgia Family Connection- mission is to improve quality of life for family and children through collaboration)
Board of Health Members
Department of Family and Children Services
Piedmont Fayette Hospital
Southside Support (parents with children of special needs) [represent high risk populations]
McIntosh Trail Community Service Board - (provides mental health, developmental disabilities, and addictive disease services for the underserved)
Exceptional Ops - (developmental disabilities support) [represent high risk populations]
UGA Cooperative Extension
Fayette County Parks and Recreation
Fayette County HeadStart Pre-K –[represent high risk populations]
Promise Place – (Domestic Violence Shelter)
Healing Bridge Clinic – (free medical care for underserved and uninsured)
The Real Life Center – (food, clothing, and financial training assistance)

The FLTW coalition meetings were conducted monthly and invitations to each meeting were emailed out to all partner organizations. Those who attended the meetings received paper printouts of all presentation materials and the presentation information was also posted on our District 4 Public Health website. Community engagement was performed via surveys to the community, board of health meetings, and collaborative community meetings, and individual surveys.

Health Assessments

The FLTW coalition followed the MAPP process throughout the entire community health assessment. During this process, we completed the following four health assessments: Forces of Change, Local Public Health System, Community Health Status, and Community Themes and Strengths. Data will be sustained for future assessments via semi-annual collaborative meetings including analysis reports and documented via meeting summary notes/minutes.

The following is an explanation of each assessment:

January 2014 - Forces of Change Assessment

This assessment was conducted by assessing FLTW coalition members on forces that include trends, factors and events that affect Fayette County.

March 2014 – Local Public Health System Assessment

This assessment was conducted by assessing FLTW coalition members and additional community members that were invited to this meeting on the Local Public Health System.

May 2014 - Community Health Status Assessment

The survey was distributed by paper version in coalition member organizations and also online via survey monkey. The survey monkey link was sent out to community partners and was placed on the Fayette County Chamber of commerce website and the District 4 Public Health website. WIC, HeadStart, Southside Support, and Exceptional Ops represented high risk populations.

June 2014 - Community Themes and Strengths Assessment

This assessment was conducted by assessing FLTW coalition members on answering questions of Community Themes and Strengths including:

What is important in Fayette County?
How is quality of life perceived in our community?
What assets do we have that can be used to improve community health?

Data Sharing

The data collected from the health assessment and this report will be posted on District 4 Public

Health’s website. Each community health assessment involved either community residents or the FLTW coalition members. After each assessment was conducted, the results were presented at the following FLTW coalition meeting. The community health assessment report will be made available to the community via the District 4 Public Health website and paper copies in the Fayette County Health Department. It will also be distributed to all FLTW coalition members to distribute to their clients.

Geographic Assessment Area

The Fayette County Health Department primary service area is defined as the geographic area encompassing the zip codes of Tyrone, Fayetteville, Peachtree City, Woolsey and Brooks, Georgia.
County-level quantitative data was utilized throughout the assessment to provide comparable measures to further define the

health needs of local residents.

Fayette County consists of a mixture of rural and suburban communities whose health needs are met by one hospital system, a mixture of private practices, the county health department and other social services.

Services Provided

The health department provides a wide range of outpatient services, including:

BreasTEST & More

Breastfeeding and Breast Pump

Cervical Cancer Screening

Child Health

Children 1st

Chronic Disease

Communicable Disease Program

Community Collaborative Efforts

Emergency Response

Environmental Health

Health Check

Health Education

Bioterrorism

Health Fairs

High Risk Nutrition

HIV Screening

Immunizations

Safe Kids

School, Daycare and Pre-K Audits

Scoliosis Screening

Sexually Transmitted Disease

Travel Clinic

Tuberculosis Program

WIC (Women, Infants, & Children)

Bioterrorism

Community Engagement

We conducted a Community Health System Assessment survey to engage the community via survey monkey and paper copies in community organizations. The Community Strengths and Themes surveys provide qualitative information on how Fayette County residents perceive their health and quality of life concerns as well as their knowledge of community resources and assets.

The Community Strengths and Themes Assessment, was determined by the Mobilizing for Action through Planning and Partnerships (MAPP) strategy. The MAPP process was employed to gain insight upon the quality of life in Fayette County, Georgia. This was done through interviewing collaborative committee members. The results of the assessment will provide District 4 Public Health office with a comprehensive summary of community perceived views on the current state of health in Fayette County, Georgia.

