2012-13 Pratt County
Community Health Needs Assessment
An assessment of Pratt County conducted jointly by Pratt Regional Medical Center and the Pratt County Health Department.
During 2012-13, a community health needs assessment (CHNA) was conducted by Pratt Regional Medical Center (PRMC) and the Pratt County Health Department for the 9,781 residents of Pratt County, Kansas. Pratt County includes its county seat, Pratt, a city of approximately 6,000 residents located in the plains of south-central Kansas. Pratt Regional Medical Center and the Pratt County Health Department serve the medical needs of the citizens of Pratt and the surrounding rural area in Pratt County.
Description of the Community Served
Deemed the "Gateway to the High Plains" the area in which Pratt is located is a rolling plain of green grassland, broken by the Ninnescah River and the hills along Elm and Turkey creeks.
Pratt is proud of its 270 acres of parks. Once a tall-grass prairie, Pratt is known as "a tree city." The largest park in Pratt, Lemon Park, is approximately 117 acres and has a nature trail, wood sculptures, pond, shelter houses, gazebo, lighted walking path, baseball, softball, and playground facilities.
Pratt is a regional center for shopping, medical care, higher education, cultural activities, outdoor recreation, agriculture, and industry. The hub of Kansas Wildlife and Parks management is located near Pratt and the Kansas Department of Wildlife and Parks Nature Center is located just two miles east and one mile south of Pratt.
The average household income for Pratt County residents is $56,263 and median age is 44. The 2011 population breakdown by age group is: 30% ages 45 to 64; 27% ages 20 to 44; 24% ages 0 to 19; and 19% ages 65 and up. Pratt’s 65 and older population (19%) is higher than the state or national percentages, which is 13% for both. Data and maps detailing current demographics, including income levels, age and educational attainment for the area with a comparison to state and national information is included in Attachment A.
Who was Involved in the Assessment?
The assessment process was initiated and chaired jointly by Pratt Regional Medical Center and the Pratt County Health Department. Each provided roughly equal financial and in-kind support for the assessment process. All of the educational, governmental, civic and health related organizations within the County were invited to participate. To ensure input from persons with a broad knowledge of the community, notices of all meetings were announced, as a public service, on the local radio station, and in the local newspaper. In order to include feedback from a wide range of people, personal interviews were set up with organizations, community leaders, civic clubs and business owners; surveys were distributed at the Health Fair, library and Health Department.
Those who showed enthusiasm about the assessment and planning process became the members of the Pratt County Health Assessment Team (PCHAT). Attachment B to this assessment lists the PCHAT members and all those who participated in the interview, survey or planning process.
How the Assessment was Conducted:
The Pratt County CHNA began with a review of the data for Pratt County displayed on www.kansashealthmatters.org.This information was combined with more recent statistics from city, county, state and national resources.
The PCHAT reviewed the data collected and discussed trends and identified comparisons within the community and with similar sized counties. Based on the data and discussion, the team agreed to share the Pratt County health indicators found on the www.kansashealthmatters.org website with those involved in the personal interviews or focus group discussions prior to beginning the question and answer session. Sharing the local health indicators was identified as an important step because it gave participants an understanding that a healthy community was not based solely upon physical health, but on other factors such as the economy, transportation, economic development and environment. The team decided to ask community leaders and focus groups the standard dialogue questions found in The Community Tool Box. The questions were developed to assist facilitators in leading a community dialogue on building a healthy community. A link to The Community Tool Box can be found on the www.kansashealthmatters.org website. The questions and responses may be found in Attachment C.
Once the interviews were completed and surveys were returned from local partners, the PCHAT reviewed and organized the information collected. The team identified issues and agreed upon a set of criteria to evaluate and prioritize. Town hall meetings were organized and all participants and community members were invited to review, discuss and help prioritize issues that have been identified as a community need.
