mayo clinic health system albert lea and austin · 2014. 1. 3. · mayo clinic health system in...

Mayo Clinic Health System – Albert Lea and Austin

Albert Lea, Minnesota

September 30, 2013

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Table of Contents Executive Summary………………………………………………………………………………………..…...……..3

Our Community ....................................................................................................................................... 5

Assessing the Needs of the Community…………………………………………………………………..………..7 Addressing the Needs of the Community………………………………………………………………………..11 Appendix A: Community Health Needs Assessment Advisory Group……………………………….15 Appendix B: Community survey results…………………………………………………………………….16

Appendix C: Key informant interview ........................................................................................... 30

Appendix D: Mayo Clinic Health System inpatient/ER top diagnoses................................. 35

Appendix E: BC/BS Growing Up Healthy survey ........................................................................ 36

Appendix F: Children’s Center parent survey…………………………………………………………………40 Appendix G: Non-English speaking patient survey………………………………………….…………43

Appendix H: Senior Resources survey………………………………………………………………………44

Appendix I: Other data sources………………………………………………………………………………..….. 47

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Executive Summary Enterprise Overview:

Mayo Clinic is a not-for-profit, worldwide leader in patient care, research and education. Each year Mayo Clinic serves more than one million patients from communities throughout the world, offering a full spectrum of care from health information, preventive and primary care to the most complex medical care possible. Mayo Clinic provides these services through many campuses and facilities, including 23 hospitals located in communities throughout the United States, including Arizona, Florida, Georgia, Minnesota, Wisconsin and Iowa.

A significant benefit that Mayo Clinic provides to all communities, local to global, is through its education and research endeavors. Mayo Clinic reinvests its net operating income funds to advance breakthroughs in treatments and cures for all types of human disease, and bring this new knowledge to patient care quickly. Through its expertise and mission in integrated, multidisciplinary medicine and academic activities, Mayo Clinic is uniquely positioned to advance medicine and bring discovery to practice more efficiently and effectively.

In addition, through its Centers for the Science of Health Care Delivery and Population Health Management, Mayo Clinic explores and advances affordable, effective health care models to improve quality, efficiency and accessibility in health care delivery to people everywhere.

Entity Overview:

Mayo Clinic Health System in Albert Lea and Austin is an integrated organization, with main sites in Albert Lea and Austin and eight regional clinics within 20 miles of each site. The primary service area for each is about 35,000 residents, concentrated in Freeborn and Mower counties, respectively. Mayo Clinic Health System in Albert Lea offers a broad range of inpatient, outpatient and specialty services in southern Minnesota and northern Iowa, including a convenience care clinic, cancer center, physical medicine and rehabilitation center and inpatient and outpatient drug and alcohol treatment facilities. In 2012, hospital inpatient days in Albert Lea totaled 6,417, with 818 additional days for newborn care and 45,340 outpatient visits in Albert Lea and its five regional clinics.

Summary of Community Health Needs Assessment:

For more than 100 years, it’s been the practice of Mayo Clinic Health System in Albert Lea to reach out to the community for feedback, to identify needs and to build partnerships to meet those needs.

We are committed to these valuable partnerships and to our role in improving the quality of life for those who live in the communities we serve. To that end, our leadership and staff serve on local boards

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and initiatives, including economic development and Chamber of Commerce committees, family services collaborative, community college foundation, historical societies, Red Cross and everything in between.

Working in conjunction with Freeborn County Public Health and the Minnesota Department of Health, Mayo Clinic Health System in Albert Lea took a multi-faceted approach to gathering information and identifying local health needs.

Our primary tool was a community survey (see survey methodology, page 8) developed to determine individual health habits and health concerns that would provide a glimpse into the health status of the community, which then could be compared against other county and state data to identify outliers.

The survey was supported by key informant surveys and face-to-face meetings with community representatives. Survey respondents and community representatives provided valuable feedback and anecdotal information to clarify issues and gaps in community care and services and reviewed other local organizations’ surveys of their constituents.

A Community Health Needs Assessment Advisory Group, comprised of local stakeholders and community organizations, was created to help identify and prioritize needs and determine which ones could be impacted realistically by working collaboratively within the community.

