Community Health Needs Assessment

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To view the full report, follow this link to download the 2019 Community Health Needs Assessment

Cottage Health, representing Goleta Valley Cottage Hospital, Santa Barbara Cottage Hospital, and Santa Ynez Valley Cottage Hospital, partnered with community organizations and agencies from Santa Barbara County to conduct a comprehensive 2019 Community Health Needs Assessment (CHNA).

Assessing Santa Barbara County’s most pressing health needs, this report 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 ten years by the U.S. Department of Health and Human Services.

Data Sources

To obtain data for this report, Cottage Health conducted a telephone and web survey with approximately 900 community members and a Listening Tour with more than 240 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. This approach is consistent with the methodology established in the 2016 Cottage Health CHNA, which also serves as benchmark for the 2019 data.

Health Data

Cottage Health contracted with the Evaluation Institute at the University of Pittsburgh, an academic research unit with extensive experience in survey methodology, analysis, and reporting. The Evaluation Institute used two data sources for the CHNA: a telephone and web survey designed specifically for this effort and existing health and demographic data (such as U.S. Census data) already collected for the county and California.

The telephone and web survey, conducted from July through October 2019, 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).

Respondents could complete the survey on the telephone or online. A convenience sample was also recruited targeting both the general population in Santa Barbara County and vulnerable populations. The data were weighted to make sure that survey results were representative of county demographics, such as age, race/ethnicity, and gender, and then compared to the 2016 Santa Barbara County BRFSS, California BRFSS, and Healthy People 2020 Leading Health Indicators. Data presented in this report reflects the randomly selected sample only, as this sample most closely compares to previous county estimates as well as state and national estimates.

Community Perspectives: Listening Tour

The Behavioral Health Listening Tour solicited input from a wide array of community members and leaders, including public health officials, health providers, nonprofit workers, Cottage Health employees, and government leaders. These participants identified significant behavioral health needs in the community. In total, more than 240 individuals participated in the Listening Tour through twenty focus groups conducted from August through September 2019.

Assessment Results

Based on results from the 2019 CHNA telephone and web survey, secondary data analysis, Listening Tour and 2016 Cottage Health CHNA, nineteen health indicators were identified for in‐depth analysis and prioritization. These indicators were selected using the Leading Health Indicators from Healthy People 2020 and CDC’s Community Health Status Indicators (CHSI) as sources.

Table 1 summarizes these indicators, and shows the five indicators for which Santa Barbara has exceeded or met HP 2020 targets and the seven below the targets. Five of the nineteen indicators do not have a comparable HP 2020 target, but Cottage Health decided to analyze these because of their overall prominence and importance to the community and guidance from CHNA partner organizations.

Two of the nineteen indicators, anxiety and other mental health disorders and low resilience, were included in the prioritization process, but are not included in the table below because they lack state and national benchmarks.

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.

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

Health Indicator Santa Barbara
%
California*
%
Healthy People
2020 Target %
Exceeds HP 2020 Target
Alcohol use (binge drinking, past 30 days) 16.7 16.1 24.4
Obesity 25.5 25.8 30.5
Oral health (dentist in past year) 68.9 67.4 49.0**
Physical inactivity 19.9 21.0 32.6
Smoking (cigarettes) 11.5 11.2 12.0
Below HP 2020 Target
Overall good health 77.0 81.9 79.8
Insurance status (insured) 87.5 88.3 100***
Primary care provider (have usual PCP) 69.3 74.7 83.9
Cost as a barrier to care 18.1 11.9 4.2****
Diabetes 7.8 10.4 7.2
Food insecurity 21.5 NA 6.0+
Depression 23.9 15.4 5.8++
HP 2020 Target Not Available
Mental health days (poor days >=15) 12.3 10.6 NA
Serious mental illness 8.6 5.3 NA
Adverse Childhood Experiences (ACEs) Score >=4 24.6 16.7+++ NA
Mental health stigma (not caring) 31.3 43+++ NA
Housing insecurity 13.3 NA NA

Chart Legend

* 2018 Behavioral Risk Factor Surveillance System data.
** Healthy People 2020 Target includes children and adults aged ≥2 years.
*** 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.
++ The HP2020 target is defined as adults aged ≥18 who experience major depressive episodes.
+++BRFSS data from 2008, 2009, 2011, and 2013 compiled by the Center for Youth Wellness.
++++RAND Health data from 2013.


Conclusions

The results show that on many health indicators, Santa Barbara County is slightly lower than California and has already met five Healthy People 2020 targets. The benefits of good health and well‐being do not extend to all groups in the county, with Hispanic/Latinx 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. Behavioral Health
  3. Chronic Conditions
  4. Resiliency
  5. Social Needs

Efforts to address these areas could lead to significant population health improvements in the county. Cottage Health is committed to taking action based on the findings in this report and leading the community in implementing evidence‐based population health programs and policies. Learn more in the 2019 – 2022 Community Benefit Implementation Strategy.

Citation

We hope that these findings will be useful to future health improvement work and contribute to a healthier, more equitable community. Please use the following citation:

Cottage Health, Population Health (2019). Cottage Health Community Health Needs Assessment Report, 2019. Santa Barbara, CA.

Cottage Data2Go

Cottage Health Data2Go

Cottage Data2Go maps Cottage Health’s Community Health Needs Assessment (CHNA) data, census data and other publicly available data for factors that influence health outcomes. The tool provides a view of the specific health needs by demographics, geography and health outcome or influencer.

Cottage Data2Go

USING DATA TO DRIVE PROGRESS

This 2019 Community Health Needs Assessment webinar provides an overview of key findings and how to learn more about these data.

VIEW THE WEBINAR

Behavioral Health Listening Tour

Health professional consoling a patient

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

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