CHNA highlights 12.03.16 · MAPP of the Southern Kenai Peninsula – CHNA Highlights - December 2016 3 Community Health Assessment Background Spearheaded by South Peninsula Hospital

MAPPoftheSouthernKenaiPeninsula–CHNAHighlights-December2016MAPPoftheSouthernKenaiPeninsula,Alaska

December2016

Mobi l i z i ng fo r Ac t io n t h roug h P la nni ng and Par t ne rs h ips

MAPPoftheSouthernKenaiPeninsula–CHNAHighlights-December20162


CommunityHealthAssessmentBackground

SpearheadedbySouthPeninsulaHospitalinNovember2008,overfortyorganizationsgatheredinNovember2008toconductthefirstcollaborative,area-wideCommunityHealthNeedsAssessment(CHNA),withthegoalofidentifyingopportunitiesforhealthimprovementandtoserveasacatalystforcommunityaction.TheMobilizingforActionthroughPlanning&Partnerships(MAPP)frameworkdevelopedbytheCentersforDiseaseControl&Prevention(CDC)andtheNationalAssociationofCity&CountyHealthOfficials(NACCHO)wasselectedtoguidetheassessmentprocess.Buildingonthelessons-learnedandresultsfromthefirstandsecondCHNAs,thethirdCHNAiscomposedofthefollowingfourseparateassessments:

I. LocalPublicHealthAssessment(p4)Aprescribedperformanceassessmenttoolcollaborativelydevelopedbynationalpublichealthpartnersthatmeasureshowwelldifferentlocalpublichealthsystempartnersworktogethertodeliverthe10EssentialPublicHealthServices.ThisassessmentwasconductedduringthefirstandthirdCHNAs,butnotduringthesecond.

II. CommunityThemes&StrengthsAssessment(p16)Qualitativeinputfromcommunitymemberstoidentifytheissuestheyfeelareimportant

a.PerceptionsofCommunityHealthSurveyb.WellnessDimensionFocusGroups

III. ForcesofChangeAssessment(p28)

Identifyingforcessuchaslegislation,technology,andotherimpendingchangesthataffectthecontextinwhichthecommunityanditspublichealthsystemoperate

IV.CommunityHealthStatusAssessment(p34)Quantitativecommunityhealthdata(representingcultural,economic,educational,emotional,environmental,physical,social,andspiritualwellness)thatidentifiespriorityhealthandqualityoflifeissues

Themesareidentifiedfromeachsub-assessmentandcomparedacrossallfoursub-assessments,thusenablingaholisticreviewofourcommunityhealthstrengths,needs,andopportunities.Usingthecombinedresults/observationsfromallfoursub-assessments,acommunityprocessisusedtoprioritizetheopportunitiesthatcommunitymemberswillcollaborativelyaddressforthenextfewyears.However,theresultsfromspecificsub-assessmentscanbeusedindependentlytoinformorganizationalandcommunity-levelopportunitiesforimprovement.

Figure1.MAPPFrameworkFlowchart


RecurrentThemes

ThefollowingthemeswereidentifiedbytheMAPPSteeringCommitteeasconsistenttopicsorqualities

thataroseacrossmostorallEssentialServices.

AccessibilityofData

Accessinginformation,specificallydataandappropriatetechnologytosupportdata-sharing,surfaced

acrossEssentialServicesasbothastrengthandchallenge.InregardstotheCommunityHealthNeeds

Assessment,thereisstilluncertaintyonwhatdatatoprioritize,collectandmonitoralthoughall

informationissharedinaninteractiveformatinonelocationontheMAPPwebsite.Fragmentationof

efforts(silos)anddifferentreportingsystemsreinforcechallengestoaccessing,using,andreporting

dataconsistentlyandmakingtheseavailabletothecommunity.Creativeideasarestillneededto

improvedataanddata-sharingacrosspartnersandwiththepublic.

Communication

Communicationwasconsistentlyidentifiedasastrengthofpublichealthsystempartners,however,

onethatcouldcontinuallybeimprovedupon.Therearemanylevelsofcommunicationneededto

strengthencollaboration,communityawareness,andcommunityengagement.Therearealsomany

opportunitiesforarticulatingandclarifyingsharedcommunicationprocessesandgoalswithin

organizationsandacrosspartners.

CaringCommunity

AconsistentstrengtharticulatedacrossEssentialServiceswasourstrongcommunityinvolvement.

Thereisahighlevelofcommunityactivismandsupport,peoplecometogethereasilyandquickly,are

invested,andhavetheabilitytotalkaboutthings.

Geography

GeographyposesachallengetoourSouthernKenaiPeninsulacommunityasitisdifficulttoreachand

meaningfullyengagewithoutlyingpopulations.Distance,culturaldiversity,anduncertainbudgetsall

impacttheeffectivedeliveryofEssentialServicesintheentireregion.

Collaboration/Coordination

MAPP’scommunityhealthimprovementeffortsreinforcetheimportanceofcollaboration.

Collaborationandnetworkingisvaluedbypartnersandhasinfluencedtheexpectationsinwhichlocal

publichealthsystempartnersengageandworktogether.

LOCALPUBLICHEALTHSYSTEMASSESSMENT

MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December2016

5

Capacity

Workforceretentionandrecruitmentwerecommonlyidentifiedasimportantcomponentsof

sustainabilityandeffectivedeliveryofEssentialServices.Theybothposeachallengeinourareaand

aremorechallengedwithstatefiscalissues.Statebudgetchangesalsodirectlyimpactthecapacityof

organizationsandthelocalpublichealthsystem’sabilitytofulfillEssentialServices.

Community-LevelPlans/HealthBoard

Itwasconsistentlynotedthatourlocalpublichealthsystemdoesnothaveadefinedlocalhealth

departmentnoralocalhealthboardandthattheexistenceofsuchanentitycouldenhanceourability

todevelop,implement,andevaluatecommunity-levelprocessesandgoalsforimprovement.By

maintainingacommunity-levelperspectivetoinformplans,policies,andstrategies,thisbodycould

supportalignmentofcommunitypartnerstomoreeffectivelydelivertheEssentialServices.

Proactivity

Withbudgetarychangestostate,regional,andlocalprograms,itisclearthatorganizationsneedtobe

adaptive,collaborative,andinnovativetosupportEssentialServicedelivery.Whileimproved

collaborationwasrepeatedlyidentifiedasastrategyforresource-sharingandservicedelivery,being

proactivewasalsoidentifiedascritical.Reactivitymightpreventopportunitiesfrombeingidentified.

10EssentialPublicHealthServices 2009LPHA

OverallScore2016LPHA

OverallScore1 MonitorHealthStatus 13% 53%

2 DiagnoseandInvestigate 56% 90%

3 Educate/Empower 31% 31%

4 MobilizePartnerships 35% 68%

5 DevelopPolicies/Plans 31% 50%

6 EnforceLaws 51% 44%

7 LinktoHealthServices 45% 59%

8 AssureWorkforce 34% 75%

9 EvaluateServices 20% 41%

10 Research/Innovation 18% 49%

Overall 33% 56%


6

EssentialService1:MonitorHealthStatus

ThisEssentialServiceisabout:

• Accuratelyandcontinuallyassessingthecommunity’shealthstatus.

• Identifyingthreatstohealth.• Determininghealthserviceneeds.• Analyzinghealthneedsofgroupsthatareat

higherriskthanthetotalpopulation.• Identifyingcommunityassets/resourcesthat

promotehealthandimprovedqualityoflife.• Usingappropriatemethodsandtechnologyto

interpretandcommunicatedatatodiverseaudiences.

• Collaboratingwithstakeholderstomanagemulti-sectorintegrateddatasystems.