Needs assessment outcomes revealed gaps in mental health access and care and high percentages of obesity and chronic disease within our county population that have potential for improvement as community groups expand current work or identify new programs or processes to impact high-priority needs.

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Our Community Overview:

Our community health needs assessment is based on the population of Freeborn County in southern Minnesota, located at the crossroads of I-90 and I-35. Freeborn County was chosen because over 90 percent of the patients served at Mayo Clinic Health System in Albert Lea are from this geographic area.

Demographics:

2010 population estimates 31,255

Persons under age 5 6.1%

Persons ages 5 - 17 15.9%

Persons 18 - 39 23.1%

Persons 40 - 64 34.8%

Persons 65 - 84 16.5%

Persons 85 and over 3.6%

Total male 15,462

Total female 15,793

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Ethnicity/Race

White 96.5%

Black 1.0%

American Indian/Alaska Native/Hawaiian Native/ Pacific Islander/Other

0.4%

Asian 1.0%

Hispanic or Latino 8.7%

White, non-Hispanic 88.4%

Two or more races reported 1.1%

Persons living below poverty level 11.2%

Percentage of residents living in poverty in 2009: 8.6% (7.3% for White non-Hispanic residents, 0.0% for Black residents, 26.0% for Hispanic or Latino residents, 0.0% for American Indian residents, 17.0% for other race residents, 4.4% for two or more races residents)

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Assessing the Needs of the Community Community Input:

Individuals contacted who represent broad interests of the community: Name/Title/Organization Date of input Describe how (meetings,

focus groups, surveys, written correspondence, etc.)

Johanna Thomas, dean of students Albert Lea High School

2-28-13 Key informant meeting

Penny Jahnke, coordinator English as Second Language


Linda Lares, director SEMCAC


Alice Englin, director Freeborn County Family Services


Kim Nelson, director Children’s Center


Craig Raymond, dean of students Glenville/Emmons Schools


Melissa Dopplehammer, director Freeborn County Workforce Development


Pat Stumme Senior Resources


Jesus Cantu, police officer Albert Lea Police Department


Pastor Katie Fick, clergy


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Individuals contacted who have special knowledge of or expertise in public health: Name/Title/Organization Describe

expertise Date of input Describe how (meetings,

focus groups, surveys, written correspondence, etc.)

Lynn Krell RN and Healthy Families program visitor


Natalie Loock RN and Healthy Families program visitor


Sue Yost Director, Freeborn County Public Health; oversees all county health programs


Ann Kinney, Ph.D Senior research scientist; expert knowledge of survey development, compilation and interpretation

Feb. 2013 through June 2013

Face-to-face meeting; phone conference, email

Process and Methods:

The following data collection methods were used to determine community health needs.

Community Survey

Random survey was mailed to Freeborn County residents to determine current health status of community.

Survey respondents totaled 449 community residents; the survey was weighted to keep the results as accurate as possible.

The survey queried respondents about their health, health status and other types of questions to determine needs, based on a composite of individuals. It was not designed to ask respondents about the health of others or the community

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Ann Kinney, Ph.D., Minnesota Department of Health, assisted in refining survey questions, choosing the format and mailing vendor and, generally digging into the data to identify correlations among issues and responses to help determine the community’s health status.

Staff from Freeborn County Public Health and Mayo Clinic Health System developed the questions for the survey, with technical assistance from the Minnesota Department of Health Center for Health Statistics. Existing items from the Behavior Risk Factor Surveillance System (BRFSS) survey and from recent county-level surveys in Minnesota were used to design some areas of this one. The survey was formatted by the vendor, Survey Systems, Inc., New Brighton, Minn., as a scannable, self-administered, English-language questionnaire.

Survey methodology

A two-stage sampling strategy was used to obtain a probability sample of adults living in Freeborn County. For the first stage, a random sample of Freeborn County residential addresses was purchased from a national sampling vendor, Marketing Systems Group of Horsham, Pa., which acquired them from the U.S. Postal Service. Address-based sampling was used so that all households would have an equal chance of being chosen for the survey. For the second stage, the “most-recent-birthday” method of respondent selection within households was used to specify one adult from each selected household to complete the survey.

