Oct. 29—GRAND FORKS — Mental health, addictions and transportation are among the top ongoing concerns of community members in Grand Forks and Polk counties, according to the most recent
Community Health Assessment
published in Grand Forks.
The assessment, released last week by Grand Forks Public Health, Altru and the UND Masters of Public Health Program, is the latest in a series of community health assessments conducted every three years since 2013. The assessment became a three-way collaboration between Altru, the UND MPH program, and Grand Forks Public Health, and informs public health priorities and action plans for Altru and Grand Forks Public Health.
Mental health, substance use and transportation are public health issues that were also identified in the 2019 CHA, but other key concerns identified in this year’s assessment include access to healthcare. health, access to childcare and insurance coverage.
The planning, data collection, and data analysis portion of the assessment is carried out by UND graduate students in the school’s MPH program.
“This is a great opportunity for our students and an opportunity they can grow from,” said MPH Deputy Principal Ashley Bayne.
Sarah Larson, an MPH student specializing in Indigenous health, said conducting the research was professionally beneficial, but also helped her learn about the community and see what collaboration looks like to improve community health in Great Forks.
“These really important public figures coming together to work together to promote and serve the general public is a really good opportunity to see what partnership looks like on a public level,” she said.
The assessment consists of three components: secondary data from national, state and local sources, a community survey with nearly 400 responses, and focus group discussions with community leaders and special populations. Focus groups on special populations included new Americans, LGBT people, Native Americans, and adults with disabilities.
Secondary data includes information on demographics, risk factors and health outcomes and is collected by other agencies to provide insight into community health, while the survey and focus group discussions conducted by the UND are more community-specific.
Bayne said that across all components, the data told the same story in the community.
“You can use focus groups to further inform community survey and secondary data, so the themes all line up really well,” Bayne said.
In 2019, substance use, mental health, obesity, transportation, health care costs and housing were identified by the Grand Forks Community Advisory Committee as the top six health priorities for next three years. Although official priorities have yet to be selected for the next three years, Debbie Swanson, Grand Forks’ director of public health, says that based on data from this year’s study, mental health and l access to behavioral health services will likely continue.
While the population to mental health provider ratio improved in Grand Forks and Polk counties from 2019 to 2022, the average number of poor mental health days reported over a 30-day period in both counties increased . While Grand Forks County’s ratio of mental health care providers fell from 350:1 in 2019 to 280:1, poor mental health days fell from 3.1 days in 2019 to 3.5 days in 2022. In Polk County, the population to mental health provider ratio improved from 490:1 to 390:1, but poor mental health days decreased from 3.1 days to 4.1 days between 2019 and 2022.
Additionally, in the community survey, approximately 30% of respondents said that access to mental health services in the community was poor. The lack of mental health services and providers was listed as a barrier to health care and a concern that respondents regularly face.
“It seems these issues have become a bigger concern in the community – both access to services and general mental well-being,” Swanson said.
Concerns about substance use in the community are also consistent with the 2019 assessment, Swanson said.
The similarities in results from year to year speak more to the prevalence of issues such as mental health and addiction in the community than to the success of ongoing work to address these issues, Larson said.
“The fact that they are continually worked on and continue to be pressing issues further validates the need to prioritize these types of issues,” Larson said. “That’s not to say they’re not being worked on, but it’s just to say that they’re so complex that they need to be viewed from different angles and continually prioritized.”
This year’s ESC also highlighted new concerns among community members. One was how a lack of cultural inclusivity or culturally competent care can be a barrier for some populations in the greater Grand Forks community.
“We had a really good discussion about how all of the service providers and health care providers in the community can do better to serve the residents of the greater Grand Forks area,” Swanson said. “It’s a new discussion, but it’s certainly a theme that has been there in the past in terms of access to care.”
After the 2019 assessment, in early 2020, Altru and Grand Forks Public Health created a Community Health Improvement Plan and Implementation Strategy that outlined how they would address identified community health priorities. However, Swanson says, the COVID-19 pandemic, which began in March 2020, has affected both parties’ ability to carry out those plans.
“We never really had a way to very effectively monitor our progress and see how we were doing because all of the entities that were involved in our assessment and planning work were heavily involved in the response to the pandemic. “, she said.
Some COVID-19 data is included in the study, such as vaccination and infection rates in Polk and Grand Forks counties, but the long-term impact of the pandemic on community health is still unknown.
“I think there are preliminary effects that we can obviously see, but I think there are long-term impacts that we won’t see for a while,” Bayne said.
Although COVID-19 has been a significant public health event since the 2019 study, Larson said she rarely heard of COVID-19 as a primary health issue in focus group interviews.
“It was more peripheral,” she said. “Once or twice people may have said that COVID exacerbates mental health or substance use, but again, that’s an individual perspective and you can’t really draw that full conclusion.”
Swanson says that later this year, the Community Advisory Committee will formally establish community health priorities for the next three years and release a comprehensive report. From there, Altru and Grand Forks Public Health will bring groups together to develop an implementation plan on how to address these priorities.