ModelStandardScores

Strengthsa. IncreasedawarenessoftheCommunityHealth

NeedsAssessment(CHNA),accessibleonlineontheMAPPwebsite.

b. PublicHealthNursescontinuouslycollectdatarelatedtotheirexternalpriorities;informationisultimatelycontributedtoCHNA.

c. Continuouslyworkingtowardmoresharabledataacrossorganizations.

d. Havelocal-levelinformationtocompareagainstHealthyAlaskans2020top25indicators.

e. Abletounderstandcommunity’sspecificstrengthsandneedsbyaccessingSouthernKenaiPeninsula-specificdatafromstateorganizationsandcompiledcensusdata.

Challenges

a. NotmanyhardcopiesofCHNAavailableforgeneralpublic;printedformatisverydense.

b. CHNAcouldbebetterusedatcommunitylevel;mostfrequentlyusedfororganizationalpurposes(particularlygrantwriting).

c. Strugglewithcapacitytomaintainongoingdataupdatesandintegratingdataintocommunitygroups/use.

OpportunitiesforImprovement

a. Investigateandreachouttoregistriesthatexistin/forourarea;encouragedatasubmissionanduseofregistries.

b. FocusoutreachofCHNAresults,sharablemeasures,and/orcommunitystories/themes.Createmoreoutreachproductsthatprovidesummaries/moredigestibleinformationforthepublicandorganizations.

c. FocusorganizationalandcoalitionengagementofCHNAmeasurestobetterconnectcommunityeffortstomeasurableimpacts.

d. Reinforceuseofavailablebutunderutilizedtechnologies

OverallScores

2009:13% 2016:53%

7

EssentialService2:Diagnose&InvestigateHealthProblems


• Accessingapublichealthlabtoconductrapidscreeningandhigh-volumetesting.

• Establishingactiveinfectiousdiseaseepidemiologyprograms.

• Creatingtechnicalcapacityforepidemiologicinvestigationofdiseaseoutbreaks/patterns.

ModelStandardScores

Strengthsa. PublicHealthNursingnotifiedof

communicablediseasecaseswithin24hours.b. Highlevelawarenessofcommunicabledisease

casesexistswithhospital(SPH)employeesandpartners.

c. Benefitfromstrongbondsbetweencommunitypartners.

d. GoodcoordinationbetweenSectionswithDivisionofPublicHealth.

e. Effectivecommunicablediseasereportingandglobal/emerginghealththreatsmonitoring.

f. Frequentreportsfromstateepidemiologicbulletins;abilitytokeepdataflowinghorizontallyinthecommunity.

g. CommunicatinginfectiousdiseasecasereportswithPublicHealthNursingandstateepidemiologydepartment.

h. Localairlines’support(freetransportationofmedicalsupplies);statelabresourcesutilizedforcommunicablediseasecontrol.

i. StronglocalHAMradioculture.Challengesa. Diminishingstateresources.b. Anticipate25%decreaseinPublicHealth

NursingservicesFY16-FY17.c. Coordinationbetweenclinicsduringandafter

disastersoremergencydrills.d. Lacklocalresourcesforallscenarios,but

systemexistsforrequestingBorough,State,andFederalresources.

e. Inabilitytoincinerate/destroysamplesthataretoohazardoustotransport.

f. EmployeediscomfortactivatingleveloneHospitalIncidentCommandSystem(HICS).

g. Possibilitiesindelayofsupportduetoenvironmentalandgeographicconditions.

h. Unpreparedtorespondtounforeseenscenarios,suchasbiologicalterrorism.

OpportunitiesforImprovementa. Clarify,updateandshareprimaryandback-up

contactlistofemergencyresponsepersonnel.b. Strengthenlocalemergencycoalitionmtgs.c. Regularlypracticeemergencyscenarios.d. Developprocessforpost-incidentdebriefing

andidentifyingimprovementopportunities.e. Improvecommunication.f. Ensurestaffretentionandsecureworkforce.

OverallScores

2009:56% 2016:90%

8

EssentialService3:Inform,Educate,andEmpowerPeople

ThisEssentialServiceisabout:• Creatingcommunitydevelopmentactivities.• Establishingasocialmarketingandtargeted

mediapubliccommunicationplan.• Providingaccessiblehealthinformation

resourcesatcommunitylevels.• Reinforcinghealthpromotionmessages/

programswithhealthcareproviders.• Workingwithjointhealtheducation

programs.

ModelStandardScores

Strengthsa. Schoolsysteminfodistributionchannels.b. Mediaaccesstolocalexperts.c. Diversecommunitygroupseffectiveat

identifyingproblems/brainstormingideas.d. Radiostationreachesoutlyingpopulations.e. Communicationbetweenorganizations.Challengesa. Hardtobeinclusivewithoutlying

populations.b. Manysocialbarriersbetweencommunities.c. Lackoffunding,decreasedstatebudget.

d. Lackofhealthcommunicationplan;underutilizingtacticslikesocialmedia/texting.

e. Difficulttoreport/communicateonsensitiveissuessuchassuicideanddomesticviolence.

f. Lackofagencyspokespeopleformedia,andinaccessibilityofpaperdocuments.

g. Inadequatenumberofavailablepublicinformationofficers.

h. Differingproceduresforemergencypreparednessaccreditations.

i. Lackofavailablestafftodevelopandcommunicateemergencypreparednessplansbetweenorganizationsandtheborough.

OpportunitiesforImprovementa. Strengthencommunication/collaboration

withdifferentagencies/organizations.b. Developstandardcommunicationplan(s)

forhealtheducation.c. Developmediarelations.d. KBBIcommunityadvisoryboardoutreach.e. IncreasecommunityparticipationinPublic

InformationOfficer(PIO)training.f. Upgradetechnologyandemergency

preparednesscontactinformation.g. HostPIOclasswithstakeholders.h. Developemergencypreparednesstraining

forlocalstaff.

OverallScores

2009:31% 2016:31%

9

EssentialService4:MobilizeCommunityPartnerships


• Conveningandfacilitatingpartnershipsamonggroupsandassociations.

• Undertakingdefinedhealthimprovementplanningprocessandhealthprojects.

• Buildingacoalitiontodrawonthefullrangeofpotentialhumanandmaterialresourcestoimprovecommunityhealth.

ModelStandardScores

Strengths

a. Numerouscommunitymeetingstodiscusslocalwellnessissues.

b. Healthassessmenthighlightspopulationsthatarenotwellrepresented.

c. Many“pointsofentry”toengageincommunityhealth.

d. Broaddefinitionofhealthmakesiteasiertoinvitediverseparticipants.

e. Activitiesoccurringinall8dimensionsofhealth(butcouldbebetteraligned).

Challenges

a. LowawarenessofCHNAanditscontents;downloadableversionisavailablebutnotasuser-friendly.

b. Geographyisabarrierforengagement.c. “Organizationalsilos”duetolimited,

mission-focusedbudgets.d. Missingmanycommunitysectorsinhealth

improvementcoordination,planningandcollaboration.


a. MAPPoutreachtooutlyingcommunities.b. Offeravarietyoftimeoptionstomaximize

participation.c. Identifykeypartnersnotengaged.d. Advocatefororganizationsthatcanallocate

resourcesorbuildcapacityin(outlying)communitiestoaddressrootissues.

e. Takebetteradvantageofteleconferencingandvirtualparticipationtools.

f. Conductagapanalysiswithineachofthe8WellnessDimensions.

OverallScores

2009:35% 2016:68%


10

EssentialService5:DevelopPoliciesandPlans


• Ensuringleadershipdevelopmentatalllevelsofpublichealth.

• Ensuringsystematiccommunity-levelandstate-levelhealthimprovementplanning.

• Developingandtrackingmeasurablehealthobjectivesaspartofacontinuousqualityimprovementplan.

• Establishingjointevaluationwithhealthcaresystemtodefineconsistentpolicies.

• Developingpolicyandlegislationtoguidethepracticeofpublichealth.

ModelStandardScores

Strengths

a. Publichealthnursesworktoensureprovisionof10EssentialServices.

b. Strongcommunityvolunteerbase(vs.formalgovernmentpresence).

c. DivisionofPublicHealthisworkingtowardsaccreditationstandardsthusholdingupstandardsofexcellence.

d. Localproviderscanaccessstateservicestohelppromotecommunityhealth.

e. Effectiverelationshipswithstatepartnerstohelpdeliver10EssentialServices.