Survey administration

An initial survey packet was mailed to 1,200 sampled households on April 5, 2013. It included a cover letter, the survey and a postage-paid return envelope. Nearly two weeks after the first packets were mailed, a reminder postcard was sent on April 17 to all sampled households, reminding those who had not yet returned a survey to do so, and thanking those who had already responded. Two weeks after the reminder postcards were mailed, another full survey packet was sent on May 1 to all households that still had not returned the survey. The remaining completed surveys were received over the next four weeks; May 30, 2013 was the final date for the receipt of surveys. The responses from the completed surveys were scanned into an electronic file by Survey Systems, Inc.

Completed surveys and response rate

During the survey administration, 27 sampled addresses were replaced by other eligible addresses due to duplicates in the address file or moves out of Freeborn County. Completed surveys were received from 455 adult residents of Freeborn County, with an overall response rate of 37.9 percent (455/1,200).

Data entry and weighting

To ensure the survey results were representative of the adult population of Freeborn County, the data were weighted when analyzed. The weighting accounts for the sample design by adjusting for the number of adults living in each sampled household. The weighting also includes a post-stratification adjustment so the gender and age distribution of the survey respondents mirrors the gender and age distribution of the adult population in Freeborn County, according to U.S. Census Bureau 2010 estimates.

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Key informant sessions

Participants were chosen because they represented different segments or community groups or worked with specific community groups like students, medical assistance clients, displaced workers, the faith community, low-income residents or parents of preschool and elementary school students (see participant list above under “Community Input”.)

Groups were facilitated by the director of Public Health and the director of public affairs for Mayo Clinic Health System in Southeast Minnesota. Participants unable to attend sessions submitted completed key informant surveys. Responses were compiled and common responses counted (see Appendix C.)

An abbreviated key informant survey was developed for Spanish-speaking residents. Surveys in Spanish were distributed to Public Health clients and Mayo Clinic Health System in Albert Lea and Austin patients at the Albert Lea site. Respondents identified community issues from their perspective (see Appendix G.)

Community agency or program survey review (see Appendix C)

Surveys reviewed for information appropriate to identifying community needs:

BC/BS Growing Up Healthy grant survey (See Appendix E)

Children’s Center survey (See Appendix F)

Senior Resources survey (See Appendix I)

Information gaps

The largest information gap is the lack of current census data to match the information we have gathered through the mail-out survey and key informant sessions.

Our non-white, Hispanic population is reticent to complete surveys or participate in focus groups. There is a distrust of how participation or results will affect them and, generally, they shy away from public events for fear of being singled out or negatively identified in some way. Our random, mailed community survey does not accurately reflect our community’s ethnic diversity. We did, however develop a brief, key informant survey in Spanish and distributed it to our patients and Freeborn County WIC program participants.

Our Nuar, Karen and Sudanese communities are not well represented through the community survey or participation in the key informant groups, surveys or focus groups.

Chronic disease information primarily was gained from the community survey, not individual or group meetings with people affected with chronic disease.

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Addressing the Needs of the Community Overview:

Our Community Health Needs Assessment Advisory Group (see Appendix A for membership) was convened in the CHNA planning stages and again when survey and key informant session results were completed. The group was charged with:

• Reviewing demographic data, community survey results and key information session feedback and Spanish language surveys

• Comparing local health status results from the survey with other Minnesota county and state data to identify outliers

• Choosing priority health needs based on the following criteria:

o Current local programs already working to meet identified needs

o Ability to impact those needs

o Resources necessary to impact needs

o Anecdotal information or representative experience with needs and programs developed or methods used to affect improvements or change

Identified Health Needs:

1 Mental health – depression, anxiety, hopelessness, fear needs unmet

Community survey results, key informant sessions, identified lack of providers, identified lack of access in community

Access

Only 1.2 full-time psychiatrists in community; loss of three psychologists and two therapists within last few months

17.6% of survey respondents reported delay in getting mental health care

Of survey respondents reporting mental health diagnoses:

• 17.8% have been diagnosed with depression – higher than state average

• 10.7 have been diagnosed with anxiety – higher than state average

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• 27.4% reported feelings of mental distress – no state data available

• 4.5% of respondents have been diagnosed with “other” mental health problems – no state data available

Key informant feedback and anecdotal information

Mental health was identified as top community health care concern by majority of key informants