A list of 20 community needs was identified and developed (Attachment D). PCHAT members agreed on a set of criteria used to evaluate the list of 20 health needs identified through the fact finding process. The criteria included:
- The number of persons affected,
- The seriousness of the issue,
- Whether the health need particularly affected persons living in poverty or reflected health disparities, and
- Availability of community resources to address the need.
Each team member used the criteria to rank the health needs. These individual results were then shared with the PCHAT members for discussion. Team members were given the opportunity to revise their ranking given the information shared during the discussion. The individual rankings were combined to produce a composite ranking. Information was widely disseminated in the local news with invitations for electronic responses and several town meetings were held to discuss and affirm the selections.
The prioritization process identified four priority issues for the community:
- Healthy Lifestyles
- Community Building
- Positive Decision Making for Adolescents and Teens
- Access to Healthcare
It should be noted that voters approved the ¾ cent sales tax to support the hospital building project, therefore that identified community need is being addressed.
Health Needs Identified
Most residents would agree that we have access to numerous parks and recreational activities. The question is: are we using them to be healthy? The 2012 County Health Rankings and Roadmaps show Pratt County ranks 29th in Health Factors, which represents what influences the health of the county; at the same time, Pratt County ranks 70th in Health Outcomes, which represents how healthy a county is. Meaning, we have access to a healthy environment, yet we could improve our health by taking advantage of healthy opportunities.
The Kansas Health Matters website shows 44% of Pratt County adults are overweight. The data also shows residents could increase the amounts of fruits and vegetables they consume.
Educating the community on healthy lifestyle choices, coupled with a health friendly environment, should result in improving the obesity rates in Pratt County.
The need to improve or focus on community building stems from numerous comments received during the interview and survey process regarding economic development, communication methods and job creation.
The data available through the Kansas Health Matters website shows foreclosure and homeownership to be somewhat at risk. These are both economic indicators for the community. The data combined with the comments regarding the need to create jobs and focus on economic development would improve the strain taxpayers in Pratt County are feeling.
A phone survey was completed in 2011 by Patron Insight. (A company hired by Pratt County to research what the community felt needed to be done regarding the aging hospital facilities owned by the county.) We learned economic development and job creation are areas where Pratt County needs to improve. The question was asked: “Where could Pratt and Pratt County Improve?” The top answers were:
- Lack of new Business/Industry/Jobs (174 people)
- High Taxes (159 people)
- Limited Retail/must travel to shop (116 people)
- Lack of things to do (53 people)
This information was true in 2011 and was echoed during the CHNA interview and survey process in 2012. Community Building in Pratt County is a priority.
Positive Decision Making for Adolescents and Teens
Young people are faced with many decisions that could affect their lives in either a positive or negative way. Concerns regarding teen pregnancy, drug, and alcohol use and other risky behaviors are important to the community. Our youth are our future.
Teen pregnancy is an issue that needs to be addressed in Pratt County. According to the Kansas Health Matters website, Pratt County’s teen pregnancy rate is 12.5% for the time period 2008-2010. Neighboring Stafford County is higher at 14.4% and Barber County is 12.7%. The average in Kansas is 10.1%.
Although concern for teen pregnancy rates did not surface in numerous interviews or surveys, it did not go unmentioned. As the PCHAT reviewed the data and discussed the information, all agreed this concern should be a health priority.
The data also indicated that Pratt County is below the State of Kansas average of mothers who receive prenatal care within the first trimester (Pratt 65.9% vs. KS 74.1%). This score and the teenage pregnancy score may indicate that not only are teens becoming pregnant, but we ask the question, “Are they seeking medical care during their first trimester.”
Suicide rates and substance abuse were also an identified as a concern. By educating and promoting positive decision making young people will be better prepared to make decisions that will lead them in a productive and positive direction.
Access to Healthcare
Access to Healthcare has been identified as a need in Pratt County. As a result, local physicians, caregivers and community leaders began a free clinic for uninsured adults in October 2011. The Agape Health Clinic is open on the first Saturday of every month.