Challenges

a. Individualorganizationshaveownstatutes/regulations,butsystemasawholedoesnot.

b. Notruelocalhealthdepartmentorcommunitygroupmonitoringlargercommunityhealthpicture(specificallypoliciesneededandenforcement).

c. Creationofpoliciesismorereactionary.d. Lackofcurrentresources(andlikelylossof

additionalfinancialresources)createsdifficultydeliveringEssentialServices.


a. ReviseHomer’sClimateActionPlan.b. Localorganizationstoincorporatefindings

ofCHNAandgoalsofCHIPintotheirorganizationalstrategicplans.

c. Communitycoalitionsandworkgroupstobetterincorporatelocaldataintotheirstrategiesandmeasureforimpact.

d. CreateahealthadvisoryboardthatlooksattheCHNAand/orlargerhealthpicture.Incorporatehierarchyofhealthneedstoprioritizespecificpoliciesneededtosupportwell-beinginourcommunities.

OverallScores

2009:31% 2016:50%


11

EssentialService6:EnforceLawsandRegulations


• Enforcingsanitarycodes.• Protectingdrinkingwatersuppliesand

enforcingcleanairstandards.• Monitoringqualityofmedicalservices.• Followinguponhazards,preventable

injuries,andexposure-relateddiseases.• Reviewingnewdrug,biologic,andmedical

deviceapplications.

ModelStandardScores

Strengths

a. Cityisnuclear-freezone.b. Citizensactivelyengage/participatein

makinglawsandquicklyrespondtoseriousproblems.

c. Existinglawsandregulationssupportpublichealth(i.e.,diseasereporting).

d. Anestablishednetworkmeetsregularlytodiscussissuesandreviewlawsrelatedtodomesticviolence.

Challenges

a. Individualsdonotwishtoberegulated.

b. Unequalaccesstolegalresources/counselallowsforlawstobemanipulated.

c. Poorissueprioritizationthatwouldhelpalignfocusandbeproactiveinefforts.

d. DepartmentofEnvironmentalConservationunderstaffed,hardtoreach;weakcleanairstandards,nodustorairqualitymonitoring.

e. Norulesorregulationsexisttocontrolherbicidespraying,climatetaxes,orprotectdrinkingwater.

f. Lackofresourcestoaddressrootcausesofunhealthybehaviors;unabletoaddressonlyfrompolicylevel.

g. Stigmasthatcreatereluctancearoundreportingcertainviolations;perceivedlackofactionbyjusticesystem;fewadvocatestohelppeoplenavigatesystems.

h. Nolawsorregulationstoaddressobesity(pluschallengingtoenforce).

i. City,borough,stateandfederalboundariescreatehurdlesincreating/enforcingpolicies.


a. Sethealthpolicyprioritiesatapubliclevelsoeveryoneunderstandshow/whydecisionsaremade.

b. Educatepeopleonhowtoeffectivelygetinvolvedindecision-making;encourageearlyinvolvementandtheuseofcorrectsystemstoproactivelyeffectchange.

c. Worktowardamoreinformed,competentworkforce.

OverallScores

2009:51% 2016:44%


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EssentialService7:LinktoHealthServices


• Ensuringeffectiveentryforsociallydisadvantaged/vulnerablepersonsintoacoordinatedsystemofclinicalcare.

• Providingculturally/linguisticallyappropriatematerials/stafftoensureservicelinkforspecialpopulationgroups.

• Ensuringongoingcaremanagement.• Ensuringtransportationservices.• Orchestratingtargetedhealtheducation/

promotionanddiseasepreventiontovulnerablepopulationgroups.

ModelStandardScores

Strengths

a. Manygatheringsofkeycommunitygroupstodiscussbarriers.

b. TrainedVeteran’sAffairsassistantsatSVTHealthandWellnessandotheragencies.

c. Awarenessofneedforcarecoordination.d. HomehealthwelcomedinRussianhomes.e. MultipleMedicalHomes.

Challenges

a. Poorjobaddressingchronicillnesseswithservices(unhealthyfoodatfoodpantry).

b. Bureaucracy/discomfortwithtechnologyoverwhelmingforpatients/clients.

c. Limitedawarenessofresources.d. Transportationsupportneeded.e. Limitedin-home/live-incare.f. Limitedfunding.g. NointegratedElectronicMedicalRecords.h. Lackofcarecoordinationlimitsabilityto

staycurrentonrules,programs,etc.i. Decreasedfoodpantrydonations.j. Outdatedresourcebooks/manuals.


a. Foodpantrytoworkwithhospitaldieticiantoaddresshealthyfoodofferings.

b. Investigategrantopportunitiesforcarecoordinator(s).

c. Focusondischargeplanningandassessingpatientsthatarereadmitted.

d. Signed‘releaseofinformation’authorizationtofacilitateconnectionsbetweenserviceproviders.

e. Usefoodpantryasassumedaudienceneeding,butnotreceiving,resources.Inviteserviceproviderstofoodpantrytoenrollpeopleinprograms.

f. Integrateprimarycare/behavioralhealth.g. Improvecarecoordinationmeetings.h. ReviewIndependentLivingCenterresource

manual;investigategranttoupdateifneed.i. Increaseproactiveoutreachanduseof

resources(suchascommunitygroupmtgs).j. Runtrolleytohealthfair.k.Putsocialworkinthehomes.

OverallScores

2009:45% 2016:59%

13

EssentialService8:AssureaCompetentWorkforce


• Educating,training,andassessingpersonneltomeetcommunityneedsforpublicandpersonalhealthservices.

• Establishingefficientprocessesforprofessionalstoacquirelicensure.

• Adoptingcontinuousqualityimprovementandlifelonglearningprograms.

• Establishingactivepartnershipswithprofessionaltrainingprogramstoensurecommunity-relevantlearningexperiences.

• Continuingeducationinmanagement/leadershipdevelopmentforadministrative/executivepersonnel.

ModelStandardScores

Strengths

a. Beautiful,welcomingcommunity;appealinglifestyle;shortworkcommutes.

b. Delineatedrecruitment,hiring,andevaluationprocessesthroughlegalandprofessionalrequirements.

c. CommoncorecompetenciesfordirectserviceprovidersthatarealignedthroughAlaskaandnationalorganizations.

d. Opportunitiestoofferpersonalleadershipskillstothecommunity.

e. Trainingopportunities,includingculturalcompetency,offeredwithinorganizations.

f. Nursing,CNA,andalliedhealthdegreeandStatelicenseprogramsthroughlocalUAA-KPCcampus.

g. Publiclectureseries,personalenrichment,andprofessionaldevelopmentclassesthroughlocalUAA-KPCcampus.

Challenges

a. Mustlookoutsidecommunityforprofessionals;lackoffocusonracialorethnicdiversity;lackoflocalprofessionaldevelopmentopportunities.

b. Highcostoflivingmakesitchallengingtorecruitandretainneededworkforce.

c. Lackofinteragencydiscussionre:needs.d. Nocommunity-widecompetencies.e. Lackofinformalorformalmentoring.f. Limitedentrypointsforleadership/training

inAKNativeandOldBelieverpopulations.g. Nolocalworkforceassessmentcompleted.h. Lackofstudenthousing.


a. Investigatecommonalitiesofcorecompetenciesbetweenagenciesthatcouldhelpconsolidateresources.

b. Moreapprenticeshipormentoringopportunitiestodeveloplocalleaders,withafocusonrepresentingculturaldiversity.

c. Increasecollaborationandcreativityinresponsetodecreasedfunding.

OverallScores

2009:34% 2016:75%

14

EssentialService9:EvaluateServices


• Assessingprogrameffectivenessthroughmonitoringandevaluatingimplementation,outcomes,andeffect.

• Providinginformationnecessaryforallocatingresources,reshapingprograms.