Children’s mental health rated concern by majority of participants

2 Obesity prevention and intervention

Community survey results – self reporting by respondents who listed height/weight and nutrition, exercise habits; general consensus from key informants

Survey respondents reporting obesity or overweight diagnoses:

• 41.9% have been diagnosed as overweight

• 13.0% have been diagnosed as obese

• Survey respondents reporting height/weight (BMI calculated)

• 29.7% overweight but not obese

• 41.2% obese

Key informant feedback and anecdotal information

All participants agreed obesity is both a national and local crisis and health concerns

3 Chronic disease prevention

Community survey results – self reporting by respondents with high blood pressure, high cholesterol and diagnoses of diabetes

Survey respondents reporting health diagnoses:

• 39.7% have been diagnosed with high blood pressure

• 37.4% have been diagnosed with high cholesterol

• 10.7% have been diagnosed with diabetes

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Survey respondents reporting health habits:

• 60.3% reported less than four days of moderate (30 min. or more physical activity in the last week

• 63.1% reported less than 3-4 servings of fruits and vegetables “yesterday”

• 20% of respondents reported tobacco use

Mental health priority

Our community survey revealed a significant number of respondents with diagnosed mental health issues, as well as those who have experienced “feelings of hopelessness, anxiety or loss of interest”.

The identified lack of local mental health care providers (see Mental Health Resources Directory, page 12 in the Appendix) was confirmed by a community mental health care coalition comprised of a local attorney, director of county human services, United Way director and Freeborn Family Services Collaborative grant coordinator. The group painted a clear picture of clients unable to schedule appointments in a timely manner or going without needed mental health care because no appointment was imminently available, as well as a recent loss of county mental health professionals and barriers to individuals seeking care from the private sector because of cost and no self-referral options.

Lack of children’s mental health providers, according to key informants, is currently at the crisis stage with the departure of those providers from Mayo Clinic Health System in Albert Lea and the increasing need for this service expressed by staff from the area schools, Children’s Center, Public Health Home visitors and SEMCAC.

Of the survey respondents who identified a mental health diagnosis or who had experienced “feelings of hopelessness, anxiety or loss of interest,” 17.6 percent delayed seeking treatment due to perceived severity of the issue, cost, inability to get an appointment or lack of insurance coverage. The advisory group’s consensus was there is still a stigma attached to mental health care and a lack of understanding about when/how to seek help.

Obesity priority

As a national epidemic and confirmed disease, obesity in Freeborn County follows the national trend. However rates of obesity appear higher in Freeborn County than in other Minnesota counties, with 41.9 percent of Freeborn County survey respondents having been diagnosed as overweight and 13.0 percent as obese. These rates of overweight and obese people are significantly higher than those of eight other counties with which Freeborn County was compared. In fact, Freeborn County’s percentages were almost twice as high as other reporting counties.

Weight status based on BMI, was calculated from the survey respondents’ self-reported height and weight and indicated that 29.7 percent of Freeborn County respondents were overweight and 41.2

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percent were obese, compared with Minnesota percentages, respectively, of 36.8 percent and 26.7 percent.

Freeborn County rates are alarming, especially when compared with eight other counties with obesity percentages ranging from 19.1 percent to 33.3 percent and the Minnesota average of 26.7 percent. Because obesity is a precursor to chronic disease, the current and future impact of obesity on the health care system, our local workforce and general quality of life is staggering. Prevention of and early intervention in obesity across all demographics is imperative not only to reduce the incidence of chronic disease, but also to improve mental health status.

Chronic disease prevention priority

The broad scope of chronic disease prevention encompasses mental health and obesity priorities and a whole host of social, economic and employment issues. Freeborn County’s community survey results leave no doubts about local health status, with incidence of chronic disease diagnoses significantly higher than the eight comparison counties and state averages.

Because of our county’s significant prevalence of chronic disease and the national spotlight recently cast on obesity, now is the time to address these needs while we have the public’s attention and can work to create awareness of healthy habits and behaviors and their benefits.