In the first year, the Agape Health Clinic has had 236 patient visits/helping 125 people (some patients account for multiple visits). The clinic provides primary care and dental services for uninsured patients who cannot afford medical care. Physicians, dentists, mid-levels, nurses and community members volunteer their time to treat patients. Volunteer hours totaled 936 hours during the first year. The Agape Health Clinic employs one person to manage the operations.
The community has worked together to make the Agape Health Clinic possible. Volunteers provide the medical care, Pratt Community College provides the space, Pratt Regional Medical Center provides the lab and radiology tests and a trained group of volunteers assist patients in applying for free or reduced cost medications.
Continuing to support the activities and efforts of the Agape Health Clinic will take a commitment from volunteers, physicians and the community. Remaining focused on the mission to provide access to health care is a priority.
Proper use of the emergency department is also a concern regarding access to care. People who use the emergency department for non-emergent visits are not only generating large bills, they often do not have a primary care physician or a medical home. Having a medical home is important to a person’s overall health. Discovering the reasons for non-emergent use of the emergency department will help determine if people feel they have adequate access to care in the proper setting.
Community Assets Identified
The assessment identified a number of strong community assets (Attachment E), including the parks, hospital and medical providers, schools, Agape Health Clinic, civic clubs and organizations, and churches. An extensive Pratt Community Resource Guide is available to residents who are seeking information about available resources in the Pratt area. The resource guide (Attachment F) is managed and maintained by the social services department at PRMC. The Pratt Community Health and Resource Council assists with gathering and updating resource information for the Pratt Community Resource Guide.
In 2011, Pratt County hired Patron Insight to do a telephone survey covering the citizens in Pratt County. The results were shared at a community meeting on December 14, 2011. In addition, the survey results guided residents and county leaders through the information gathering process regarding what to do with the aging hospital facilities owned by the county. Listed below is a look at the process and what was learned:
- Completed interviews with 400 randomly selected, head-of-household, registered voter patrons.
- 80% of the completed interviews were with individuals living in the city of Pratt, while the remaining 20% lived elsewhere in Pratt County.
- This process means that the results are within 5% (the “Margin of Error”) of what they would be every registered voter, head-of-household in Pratt County had participated, rather than just 400.
What are the best things about Pratt County? This open-ended question (meaning people were asked to offer their ideas, rather than to react to a list of choices) helped to understand how people view the hospital’s place in the community. The top answers were:
- Good Schools (181 people)
- Good Parks (127 people)
- Small-Town Atmosphere (117 people)
- Friendly People (88 people)
- Good Hospital (77 people)
It is interesting to note that the phone survey results are very similar to the results gathered through the CHNA process.
Summaries: Assessment and Priorities
Assessment data, identified needs and descriptions of the priority setting approach can be found in Attachment D. PCHAT members selected the priorities identified below:
- Healthy Lifestyles
- Community Building
- Positive Decision Making for Adolescents and Teens
- Access to Healthcare
The PCHAT members divided into four separate teams to develop implementation strategies for each priority (Attachment G). Team leaders have agreed to continue to serve on the PCHAT. Each team is responsible for:
- Research best practices regarding the priority,
- Organize a team of community members and field professionals,
- Develop a plan of work or strategy regarding the priority,
- Establish how outcomes will be measured,
- Communicate activities to community and other implementation teams.
PCHAT is developing a community report card to be published on an annual basis beginning in 2013. The team has agreed and is committed to conducting another comprehensive needs assessment in three years.
This process has allowed team members to focus on what they have learned and how to fill in information gaps. Furthermore, the process developed a better understanding of the health and needs of the community. This allows for a process to take place and improvements to be made as information is shared and implementation strategies are in place and measured.
This assessment is available on the websites of Pratt Regional Medical Center www.prmc.org. A copy may also be obtained by calling Pratt Regional Medical Center at 620-450-1160.