ModelStandardScores

Strengths

a. Agenciesactivelyseekinformationaboutcommunity,coordinatewithproviderstomeetneeds.

b. Largeorganizations(ie,SouthPeninsulaHospital)evaluatethemselveswell.

c. Containedandwell-knownpopulationofhealthcareconsumers/providers.

d. Involved/collaborativecommunitysectors.

Challenges

a. Individualorganizationsevaluatethemselveswell,butsystemitselfdoesnot.

b. Lackofsubstanceabusetreatment.c. Lackofdiversity;samepeople,sameideas.d. Providersdonotsharecommonlanguage.e. Fundraisingeffortstargetsame

businesses/individualsoverandover.f. Servicesbeingerodedduetostatebudget.

g. Needforsharedobjectivedata.h. Difficulttoprovideconsistentservicesto

hard-to-accessoutlyingcommunities.i. Lackoffunding,resources,and

sustainability.j. Numerousassessmentsinadequatelyresult

inaction.


a. Obtainobjectivedatafromprovidersusingappropriatepopulation-basedmetrics.

b. Investigatecensusdatatodeterminewhatpopulationsareenrolledinvariousservicestoidentifygaps.

c. Betterutilizestatewidehealthprofiles.d. Improveinteragencycommunicationto

shareinformationandservicesavailable.e. Shareevaluationsbetweenorganizations.f. Involvesubstanceabuse/treatment

providers.g. CustomizeLocalPublicHealthAssessment

fortheareaanduseasevaluationtool.h. Hostcommunityresourcefair.i. Considerdoor-to-dooroutreach.j. Betterutilizeexistingpartnerships.k. Secure/maintaincompetentworkforceto

ensureresourcestoproperlynetwork.l. Developsharedlanguagebetweenagencies

tobettersharedataandmeasurements.m. Developlarge-scaleevaluationtool,

includingclinicsbecomingPatient-CenteredMedicalHomes.

OverallScores

2009:20% 2016:41%

15

EssentialService10:ResearchandInnovations


• Establishingafullcontinuumofinnovation,rangingfrompracticalfield-basedeffortstofosteringchangeinpublichealthpracticeandencouragingnewdirectionsinresearch.

• Linkingwithinstitutionsofhigherlearningandresearch.

• Creatinginternalcapacitytomounttimelyepidemiologicandeconomicanalysesandconducthealthservicesresearch.

ModelStandardScores

Strengths

a. Localsupportforresearchprojects.b. Organizationspartnerwellwithhigher

learninginstitutions.c. Leadershipsupportsresearch/innovation.d. Useofcommunityspacestoshare

informationwithpublic.e. Manylocalinternship/educational

opportunities.f. Multipleconnectionsthroughmany

agenciestostateandnationalinstitutions.g. Organizationalaccesstotechnology.

h. Institutionalknowledgeoflong-termresidents.

Challenges

a. ElectronicMedicalRecordsthatdon’t“talk”toeachother.

b. Lowhealthliteracy.Parentsoptingkidsoutofschoolhealtheducationprograms.

c. Nolocalepidemiologydepartment.d. Manyeconomicbarrierstoresearch.Low

funding,notenoughcapacity.


a. Communityengagementinhealthandlinkingthecommunitywithsciences.

b. Startingearlytobuildhealthliteracy.c. Improveexistinghealthprogramsin

schools.Health‘roundtables’withstudentsandnurses.

d. Increaseoptions(suchastelemedicine)toconnectwithhealthprofessionals.

e. Makelearningmoreaccessibletomorepeoplebyinvestinginonlineplatforms.

f. Developcollaborativegroup(researchcouncil)toprioritizecommunity-levelresearchquestions.

g. Exploreopportunitiesfororganizationsandindividualstopartneronresearch.

h. Prioritizeresearchandservicesbydevelopingahealthpyramidthatensuresbasicneedsaremetfirstbeforeworkinguptoaddressqualityoflifeissues.

OverallScores

2009:18% 2016:49%


16

Results:HighestRankingResponsesfromthe2015PerceptionsofCommunityHealthSurvey

HighestRanking 2ndHighestRanking 3rdHighestRanking

1.SubstanceAbuseandTreatment

2.JobsandEconomicOpportunities 3.PublicTransportation

2.NaturalBeauty 3.PublicSafety

2.PhysicalHealth 3.BehavioralHealth&Services

2.AccesstoJobTrainingandHigherEducation

3.Sustainability(EconomicandEnvironmentalHealth)

3.PeopleHelpEachOther

Results:HighestRankingThemesfromthe2016WellnessDiscussions

HighestRanking 2ndHighestRanking 3rdHighestRanking 4thHighestRanking

1.EconomicHealth

2.Sustainability(EconomicandEnvironmental)

3.RespectforVariedViewpoints 4.BuiltEnvironment

3.RecreationalOpportunities

4.SocialConnections

COMMUNITYTHEMESandSTRENGTHSASSESSMENT


17

8DimensionsofWellnessFocusGroups:IdentificationofTop5Strengths&Challenges

Combined3.11.16Morning&AfternoonDiscussionNotes

CulturalWellness:Individualawarenessofone’sowncultureaswellasunderstandingandrespectingthediversityandrichnessofothercultures

CulturalWellnessStrengths CulturalWellnessChallenges

1. Supportiveenvironment/community.Communitysupportsarts,activities,inmanyways.Supportforartiststoexpressthemselves.[8,9,10]

1. Isolatedethnicdiversity.Predominatelywhite.[8]

2. Crossroadsofculture.Homerisverydynamic,constantlyrenewingitself.[8]

2. Whiteprivilege&entitlement,challengeswithequity.HomerisadifficultplacetobeaNativeAlaskanin.Whiteprivilege:weareallunique&special&tolerant,sothereforewedon’tseparateoutpeople/groups.Isnotintentional,butweneedtoeducatepeopletounderstand.[8,9]

3. Arts/dynamiccreativity.[10] 3. Haveatransientnature.Peoplecome&go,&Homer-sapienscanjudge&ask“howlongaretheygoingtolast?”[37,38]

4. Individuation,freedominHomer.[9] 4. Dilutedcommunication&awarenessofwhatisgoingon.[27]

5. Universaluniqueness. 5. Competitionforthelimitedresourcesthatareavailable.[13,29,31]

Numberswithinthebracketscorrespondtothemesidentifiedwithinandlistedonpage41oftheThemes&Strengthssub-assessment.


18

EconomicWellness:Theabilitytomeetfinancialneeds&adapttounanticipatedfinancialsituations.

EconomicWellnessStrengths EconomicWellnessChallenges

1. Diverseeconomy.Notcenteredaroundamineorprocessor.[1,29,31]

1. Statefiscalcrisis.Everyoneisgoingtobeaskedtopaymore;thiscreatesuncertaintyintheeconomicrealm.Peoplecouldleave;outsidersmaynotwanttomovehere.Affordablehousing.“Silvertsunami.”[1,29,31,15,40,41]

2. Maritimefishing&marinetrades,orientedtowardsthewater.[1,31]

2. “Seasonal”economy.Veryactiveduringthesummer,notsomuchduringwinter.Reductioninoilindustryjobs.[1,31]

3. Smallbusinesses.Commercialfishing,weldingshops,etc.[1,29,31]

3. Notahighgrowthcommunity,verystagnantwithpopulation.[41]

4. Renewable,sustainable,healthyresourcesthatareavailable.[29,31]

4. Trade/vocationaljobs.Peoplelookdownonjobsthatareactuallyveryhighpaying,likewelders&plumbers.[1,4]

5. Activityofentrepreneurialsmallbusinesses,makesusavibrantcommunity.[13,29,31]

5. Nolocal/communitybank.Havetoapproachnationalbanks.[31]



19

EducationalWellness:Recognitionofcreativeabilitiesandtheexpansionofknowledgeandskills.

