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Community Health Needs Assessment

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To view the full report, follow this link to download the 2016 Community Health Needs Assessment

Cottage Health, representing Goleta Valley Cottage Hospital, Santa Barbara Cottage Hospital, and Santa Ynez Valley Cottage Hospital, conducted a Community Health Needs Assessment (CHNA) in 2016 to analyze and describe Santa Barbara County’s most pressing health needs.

The CHNA describes the well-being of Santa Barbara County’s residents and selected social determinants of their health, with comparisons to California’s health profile as a whole. It also connects selected health indicators for Santa Barbara County to the goals or targets in Healthy People 2020 (HP 2020), the national planning document created every 10 years by the U.S. Department of Health and Human Services.

Data Sources

To understand the needs of the community, Cottage Health conducted a telephone survey with approximately 2,500 community members and a Listening Tour with more than 230 individuals who represent the broad interests of the community, including medically underserved, low-income, and vulnerable populations. Secondary data were also obtained from existing online sources.

Health Data

Cottage Health contracted with ICF, an international consulting firm with extensive experience in survey methodology, analysis, and reporting. ICF primarily used two data sources for the CHNA: a telephone survey designed specifically for this effort and existing health and demographic data (such as U.S. Census data) already collected for the County and State of California.

The telephone survey, conducted in the summer of 2016, obtained data from Santa Barbara County adults ages 18 and older. A group of trained interviewers contacted randomly selected residents and asked a series of questions based on the Behavioral Risk Factor Surveillance System (BRFSS) survey instrument, created by the Centers for Disease Control and Prevention (CDC). ICF weighted the data to make sure that survey results were representative of county demographics, such as age, race/ethnicity, and gender, and then analyzed data to determine relationships among the various health indicators.

Follow this link to view the full telephone survey list of questions and results.

Community Perspectives: Cottage Health Listening Tour

Cottage Population Health - Listening Tour Videos

Listening Tour Videos

This video playlist summarizes what we learned from the Listening Tour sessions.

The Listening Tour solicited input from a wide array of community members and leaders, including public health officials, health providers, nonprofit workers, Cottage Health employees, government leaders, and business owners.

These participants identified significant health needs in the community and were introduced to Population Health at Cottage Health. In total, more than 230 individuals participated in the Listening Tour through 20 focus groups conducted from June through August 2016.

Listening Tour Findings

Secondary Data

In order to provide a broad, well-rounded representation of the health of the community, as well as comparisons to California and the United States, the CHNA uses results from many secondary data sources.

The secondary data sources help describe factors, such as the physical environment, social and economic characteristics, and access to health care, and provide data for health indicators that the primary data collection cannot cover, such as hospitalization, disease, and mortality rates.

Secondary data sources included the Community Commons Community Health Needs Assessment Toolkit, Community Health Status Indicators and County Health Rankings.

We compared results from the Community Health Needs Assessment to California-level crude1 data from CDC’s 2014 BRFSS. Conducted by state health departments and CDC since 1984, BRFSS is a telephone health survey of adults, including both landline and cellular phone respondents.

Results from the Santa Barbara County survey and California were also compared to the Healthy People 2020 targets when available.

Follow this link to view the Santa Barbara County Complete List of Health Indicators from Community Commons.


1 Crude estimates were used to match the population-based estimates for Santa Barbara County. Age-adjusted CA BRFSS estimates were not used because they do not produce accurate population estimates. The age adjustment uses an arbitrary age distribution (e.g., standard million) and is valuable for comparing varying populations (e.g., two areas) when the age distribution is different between the populations.


Assessment Results

Based on assessing emergent local health trends in the phone survey, secondary data analysis, and Listening Tour, Cottage Health chose 13 health indicators for in-depth analysis and created health indicator profiles for each one.

These indicators were selected using the Leading Health Indicators from Healthy People 2020 and Center for Disease Control’s Community Health Status Indicators (CHSI) as sources.

Table 1 summarizes these indicators and shows the six indicators for which Santa Barbara County has exceeded or met HP 2020 targets and the six that are below the targets.

These data were further analyzed based on demographic differences. Many differences were found within demographic groups, such as economic status, race/ethnicity, and educational attainment. When viewing population-level data, demographic differences provide a deeper understanding of the health outcomes of various groups.

Within each profile linked in Table 1, we have included data tables, maps, and a chart that displays the relationship between the indicator and other important health factors, including health outcomes, health behaviors, social and economic factors, and clinical care.

Table 1. Health Indicator Profiles for Santa Barbara County, Compared to California and the HP 2020 Target

Health IndicatorSanta Barbara
%
California*
%
Healthy People
2020 Target %
Exceeds HP 2020 Target
Overall Good Health 80.9 81.9 79.8
Alcohol use (binge drinking, past 30 days) 16.7 15.6 24.4
Physical inactivity 18.1 21.7 32.6
Oral health (dentist in past year) 70.0 65.1 49.0**
Smoking (cigarettes) 9.3 12.9 12.0
Obesity 21.6 24.7 30.5
Below HP 2020 Target
Insurance status (insured) 88.7 85.2 100***
Primary care provider (have usual PCP) 72.5 74.5 83.9
Cost as a barrier to care 6.9 13.5 4.2****
Diabetes 8.8 10.3 7.2
Food insecurity 21.1 NA 6.0+
Depression 18.3 13.3 5.8++
HP 2020 Target Not Available
Housing Insecurity 10.7 NA NA

Chart Legend

* 2014 Behavioral Risk Factor Surveillance System data.
** Healthy People 2020 Target includes children and adults aged ≥2 years. For Santa Barbara County, adults reported that overall, 80.2% (95% CI, 74.8–85.5%) of the children in their care had seen a dental health care professional in the past year.
*** Target is for “all persons,” including children; 2016 SB BRFSS is for adults only. The rate of insurance for children included in the 2016 SB BRFSS is 95.9%.
**** Target is slightly different than data presented: “Unable to obtain or delayed in obtaining necessary medical care.”
+ The HP 2020 target includes children and adults aged ≥ 2 years; HP 2020 measure based on responses to three of 18 questions about food availability. For Santa Barbara County, the measure of food insecurity includes two questions:
1) The food that {I/we} bought just didn't last, and {I/we} didn't have money to get more.
2) In the last 12 months, did you ever eat less than you felt you should because there wasn’t enough money for food?

++ The HP2020 target is defined as adults aged ≥18 who experience major depressive episodes.


Conclusions

The results show that on many health indicators, Santa Barbara County compares well overall to California and has already met six Healthy People 2020 targets. However, the benefits of good health and well-being do not extend to all groups in the county, with Hispanic residents, people with low incomes, and those with less education suffering the most from health disparities.

Overall, five areas emerged as priority health areas in Santa Barbara County (alpha order):

  1. Access to Care
  2. Chronic Conditions
  3. Food Insecurity
  4. Housing Insecurity
  5. Mental Health

Committed to taking action based on the findings in the Community Health Needs Assessment, Cottage Health is currently working with community members and organizations to promote significant population health improvements in the county.

Population Health Listening Tour

Cottage Population Health Video - Santa Barbara

Learn about the challenges facing populations in Santa Barbara County and the implications that they have on public health.

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