Assessments

The FLTW coalition collected 79 paper surveys. Survey participants ranged in ages from 18 - 74. Participants included those from all over Fayette County. There were 79 responses with 58 (79%) female and 15 (20%) male.

Major Themes

Major themes include the following:

The 3 most important health problems in the community:
1. Aging Problems
2. Cancers
3. Heart Disease and Stroke

The 3 most risky behaviors in the community:
1. Alcohol Abuse
2. Overweight
3. Texting while driving

Satisfaction with healthcare in the community:
1. 50% said no or strongly no
2. <20% said yes

Forces of Change Assessment

The Forces of Change Assessment is designed to help participants answer the following questions:

What is occurring or might occur that affects the health of our community or the local public health system?
What specific threats or opportunities are generated by these occurrences?

The FLTW collaborative addressed these questions for the following categories: Political, Social, Economic, Environmental, Technology, Scientific, and Legal/Ethical. Our findings are listed below.

Political Affordable Care Act (ACA) - confusion, increasing costs, access to care Consolidation of services Re-districting Lack of group homes Annexation Medicaid experts or lack of Access to Social Services Information	Legal/Ethical CHINS law Barrier to Mental Health care at hospital Proper referrals
Social Homeless population Mental Health access to care Domestic Violence Pinewood studios Cultural change Growing Veteran population with increasing PTSD and mental health disorders Influx of Katrina population Lack of access to mental health care Increasing immigrant population City exclusivity/Insular Greater Diversity Lack of social activity for young people Think Tanks Acceptance of drug use and alcohol
Technological Lack of medical info for 911 Health information exchange Healthcare provider incentive Library Access to social services information	Scientific Lack of specialists No STEM schools No aviation schools Incubator/Think tank/research
Economic Property taxes Decreased work force with increased aging population Cost of Housing/lack of affordable housing Lack of transportation Education options Lack of vocational and tech schools Pinewood Sewer system	Environmental Access to highway/interstate Too much fast food Snowstorm/Katrina Lack of sewer system Golf cart paths Sidewalks Air Quality Bike lanes Public Transit-Lack

Local Public Health System Assessment

The National Public Health Performance Standards Program (NPHPSP) assessment is a helpful

tool in evaluating the current performance against a set of optimal standards. This is a partnership effort to improve the practice of public health and the performance of public health systems. This Local Public Health System Assessment (LPHS) report is intended to help the District 4 gain a good understanding of its performance and move on to the next step in strengthening the public system.

The 10 Essential Public Health Services describe the public health activities that all communities should undertake and serve as the framework for NPHPSP instruments. These include:
1) Monitor health status to identify and solve community health problems.

2) Diagnose and investigate health problems and health hazards in the community.

3) Inform, educate, and empower people about health issues.

4) Mobilize community partnerships and action to identify and solve health problems.

5) Develop policies and plans that support individual and community health efforts.

6) Enforce laws and regulations that protect health and ensure safety.

7) Link people to needed personal health services and assure the provision of health care when otherwise unavailable.

8) Assure competent public and personal health care workforce.

9) Evaluate effectiveness, accessibility, and quality of personal and population-based health services.

10) Research for new insights and innovative solutions to health problems.

The following feedback resulted from the Local Public Health System Assessment that focuses on health challenges in the community in relation to the 10 essential public health services:
Essential Public Health Service 1 and 2: Monitor Health Status and Diagnose and Investigate Health Problems

No Community Health Assessments being performed outside of the hospital
Health data collected by state and federal agencies is not easily accessible to the public
Consistently performing drills and exercises to prepare for public health threats and emergencies
In close proximity to Georgia Public Health Laboratory and CDC Laboratories

Essential Public Health Service 3 and 4: Inform, Educate and Empower and Mobilize Community Partnerships

A need for greater collaboration and communication among partner organizations
A need for innovation in public health awareness
Lacking mental health care for children
A social service resource guide is needed
Fayette has a strong Faith Based Emergency Response Network formed by the EMA

Essential Public Health Service 5 and 6: Develop Policies and Plans and Enforce Laws and Regulations

Local Public Health System (LPHS) does not coordinate with the Local Health Department in provision of services. There are a variety of social serving organizations in the community, but they all working in a collaborative manner.
LPHS and Local HD do not have a strong relationship with policy makers
Not currently a regular review of Public Health laws, regulations and ordinances
Public Health issues are addressed as they arise

