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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
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights-December20163
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
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights-December20164
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%
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December2016
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
ThisEssentialServiceisabout:
• 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
ThisEssentialServiceisabout:
• 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.
OpportunitiesforImprovement
a. MAPPoutreachtooutlyingcommunities.b. Offeravarietyoftimeoptionstomaximize
participation.c. Identifykeypartnersnotengaged.d. Advocatefororganizationsthatcanallocate
resourcesorbuildcapacityin(outlying)communitiestoaddressrootissues.
e. Takebetteradvantageofteleconferencingandvirtualparticipationtools.
f. Conductagapanalysiswithineachofthe8WellnessDimensions.
OverallScores
2009:35% 2016:68%
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December2016
10
EssentialService5:DevelopPoliciesandPlans
ThisEssentialServiceisabout:
• 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.
OpportunitiesforImprovement
a. ReviseHomer’sClimateActionPlan.b. Localorganizationstoincorporatefindings
ofCHNAandgoalsofCHIPintotheirorganizationalstrategicplans.
c. Communitycoalitionsandworkgroupstobetterincorporatelocaldataintotheirstrategiesandmeasureforimpact.
d. CreateahealthadvisoryboardthatlooksattheCHNAand/orlargerhealthpicture.Incorporatehierarchyofhealthneedstoprioritizespecificpoliciesneededtosupportwell-beinginourcommunities.
OverallScores
2009:31% 2016:50%
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December2016
11
EssentialService6:EnforceLawsandRegulations
ThisEssentialServiceisabout:
• 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.
OpportunitiesforImprovement
a. Sethealthpolicyprioritiesatapubliclevelsoeveryoneunderstandshow/whydecisionsaremade.
b. Educatepeopleonhowtoeffectivelygetinvolvedindecision-making;encourageearlyinvolvementandtheuseofcorrectsystemstoproactivelyeffectchange.
c. Worktowardamoreinformed,competentworkforce.
OverallScores
2009:51% 2016:44%
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December2016
12
EssentialService7:LinktoHealthServices
ThisEssentialServiceisabout:
• 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.
OpportunitiesforImprovement
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
ThisEssentialServiceisabout:
• 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.
OpportunitiesforImprovement
a. Investigatecommonalitiesofcorecompetenciesbetweenagenciesthatcouldhelpconsolidateresources.
b. Moreapprenticeshipormentoringopportunitiestodeveloplocalleaders,withafocusonrepresentingculturaldiversity.
c. Increasecollaborationandcreativityinresponsetodecreasedfunding.
OverallScores
2009:34% 2016:75%
14
EssentialService9:EvaluateServices
ThisEssentialServiceisabout:
• 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.
OpportunitiesforImprovement
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
ThisEssentialServiceisabout:
• 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.
OpportunitiesforImprovement
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%
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December2016
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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
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December2016
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.
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December2016
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]
Numberswithinthebracketscorrespondtothemesidentifiedwithinandlistedonpage41oftheThemes&Strengthssub-assessment.
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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]
Numberswithinthebracketscorrespondtothemesidentifiedwithinandlistedonpage41oftheThemes&Strengthssub-assessment.
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December2016
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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]
Numberswithinthebracketscorrespondtothemesidentifiedwithinandlistedonpage41oftheThemes&Strengthssub-assessment.
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December2016
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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¬necessarilythecommunity.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]
Numberswithinthebracketscorrespondtothemesidentifiedwithinandlistedonpage41oftheThemes&Strengthssub-assessment.
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December2016
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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]
Numberswithinthebracketscorrespondtothemesidentifiedwithinandlistedonpage41oftheThemes&Strengthssub-assessment.
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SocialWellness:Asenseofconnection,belonging,safety,andareliablesupportsystem.
Numberswithinthebracketscorrespondtothemesidentifiedwithinandlistedonpage41oftheThemes&Strengthssub-assessment.
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]
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December2016
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]
Numberswithinthebracketscorrespondtothemesidentifiedwithinandlistedonpage41oftheThemes&Strengthssub-assessment.
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December2016
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Results:SurveyFeedbacktoCommunityHealthPerceptions
Thefivegreatestcommunitystrengthsidentifiedwere:
Thefivecommunityaspectsmostneedingtobeimproved:*2008and2012PerceptionsSurveydidnotaskdirectlycomparablequestion
Whenaskedifanyissuespreventpersonaluseofservicesoractivitiesavailableinthecommunity,the
topfiveresponseswere:
2008PerceptionsSurvey(831responses)
2012PerceptionsSurvey(1171responses)
2015PerceptionsSurvey(680responses)
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%)
2015PerceptionsSurvey(590responses)
1 Jobs&economicopportunities(48%)
2 Publictransport(38%)
3 Substanceabusetreatment(36%)
4 Housing(26%)
5 Accesstojobtraining&highereducation(17%)
2008PerceptionsSurvey(831responses)
2012PerceptionsSurvey(886responses)
2015PerceptionsSurvey(567responses)
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:
2008PerceptionsSurvey(834responses)
2012PerceptionsSurvey(506responses)
2015PerceptionsSurvey(649responses)
1 EconomicCosts EconomicCosts(73%) PhysicalHealth(86%)
2 PhysicalHealth PhysicalHealth(68%) EnvironmentalHealth(73%)
3 Educationandtrainingcosts Mental/EmotionalHealth(47%)Education/costs&availability
(73%)
Whenaskedtorankthefactorsmostnegativelyaffectingthecommunity,thetopthreeresponseswere:
2008PerceptionsSurvey(834responses)
2012PerceptionsSurvey(454responses)
2015PerceptionsSurvey(649responses)
1 SubstanceAbuse SubstanceAbuse(79%) SubstanceAbuse(97%)
2 EconomicCosts EconomicCosts(54%) InterpersonalViolence(96%)
3 Mental/EmotionalHealth Mental/EmotionalHealth(52%) Mental/EmotionalHealth(75%)
Thefiveservicesrespondentsfoundmostlackingwere:*2015PerceptionsSurveydidnotaskdirectlycomparablequestion
2008PerceptionsSurvey(831responses)
2012PerceptionsSurvey(1060responses)
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%)
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights-December2016 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)
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights-December2016 28
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
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December201630
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
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December201631
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
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December201632
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
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December201633
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
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December201634
• 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
MAPPoftheSouthernKenaiPeninsula–CHNAHighlights–December201635
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
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