EducationalWellnessStrengths EducationalWellnessChallenges

1. Schoolsystemandqualityoffacilitiesavailable.Thediversity,number,andaccessibilityofopportunitiesfrompre-Ktocollege,professionalstaff&educatorsinthecommunity.[4,18]

1. Demographicshifts.Criticalforeducation,becauseeducationdependsonenrollment.Classsizes.[35,41]

2. Involvementofnonprofits&businesscommunitysupportofeducationacrossthecommunity.[36]

2. Accessibilityforchildcare,transportation,otherresources.[2,4,5,6,21,22]

3. Engagementofcommunityineducation.Adiverseandhighlyeducatedcommunity.[8,37]

3. Externalfunding.Budgetcutsandlackofresources.Needfundingthatisstableandsustainableoverlongperiodsoftime.Challengeswithrecruitingandretainingtalent.[29,31]

4. Communityprioritizeslearningthroughdiverseandinterconnectedservicesacrossorganizations&programs.Collaborationsbetweenagencies.[33]

4. Lackofculturalandracialdiversitytoexpandknowledge,understanding,&skills.NothonoringAlaska’spast.[8]

5. Physicallocation.Ourcommunityutilizestheenvironmentforexpansiveandexperientiallearning.[12,39]

5. Fixedvsgrowthmindset.Canalsoaffecteducators,mentors,etc.Mindsetthatkidsarefixedinoneway&thattheycan’tgrow&adapt.Schoolsarenottrauma-informed.Notalotofsocial-emotionallearningandcopingskills.ImpactonstudentswithdifferentlearningstylesorAdverseChildhoodExperiences.[9,20,34,35]

6. Limitedmedia,especiallyatnational&statelevel.[27]



20

EmotionalWellness:Theabilitytocopeeffectivelywithlife&createpersonalenrichmentthroughone’swork&relationships.

EmotionalWellnessStrengths EmotionalWellnessChallenges

1. Accesstonaturalbeauty.[12,19,23,25,39,42]

1. Addiction/mentalillness.Acrossthespectrumfrompreventiontorecovery,thereisnotalotavailablelocally.Alsoastatewideissue.Hardtoaccesstreatment,&recoverynetworks.Poorfundingforprevention.[3,20,34]

2. Religious&spiritualopportunitiesaregreatoutletsforemotionalhealth.[14]

2. Violentcrime.Domesticviolence,sexualassaultetc,thingsthatmakeyoufeelunsafecaninfluenceyouremotionalhealth.[30]

3. Schools,incorporationofdifferentlyabledchildren.[18]

3. Lackofdiversityforoutsidethinkers.Lackoftolerance.[9]

4. Diversity&richnessofresourcesforpursuingthemeanstomeetemotionalneeds.Groupmeetings,library,socialservices,etc.Quality,quantity,anddiversityofournon-profitservices.[13]

4. Highcostofliving.Noaccesstoaffordablehousing,homelessnessissue,highfoodprices,notalotoftransportation.Poverty.[2,15,5,6,31]

5. Supportandopportunitiesfordiverseculturalexpression,emotionallyvalidating&encouragespeopletofollowtheirpassion.[8,9,10]

5. Lackofjobopportunities.Smalltownlimitsopportunities.[1]

6. Sizeofcommunitypromotesbothdiversityandconnection.Manywaystocrosseachother’spaths.[8,37]

6. Hardplacetolive.Seasonaldisorders,farfromfamilies,expensive,harshanddynamicenvironment.[20,21,31,37]

7. Layersofculturethatdon’tsupportwellness:workhardanddon’taskforhelp.[37]



21

EnvironmentalWellness:Aharmoniousandsustainablerelationshipwithimmediatesurroundingsthatexpandstothenaturalworld.

EnvironmentalWellnessStrengths EnvironmentalWellnessChallenges

1. Naturalbeautyisvisibleandaccessible.Communityisintegratedintothenaturalworld.[12,19,23,25]

1. Climatechange.Oceanacidification,warmingtemperatures.Caninfluencefisheries&economy.[24,29,31]

2. Networkofindividuals&agenciesfocusingoneducation,research&environmentalconservation.[27,29,33]

2. Fiscaluncertainty.Manynon-profitsarefacingbudgetcutsthatcanresultinlossofprofessionals,abilitytoprovideconsistentprograms.“Shiftingbaseline”conceptofdata.[29,31]

3. Activeinterestswithindividualsofallages.[35]

3. Values&priorities.Conflictsinvalues.Canallidentifynaturalbeautyasastrength,butconflictintermsofwhat’sgoodindevelopment.Everyonewantstheirpersonalpieceofproperty,what’sgoodforthem&notnecessarilythecommunity.Populationgrowthandmoretechnology.[9,24,40,41]

4. Healthyandproductivehabitats(andhealthyfish&wildlifepopulations)thatprovideharvestableresources,fish,berries,etc.Promotesgoodstewardshipaspeoplecareabouttheseresources.[24,29]

4. “Bigworldeffect.”Maydoalottoprotectourcommunity,butwecan’tcontrolwhathappensinotherareas.Nomatterourvalue,visitorsmaynotsharethesamevalues/concerns.Outsideenvironmentalproblemsthataffectourenvironment.Awarenessofinterdependence.[24,29]

5. Abundanceofprotectedlands&habitats;stateparks,etc.[24,29]

5. Education&communication.Weallidentifyclimatechangeasachallenge,butschoolsarenotteachingaboutitbecauseit’scontroversial,educationispoor.Lackofconnectionbetweenbigissueproblemslikeclimatechange.Connectionwithdailylifeetc.Lackofpoliticalwill.[9,18,27,34]



22

PhysicalWellness:Theabilitytoperformdailyactivitieswithoutunduefatigueorphysicalstress.

PhysicalWellnessStrengths PhysicalWellnessChallenges

1. Progressivelymindedincollaborationacrossallaspectscommunity.Healthcarefieldishappytointeract&share,butthisalsoplaysoutinotheraspectsofthecommunity.Realfeelingofbeingonthesameteam.[33]

1. Infrastructure.Lackofsidewalks&otherADAfacilities.Inabilitytohaveadensedowntown.[32,40]

2. Accesstohealthcare&othersupportingservices.Itisveryeasytoconnectsomeonetoresourcesinthiscommunity.[6]

2. Mental&addictivehealth.[20]

3. Physicalenvironment:accesstobeaches,trailsexerciseopportunities[12,19,23,25]

3. Personaleconomics.Canlimitwhatyoucanaffordtocareforyourself.[6,31]

4. Preventionfocused–Syringeexchangeprogramexamplewithcitycouncil,doesnotcondonedrugusebutcanpreventdisease.[34]

4. Accesstotransportationservices&communityactivities.Veryspreadoutcommunity.[2,40]

5. Inclusiveacrosslifespan.[35] 5. Recruiting&retainingprofessionalproviders.Strugglewiththisinallaspects,notjusthealthcare.[17,29,31]



23

SocialWellness:Asenseofconnection,belonging,safety,andareliablesupportsystem.


SocialWellnessStrengths SocialWellnessChallenges

1. Vastanddiverseopportunitiesforsocialconnections.TherearemanyopportunitiesinHomer&surroundingareas.[37]

1. Substanceuse&abuse.Keepsindividualsawayfrommeaningfulrelationships&interactions.Createspoorhealthinthecommunity,&usesupmoney.Notalotofactivitiestodointheeveningthatdon’tinvolvealcohol.[3,31,30,37]

2. Closeknitcommunity.Facetofaceaccountabilityandinterdependence(refinedsetofacceptablebehaviors),dialogue.Businessownersallknoweachother,nonprofitboardsallknoweachotheretc.Helppeoplegetpluggedintoresourcesifstruggling.[11,33,38]

2. Senseofbelonging.Eventhoughthereareactivitiesgoingon,itistoocloseknitofacommunityforoutsiderstojoinin.Howcanwemakeitmorewelcomingandsustainableforpeople–alargetransientpopulation.Sometimeswedon’trealizewe’rebehavinginawaythatmakespeoplefeelunwelcome.[37,38]

3. Generousandkindwithtime,support,giving.Ifyouask,youwillreceive.[11,36]

3. Physical/environmentalbarriersthatdecreaseaccessibilitytoresources.Needforcommunitycenterforconnectivity.Lackofpublictransportation,lackofindoorspaceforactivities,lackofsidewalkforsafewalking,poorroadmaintenance.Darkwinters,harshenvironment.[2,19,20,25,30,40]

4. Diversityanddifferences.Notalotofjudginginthearea.[9]

4. Awarenessofopportunitiestoconnect.No“onestop”calendar.Makesithardtoseewhatisgoingon.[27]

5. Communicationanddisseminationofcommunityinfo.Alotofgoodcommunicationtoolsandvenues,newspapers&flyersetc.[27]

5. Lackofmoney.Peoplearetoobusyworkingtoearnmoneytosupportthemselvestobeabletopartakeinsocialactivities.Difficulttoaccesskidsprograms,budgetcutsforsenior/youthprograms.[1,21,29,31]

6. Communityanchors.Placesthatpeoplegothattheyidentifywith:libraries,churches,etc.[40]


24

SpiritualWellness:Asenseofpurpose&meaninginlife.