Essential Public Health Services 7 and 9: Link to services and Evaluation

Greatest barrier to care is transportation
Fayette needs public transportation to provide access to health services
Fayette does not evaluate how well the LPHS activities meet the needs of the community

Essential Public Health Services 8 and 10: Assure competent workforce and Research for new insights

No history of a LPHS workforce assessment
Need a RN at every school
Need to expand nursing schools to Fayette County
Increase Tele-health opportunities
Schools do a good job at collecting data
Need to partner with colleges and universities to conduct more in depth Public Health research and evaluation

Community Health Status Assessment

The Health Status analysis provides quantitative data on a broad array of health indicators, including quality of life, behavioral risk factors, and other measures that reflect a broad definition of health.
Demographics Characteristics

Population-108,365
<18-24.3%
>65-14.6%
African American-20.4%
American Indian/Alaskan Native-.4%
Asian-4.1%
Hispanic-6.5%
Non-Hispanic White-67.2%
% Not Proficient in English-1.5%
Female-51.7%
Rural-18.2%

Socioeconomic Characteristics

Education-78% High School Graduation
Education-76.2% Some post-secondary education
Education-Ranked 3^rd in GA
Income-Ranked 2^nd in GA with Median income of $78,717

Health Resource Availability

15% Uninsured adults
8% Uninsured children
7% of residents could not see doctor due to costs
Primary Care Physician Ratio-905:1
Access to care-Ranked 1^st in GA
Quality of Care-Ranked 1^st in GA

Quality of Life

Poor or Fair Health Days-9%
Physically Unhealthy Days-2.6%
Mentally Unhealthy Days-2.9%

Behavioral Risk Factors

Adult Smokers-12%
Physically inactive-22%
Excessive Drinking-13%
Alcohol impaired driving deaths-29%
Limited access to healthy foods-7%
Alcohol and Drug Use-Ranked 93^rd in GA

Environmental Health Indicators

Air and Water Quality-Ranked 157^th in GA
Housing and Transit-Ranked 69^th in GA
Drinking water violations-40% of population in violation
Severe Housing Problems-13%

Social and Mental Health

Social/Emotional Support-16% with no social/emotional support

Maternal and Child Health

Low-Birth Rate-7%
Teen birth rate-13%
Children in poverty-11%
Children in single-parent households-22%
Infant mortality rate-4.8% (per 100,000)
Child mortality rate-33.6

Death, Illness and Injury

Injury death rate-40
Homicide Rate-3
Leading causes of Age-adjusted death:
1. Ischemic heart and vascular disease
2. Cancer
3. Cerebrovascular disease
4. All other mental and behavioral disorders
5. Alzheimer’s disease

Leading causes of premature death:
1. Ischemic heart and vascular disease
2. Motor vehicle crashes
3. Suicide
4. Cancer of the trachea, bronchus and lung
5. Accidental poisoning

Community Themes and Strength Assessment

The “Community Strengths and Themes Assessment,” of phase three in the MAPP process was employed to gain insight upon the quality of life in Fayette County, Georgia. This was done through surveying collaborative members. The results of the assessment will provide District 4 with a comprehensive summary of community perceived views on the current state of health in Fayette County, Georgia.

In the following list, what do you think are the three most important factors for a “Healthy Community?”
Answer Options	Response Percent
Low crime/safe neighborhoods	67.10%
Good schools	45.60%
Clean environment	34.20%
Access to health care (e.g., family doctor)	32.90%
Good jobs and healthy economy	30.40%
Healthy behaviors and lifestyles	27.80%
Strong family life	22.80%
Good place to raise children	20.30%
Parks and recreation	12.70%
Religious or spiritual values	12.70%
Low level of child abuse	7.60%
Affordable housing	7.60%
Excellent race/ethnic relations	7.60%
Emergency preparedness	6.30%
Low adult death and disease rates	5.10%
Low infant deaths	5.10%
Arts and cultural events	2.50%

In the following list, what do you think are the three most important “health problems” in our community? (Those problems which have the greatest impact on overall community health.)
Answer Options	Response Percent
Heart disease and stroke	47.30%
Aging problems (e.g., arthritis, hearing/vision loss, etc.)	45.90%
Cancers	39.20%
Mental health problems	32.40%
High blood pressure	29.70%
Diabetes	27.00%
Motor vehicle crash injuries	20.30%
Domestic Violence	18.90%
Child abuse / neglect	14.90%
Teenage pregnancy	8.10%
Dental problems	6.80%
Infectious Diseases (e.g., hepatitis, TB, etc.)	5.40%
Firearm-related injuries	4.10%
Respiratory / lung disease	4.10%
Rape / sexual assault	2.70%
Sexually Transmitted Diseases (STDs)	2.70%
Suicide	2.70%
Terrorist activities	0.00%

In the following list, what do you think are the three most important “risky behaviors” in our community? (Those behaviors which have the greatest impact on overall community health.)
Answer Options	Response Percent	Response Count
Texting while driving	50.60%	40
Being overweight	48.10%	38
Alcohol abuse	44.30%	35
Drug abuse	36.70%	29
Poor eating habits	29.10%	23
Lack of exercise	24.10%	19
Tobacco use	16.50%	13
Not using seat belts / child safety seats	12.70%	10
Unsafe sex	11.40%	9
Unsecured firearms	7.60%	6
Dropping out of school	5.10%	4
Racism	5.10%	4
Not getting “shots” to prevent disease	2.50%	2
Not using birth control	1.30%	1
Lack of maternity care	0.00%	0

Community Assets

Fayette County Assets:

Strong Public School System
Pinewood Studios
Close proximity to CDC and Georgia Public Health Laboratory
Golf-cart paths
Strong hospital system
Low crime rate
Strong faith-based network

Gaps in Community Assets:

Lack of access to mental health care providers
Lack of access to transportation
No public transportation
Lack of access to highway/interstate
Very little social activity for younger population
Lack of affordable housing
Decreased work force with increased aging population
High alcohol abuse rate

Improvement Plan

Through the 4 MAPP assessments, strategic planning and action cycle sessions, and community collaboration we identified the following areas of improvement. Implementing these plans will help to improve the local public health system.

Develop an online social services database for clients to have access to all social services information in Fayette County.

Increase transportation services for health services.

Increase the number of mental health providers in the county.

Provide all Fayette County residents with awareness and access to all health care resources to increase follow-up of care and reduce inappropriate use of services.

Reduce duplication of community health organizational efforts by developing a functioning, collaborative group of community stakeholders to better coordinate health resources.

Increase public awareness of risks of alcohol, drug abuse and texting while driving in order to decrease automobile accidents caused by distracted driving.

Sources

Centers for Disease Control and Prevention. (2012). How Vaccines Prevent Disease. Retrieved from http://www.cdc.gov/vaccines/vac-gen/howvpd.htm#why .

Centers for Disease Control and Prevention. (2013). Youth Risk Behavior Surveillance System(YRBSS). Retrieved from http://www.cdc.gov/healthyyouth/yrbs / .

Centers for Disease Control and Prevention. (2014). Chronic diseases and health promotion. Retrieved from http://www.cdc.gov/chronicdisease/overview/index.htm.

Centers for Disease Control and Prevention. (2014). The Public Health System and the 10 Essential Public Health Services. Retrieved from http://www.cdc.gov/nphpsp/essentialservices.html.

Georgia Department of Education, 2014 School Reports, Fayette County. Retrieved from www.doe.k12.ga.us

Georgia Department of Public Health (2013) Georgia Registry of Immunization Transactions and Services (GRITS). Retrieved from https://www.grits.state.ga.us/

Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). Online Analytical Statistical Information System (OASIS). Retrieved from http://oasis.state.ga.us/

Georgia Department of Public Health. State Electronic Notifiable Disease Surveillance System (SENDSS). Retrieved from https://sendss.state.ga.us/sendss/login.screen

Georgia.Gov. Fayette County. Retrieved from http://georgia.gov/cities-counties/fayette-county

The Annie E. Casey Foundation. (2013). Kids Count Data Center. Retrieved from http://datacenter.kidscount.org/

U.S. Census Bureau. (2010) Profile of General Population and Housing Characteristics: 2010 Demographic Profile, Georgia. Retrieved from https://www.census.gov/mso/www/training/library_aff.html

University of Wisconsin, Population Health Institute. (2014) County Health Rankings. Retrieved from http://www.countyhealthrankings.org/

Contact Us

Fayette County Health Department

County Nurse Manager: Glenda Bryant, RN, MN, APRN-BC

140 Stonewall Avenue West Suite 207

Fayetteville, GA 30214 (770) 305-5416 Office

District 4 Public Health

District Health Director: Olugbenga O. Obasanjo MD, PhD, MPH, MBA

122A Gordon Commercial Drive

Lagrange, GA 30240

(706) 845-4035 Office

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2015 Fayette County Community Health Assessment

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