SpiritualWellnessStrengths SpiritualWellnessChallenges

1. Senseofplaceinthenaturalenvironment.Quiet,nature,animals,lackofmaterialism,senseofawe,expansiveness,connection,&respect.[12,19,23,25,39,40]

1. Extremesoftheenvironment.Canbedifficultforpeopletofind“balance”especiallyduringthewinter.[20,40,42]

2. Widevarietyofspiritualpracticesavailable.Manyopportunitiestopractice.[14]

2. Scarcity.Lackoftime,economicopportunities,isolationfromfamily,isolationfromthecommunity,lackofresources,lackofspacetomeet,lackofvoicesatthetable,lackofcommunityrhythms.Difficultforpeopletojusttaketimeto“be.”[20,21,23,29,31,37,40]

3. Opennessinthecommunity,toleranceforavarietyofdifferentbeliefs.Conversationsthathappeninthemediasurroundingspiritualissues.[9,27]

3. Accessibility&approachability.Findingspaceforpeopletomeetatlowcosts,communication,howdoallthesespiritualopportunitiesreachoutwithoutinfringingontheuniquenessofHomer?[9,11]

4. Manyopportunitiestoserveothers.Volunteer&serviceopportunities.[11]

4. Lackofopportunitiesforpeopleofallbeliefs,ornobeliefs,togettogether&talkaboutsignificanttopics.[9,37,38,40]

5. Manydifferentmodalitiesforpursuingspiritual.Arts,music,outdooractivities,etc.[10,14,19,23]

5. Challengetomovebeyondtolerance.Weshoulddomorethantolerateeachother,acceptancewouldbethetruegoal.Weshouldbelookingtoseewhoisnotsittingatthetablewithus&invitethemin.[9,11]



25

Results:SurveyFeedbacktoCommunityHealthPerceptions

Thefivegreatestcommunitystrengthsidentifiedwere:

Thefivecommunityaspectsmostneedingtobeimproved:*2008and2012PerceptionsSurveydidnotaskdirectlycomparablequestion

Whenaskedifanyissuespreventpersonaluseofservicesoractivitiesavailableinthecommunity,the

topfiveresponseswere:

2008PerceptionsSurvey(831responses)



1 Peoplehelpeachother Naturalbeauty(79%) Naturalbeauty(63%)

2 Respectforvariedviewpoints Peoplehelpeachother(68%) Peoplehelpeachother(36%)

3 Naturalbeauty Healthyenvironment(53%) Cultural/artsopportunities(29%)

4 Diverseprivate/public

nonprofitorganizationsSchools(48%) School(27%)

5 Other Cultural/artsopportunities(47%) Recreationalopportunities(24%)


1 Jobs&economicopportunities(48%)

2 Publictransport(38%)

3 Substanceabusetreatment(36%)

4 Housing(26%)

5 Accesstojobtraining&highereducation(17%)




1 Cost Cost(47%) Cost(51%)

2 Transportation Scheduleconflicts(42%) Notenoughtime(38%)

3 Distrustagencyorprovider Notenoughtime(36%) Scheduleconflicts(38%)

4 Confidentiality Lackofanonymity(14%) Lackofanonymity(16%)

5 Lackofanonymity Distrustagency/provider(13%) Transportation(15%)

MAPPoftheSouthernKenaiPeninsula–CHNAHighlights-December2016 26

Whenaskedtorankthefactorsmostnegativelyaffectingthemselvesandtheirfamilies,thetopthree

responseswere:




1 EconomicCosts EconomicCosts(73%) PhysicalHealth(86%)

2 PhysicalHealth PhysicalHealth(68%) EnvironmentalHealth(73%)

3 Educationandtrainingcosts Mental/EmotionalHealth(47%)Education/costs&availability

(73%)

Whenaskedtorankthefactorsmostnegativelyaffectingthecommunity,thetopthreeresponseswere:




1 SubstanceAbuse SubstanceAbuse(79%) SubstanceAbuse(97%)

2 EconomicCosts EconomicCosts(54%) InterpersonalViolence(96%)

3 Mental/EmotionalHealth Mental/EmotionalHealth(52%) Mental/EmotionalHealth(75%)

Thefiveservicesrespondentsfoundmostlackingwere:*2015PerceptionsSurveydidnotaskdirectlycomparablequestion



1 Medicalspecialists(43%) Teenactivities(54%)

2 Clinicservices(18%) Transportation(50%)

3 Shopping(16%) Shopping(35%)

4 Teenactivities(8%) Housing(28%)

5 Transportation(5%) Substanceabusetreatment(27%)


2015Respondentswereaskedtoratethefollowingstatementsforthemselves:

WellnessMeasure Never Sometimes Frequently Always

IlikewhatIdoeverydayandIfeelmotivatedtoachievemygoals.

1%(7)

19%(122)

55%(356)

25%(165)

Ihavesupportiveandlovingrelationshipsinmylife. 1%(7)

10%(66)

25%(163)

64%(417)

Ihaveenoughmoneytoprovideformybasicneeds. 3%(19)

20%(129)

33%(213)

45%(291)

IhaveenoughmoneytodoeverythingIwanttodo. 21%(133)

41%(262)

27%(176)

12%(75)

Ifeelthatmycommunityistheperfectplaceforme. 1%(9)

28%(179)

43%(281)

28%(183)

Ihavegoodhealthandenoughenergytogetthingsdonedaily.

2%(15)

20%(129)

48%(314)

29%(191)

Iseemyselfasapositiverolemodel. 1%(6)

16%(104)

53%(346)

30%(197)

Iamabletodealwithgenerallifestresses. 0.6%(4)

15%(97)

55%(360)

29%(191)

IhaveotherswhowilllistenwhenIneedhelp. 1%(7)

16%(104)

37%(237)

46%(301)


WellnessDimensionKey:Cultural:Individualawarenessofone’sowncultureaswellasunderstandingandrespectingthediversityandrichnessofothercultures

Economic:Theabilitytomeetfinancialneeds&adapttounanticipatedfinancialsituations.

Educational:Recognitionofcreativeabilitiesandtheexpansionofknowledgeandskills.

Emotional:Theabilitytocopeeffectivelywithlife&createpersonalenrichmentthroughone’swork&relationships

Environmental:Aharmoniousandsustainablerelationshipwithimmediatesurroundingsthatexpandstothenaturalworld.

Physical:Theabilitytoperformdailyactivitieswithoutunduefatigueorphysicalstress.

Social:Asenseofconnection,belonging,safety,andareliablesupportsystem.

Spiritual:Asenseofpurpose&meaninginlife.

FORCESOFCHANGEASSESSMENT

MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–September2016

Trend Challenge Opportunity ImpactedWellnessDimensions

1. Increasedlevelofcollaborationincommunity

- Tappingintoalreadystressedhumanresources

- Reducedfundingforindividualorganization

- Developingasharedlanguage&newparadigm

- Takestime&planning

- Efficiencies- Effectiveness- Rootcauses- Increasedcommunityhealth- Proactive

CUL EDU ENV SOC

ECO EMO PHY SPI

2. Localfarmproduction

- Shortseason–climate-canbemoreexpensive

- Supportlocalpeople- Createjobs,keep$local- Healthierfoodsources- Hightunnels

CUL EDU ENV SOC

ECO EMO PHY SPI

3. Changesincommunication/technology

- Multipleoutreachoutlets- Integratingtoactualservice- Uniquemodalitiesmayisolatecertainusergroupsanddividegenerations

- Increasedjobs- Reducedpaper,space- Increasedabilitytoconnectgrassroots

- Expandingaudiences- Moretimelyaccesstoinfo

CUL EDU ENV SOC

ECO EMO PHY SPI

4. Ever-changingleadershipwithinthecommunity

- Organizationalmemoryloss- Time/coststotrainnewstaff- Impactsrelationship-bldg,trust

- Lossofmomentum

- Newideas- Newparadigmsforfunctioning&infrastructure

- “CollaborationLanguage”

CUL EDU ENV SOC

ECO EMO PHY SPI

5. Decliningnorthslopeproduction(Decliningstatefunds,scarcitymindset)

- Decreasedgrantfunding- Decreasedresources

- Oppsfordiversification- Educationtoconsumefewerresources/livewithinourmeans

- Increasedawarenessofotheroptions

- Oppsforincreasedrenewableresources

CUL EDU ENV SOC

ECO EMO PHY SPI

6. Medicaidexpansion&reform

- Politicallyinfluenced- Medicaidhasn’tprovedtheyhavecapacitytomanagethis

- Sustainability

- Increasedaccess- Increaseinparticipation&givingbacktocommunity

- Improvedqualityoflife- Compensatesprovidersforpreviouslyuncompensatedcare&encouragesrightcarefromrightprovider

- Decreasedcostsofcare- Supportswellness

CUL EDU ENV SOC

ECO EMO PHY SPI

7. AffordableCareAct

- Perceptionwillcosttoomuchtoprovidehealthcare

- Educationofpurpose/cost&whatitmeans

- WayStateperceivesit

- Outreach/educationalopps- Increasedhealthcarebenefits,#ofpeoplewithinsurance

- Increasedprevention

CUL EDU ENV SOC

ECO EMO PHY SPI


8. PerceptionofeconomyinAlaska&itsfuture

- Proactivevsreactive- Moredifficulttorecruitprofessionals

- Lackofjobgrowth

- Lotsofpublicinterest/concern

- Relationshipsbetweenpeople&legislators

CUL EDU ENV SOC

ECO EMO PHY SPI

9. Fuelprices

- Decreasedmobility,increasedisolation

- Shiftingresources/$$- Effectsonemploymentchoices

- Healthcareaccess- Economicstress,increasedriskofhomelessness

- Decreaseintourism/travel

- Increasedbiking/walking/carpooling

- IncreasedvalueofPFD- Goodforstatebudget- Increasedtransportationconversation

- Conservationofresources- Downsizingstructures- Increaseinweatherization

CUL EDU ENV SOC

ECO EMO PHY SPI

10. Availabilityoflivingwagejobs

- Nojobs–ltdeconomicgrowth

- Ltdwell-payingjobs–seasonal

- Ltdpopulation–ltd#ofqualifiedemployees

- Opportunitiesforprofessionaldevelopment

- KPCforlocaleducation- Onlineeducation

CUL EDU ENV SOC

ECO EMO PHY SPI

11. StateBudget/FiscalCrisis

- Non-diversebudget,novariedrevenuestream

- Can’taddresstherootcauseofthefiscalcrisis

- Concernthatthestatewillnottakeitseriouslyenough

- Difficulttoreachthestatetoinfluencetheirdecisions

- Localagenciesarenotinvolvedinthedecisionmakingprocess

- Needforcollaboration- Increasedvolunteeropportunities

- Identificationofnewfundingstreams

- Communitylevelstrategicplanning

- Developmentofincreasedlocalfundingcapacity

CUL EDU ENV SOC

ECO EMO PHY SPI

12. Politicalseason(federal,state,&local)

- Differentadministration- Introductionofdifferentpriorities

- Socialanimosity,politicalpartiesaredivisive

- Fear

- Increasedengagementamonggenerationsinvoting

- Increasedengagementatcommunitylevels

- Pushformoretransparency- Fixwhat’sbroken

CUL EDU ENV SOC

ECO EMO PHY SPI

13. Decreasedrevenuesharingwithmunicipalities

- Decreasedservices- Non-sustainingsupport- Chasingthemoney

- Grantfunds- Rewardingcollaborations- Opportunitytoshare&informlocalstorybeyond

CUL EDU ENV SOC

ECO EMO PHY SPI

14. Lessdisposableincome,increasedunemployment

- Decreaseinqualityoflife- Lossofrevenueforlocalbusinesses

- Capacityofnonprofits

- Focusonresilientlifestyles CUL EDU ENV SOC

ECO EMO PHY SPI

15. Changing - Howcanseasonalbusinesses - Increasedrevenuefor CUL EDU ENV SOC


touristseason stayopenforlonger?- Unpredictable- Changesfeeloftown

businesses- Morejobs ECO EMO PHY SPI

16. Lossofservicesduetostatebudget

- Increasevulnerabilitytocommunicablediseases

- Lessopportunitiesforeducation

- Localnonprofitburden- Moredisempoweredpeople- Lesspreventativehealthservicesleadingtolong-termincreaseincosts

- Inclinationtobereactive- Jobloss

- Local-levelproblemsolving- Collaborationbetweenagencies&organizations

- Focusingonrootcauses- Reevaluationofpriorities- Opportunitiesforlocaled- Proactiveplanning- Sharingspaces,services,expertise,innovationwithavailabletechnology

CUL EDU ENV SOC

ECO EMO PHY SPI

17. Newschoolprograms&hightunnelsaddressingobesityprevention

- Riskofnewpests

- Morelocallyproducedfood- Increasedeconomicbase- Increasedstudentawarenessofhealthyfood

- Increasedadaptability

CUL EDU ENV SOC

ECO EMO PHY SPI

18. Increasedstressfromemploymentuncertainty

- Decreasedbuy-infromemployees

- Unabletomaintaincompetentworkforce

- Strongerbondswithcoworkers,communitypartners

- Lifestyleopportunities

CUL EDU ENV SOC

ECO EMO PHY SPI

19. Climatechange

- Increasedinsectinfestations- Increaseinfireregime- Changesinflora&fauna- Fishpopulations- Watertemperatures- Collaboration&alignmentneeded

- Moredecisionmakersareowningit

- Opportunitiesforeducation- Increasecollaboration- Longergrowingseason- Moretourism

CUL EDU ENV SOC

ECO EMO PHY SPI

20. Fish&fishingprices

- EconomyvBiology- Climatechange- Frankenfish- Mariculture

- Newincomestreams- Usinglocalresources–growingourownfood

- Educationonwildvsfarmedfish

- Increasedopportunityforbranding

- Desiredprofession

CUL EDU ENV SOC

ECO EMO PHY SPI

21. Wildlifedieoffinpastyear

- Lackunderstandingofsystemcauses

- Opportunityforeducation&research

CUL EDU ENV SOC

ECO EMO PHY SPI

22. BluffErosion

- Resourceallocationfunneledtothisissue

- Fundsgoingtohighwaymaintenance,dredgingharbor

- Decreasesineconomic

- Federal$tosupport- Opportunitynottodevelopcoastline

CUL EDU ENV SOC

ECO EMO PHY SPI


development/commerce- Impactsbasicsurvival

23. Oil&gasdevelopment

- Decidingwhopaysfor/costbenefitanalysis

- Boombusvssustainable(statefocusisboom)

- Impactsonenvironment&onhealth&tourism

- Jobs- Revenue- Cheaperheating/fuelcosts- Capitalizeonconstruction/infrastructureforsidewalks

CUL EDU ENV SOC

ECO EMO PHY SPI

24. RenewableResourceDevelopment

- Expensive- Increasedinitialinvestment

- Getridofgasline- Increasedawarenessfordiversitymodel

- Catalystforstudies/researchfeasiblestudies

- Affordable,sustainable

CUL EDU ENV SOC

ECO EMO PHY SPI

25. Vulnerablegeographicarea,naturaldisasters

- Shutofffromservices&food - Communitycollaborationforplanningandresponse

- Investincommunityself-reliance

CUL EDU ENV SOC

ECO EMO PHY SPI

26. KenaiPeninsulaBoroughinvolvementinhealthdecision-making

- Newstakeholdersinvolvedthatmaynotbewell-informed

- Lessofavoicefromthecommunity

- Motivationtosavedollarsovercommunityimpacts

- Boroughwidechangestosecuresustainability

- Foundefficiencies- Positionsprovidersbetterwoutcome-basedcare

- SupportMAPPinfocusingonactionoverassessing

CUL EDU ENV SOC

ECO EMO PHY SPI

27. Healthcareshiftingtooutcomebasedinsteadofpay-for-service

- Transformingindividualorganizations

- Havingcapacitytomaintaincurrentmodel&shifttonew

- Costs- Patientbuy-in

- Improvedhealthoutcomes- Moreaffordablecare CUL EDU ENV SOC

ECO EMO PHY SPI

28. Druguse,abuse,&availabilityinthecommunity

- Expandingintodifferentpartsofthecommunity&demographics

- Increaseincommunicablediseases

- Increaseshealthcarecosts- Limitedtreatmentoptions- Alwaysfindinganotherdrug/anotherway

- Limitedenforcement

- Increasedcollaboration- Increaseinsomeservices- Focusonrootcauses- Createmoreresilientcommunity,reduceharm

- Gatewaytootherservices- Opportunityforeducationinthecommunity

- Increaseincompassion

CUL EDU ENV SOC

ECO EMO PHY SPI

29. Reducedtransportationwithvoucher

- Accesstoservices- Decreasedqualityoflife- Lossofjobs

- Groupssolvedifferently- Smallbusinesscouldprovidetransportation

CUL EDU ENV SOC


programloss - Getexistingtaxistocollaborate

- “Neighborhelpingneighbor”socialnetworks

ECO EMO PHY SPI

30. Publicawarenessofcommunityviolence

- Topicofthedaythengone- Maintainingongoingawareness

- Publicperceptionmaybedifferentfromreality

- Teachpeoplehowtoprotectselfvshownottobeviolent

- Greendotprogram- Publicawareness=opportunityforeducation

CUL EDU ENV SOC

ECO EMO PHY SPI

31. CommunityCollaboration

- Peopleareoverworked,hardtotakeonmoreemployees&volunteers

- Processtakestimetobuild&sustain

- Timingpiecewithgrants

- 10Fold:worktogether,makebetterdecisions,addressmoretopics,enhanceorincreaseservices,createjobs

CUL EDU ENV SOC

ECO EMO PHY SPI

32. LegalizationofcannabisinKenaiPeninsula

- Divisiveness- Understandingthelaw&legalelementsasapropertyowner,employeretc

- Healthimpacts

- Localeconomicimpactanddiversity,jobopps

- Balancesmartpoliciesfordevelopingbrains&businessfreedoms

- Qualityoflifeimpacts

CUL EDU ENV SOC

ECO EMO PHY SPI

33. Changesindemographics

- Reductionofpropertytaxrevenueforschools,staff

- Keepingactivities&servicesrelevant

- Missionreconsiderations(seniorcare,fundingavailability)

- Diminishedworkforce

- Increasedseniorvolunteerpool

- Utilizenewexpertise- Newbusinessestomeetneeds

CUL EDU ENV SOC

ECO EMO PHY SPI

34. Criminaljusticereform

- Disputeoverchanges- Peopleareafraidofwhomightbereleased

- Opportunityforprivatization

- Minoroffenderswon’tbeaspenalized

- Changingperceptions

CUL EDU ENV SOC

ECO EMO PHY SPI

35. Growingcommunityawarenessofspiritualhealth

- Developingasharedlanguage- Beingabletotalkaboutspiritualhealth,separationfromreligion

- Newdimensionofwellnessthathasnotbeenwelldiscussed

- Oppforimprovement&ed

CUL EDU ENV SOC

ECO EMO PHY SPI


• Therewasa10%increase(+1,237)intheSKPpopulationbetweenthe2000and2010

CensusandthispopulationgrowthratehasbeenconsistentwithAmericanCommunity

Survey5-yearestimates(~9%increasefrom2000to2014).Thepopulationoverallis

growing,howeverbirthrateisstable.

• ThereisagreaterpercentageofSKPresidentsaged45andolderthancomparedtothe

entireKenaiPeninsulaBorough,AK,andtheUS(48%ofSKPpopulation45+,Kenai

PeninsulaBorough44%,Alaska35%,andUS40%).

• ThepercentageofSKPfamilyhouseholdswithindividualsunder18hasdecreasedfrom

2000–2014(36%to25%ofhouseholdswithindividualsunder18).TheKenaiPeninsula

Borough,AK,andtheUSallhavegreaterpercentagesoffamilyhouseholdswith

individualsundertheageof18(29%,36%,and32%respectively).

• TheSouthernKenaiPeninsula’sleadingcausesofdeath(#1Cancer,#2HeartDisease)

aresimilartotheKenaiPeninsula,Alaska,andUS(#1HeartDisease,#2Cancer).

• TheSouthernKenaiPeninsulameetstheHA2020targetsforthefollowingobjectives:

o IncreasingtheproportionofAlaskanswhoaretobacco-free

o IncreasingtheproportionofAlaskanswhoarephysicallyactive

o IncreasingtheproportionofAlaskayouthwithfamilyand/orsocialsupport

o ReducingthenumberofAlaskansexperiencingdomesticviolenceandsexual

assault(1of3indicatorsavailableforSKP)

• TheSouthernKenaiPeninsulahasnotyetmetthetargetsforthefollowingobjectives:

o ReducingtheproportionofAlaskanswhoareoverweightorobese

o ReducingthenumberofAlaskansexperiencingpoormentalhealth

o ReducingthenumberofAlaskansexperiencingalcoholandotherdrug

dependenceandabuse

o ReducingtheproportionofAlaskanswithoutaccesstohighqualityand

affordablehealthcare(althoughthe%ofadultsreportingthattheycouldnot

HEALTHSTATUSASSESSMENT


affordtoseeadoctorinthelast12monthsisdecreasingandin2014metthe

target)

o IncreasingtheeconomicandeducationalstatusofAlaskans

• Ofthetop10indicatorsforFamilyWell-being,SKPstatusimprovementsareoccurring

for:

o The%ofhighschoolstudentswhofeelthatintheircommunitytheymatterto

people

o The%ofadultswhomeetthecriteriaforhealthyweight

o The%ofhighschoolstudentswhofeelthattheirteacherscareaboutthem

o The%ofhouseholdsthatpaylessthan30%ofmonthlyincomeonhousing

• Ofthetop10indicatorsforFamilyWell-being,SKPstatusimprovementsarenot

occurringfor:

o The%ofhighschoolstudentswhohaveatleastoneparentthattalkstothem

aboutschoolabouteveryday

o The%ofchildrenages0-5participatinginAgesStagesQuestionnaire

developmentalscreening

o The%ofchildrenwhoparticipateinorganizedafterschool,eveningorweekend

activitiesoneormoredaysaweek

o The%ofchildrenages0-5whomeetsocial-emotionaldevelopmentcriteria

o The%ofhighschoolstudentswhohaveatlastoneadultbesidestheirparents

theycouldaskanimportantquestionaffectingtheirlives

o The%of18-24yearoldswithahighschooldiplomaorhigher

Documents

CHNA highlights 12.03.16 · MAPP of the Southern Kenai Peninsula – CHNA Highlights - December 2016 3 Community Health Assessment Background Spearheaded by South Peninsula Hospital