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Appendix A: Community Health Needs Assessment Advisory Group Freeborn County CHNA Advisory Group

Director, Freeborn County Public Health

Director, Albert Lea Family YMCAA

Director, Freeborn County Children’s Center

Pediatric Nurse Practitioner, Mayo Clinic Health System in Albert Lea and Austin

Freeborn County Senior Resources

Director, Freeborn County United Way

Director, Freeborn County Family Service Collaborative

Executive director, Albert Lea/Freeborn County Chamber of Commerce

Supervisor, Language Services, Mayo Clinic Health System in Albert Lea and Austin

Director, Southeast Minnesota Community Action Committee

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Appendix B: Community mail survey results General health

Frequency Percent Valid Percent

Cumulative Percent

Valid Poor 4 .9 .9 .9 Fair 48 10.6 11.0 11.9 Good 198 44.1 45.7 57.5 Very good 139 31.0 32.0 89.6 Excellent 45 10.1 10.4 100.0 Total 434 96.7 100.0

Missing System 15 3.3 Total 449 100.0

HiBP


Cumulative Percent

Valid No 262 58.4 59.0 59.0 Yes 176 39.2 39.7 98.7 Yes, during pregnancy 6 1.3 1.3 100.0 Total 444 98.9 100.0


Diabetes


Cumulative Percent

Valid No 392 87.2 88.2 88.2 Yes 48 10.6 10.7 98.9 Yes, during pregnancy 5 1.1 1.1 100.0 Total 444 98.9 100.0


Overweight


Cumulative Percent

Valid No 252 56.2 58.1 58.1 Yes 182 40.6 41.9 100.0 Total 435 96.8 100.0


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Cancer


Cumulative Percent



Lung


Cumulative Percent



Heart


Cumulative Percent



Stroke


Cumulative Percent



HiChol


Cumulative Percent



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Depression


Cumulative Percent



Anxiety


Cumulative Percent



OtherMH


Cumulative Percent



Obesity


Cumulative Percent



Asthma


Cumulative Percent



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Usual place for care


Cumulative Percent

Valid Doctor's office 177 39.4 39.8 39.8 A clinic 131 29.3 29.6 69.4 Some other health center 3 .6 .6 70.0 Express Care at HyVee 30 6.8 6.9 76.9 Emergency room 3 .7 .7 77.6 Urgent care clinic 49 10.8 11.0 88.6 No usual place 37 8.3 8.4 97.0 Other place 13 3.0 3.0 100.0 Total 444 98.8 100.0


Medical care delay


Cumulative Percent

Valid Yes 131 29.3 29.6 29.6 No 313 69.7 70.4 100.0 Total 445 99.0 100.0


Place for family planning


Cumulative Percent

Valid Local doctor or provider 36 7.9 8.8 8.8 Rochester 2 .4 .4 9.2 Nowhere 4 1.0 1.1 10.3 No longer need 33 7.3 8.1 18.3 Do not need 330 73.4 81.7 100.0 Total 404 89.9 100.0


Feelings of mental distress


Cumulative Percent



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Mental health care delay


Cumulative Percent



General health exam


Cumulative Percent

Valid Within the past year 296 65.9 66.7 66.7 Within the past 2 years 54 11.9 12.1 78.8 Within the past 5 years 40 8.9 9.0 87.8 Five or more years ago 42 9.3 9.4 97.2 Never 12 2.7 2.8 100.0 Total 444 98.8 100.0


Flu shot


Cumulative Percent


Missing 0 0 .1 System 7 1.5 Total 7 1.6

Total 449 100.0

Dental exam or cleaning


Cumulative Percent



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Hearing test


Cumulative Percent



Eye exam


Cumulative Percent


Missing 0 0 .1 System 22 5.0 Total 23 5.1

Total 449 100.0

Diabetes check


Cumulative Percent



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Skin cancer screening


Cumulative Percent


Missing System 33 7.3 Total 449 100.0 Colon cancer screening


Cumulative Percent


Missing System 15 3.4 Total 449 100.0 Prostate exam


Cumulative Percent



Pap test


Cumulative Percent



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Mammogram


Cumulative Percent



Health insurance coverage


Cumulative Percent


Missing System 4 .8 Total 449 100.0

Number of vegetables yesterday


Cumulative Percent

Valid 0 servings 67 14.9 15.1 15.1 1-2 servings 244 54.3 55.1 70.3 3-4 servings 98 21.9 22.3 92.6 5 or more servings 33 7.3 7.4 100.0 Total 442 98.4 100.0


Number of fruits yesterday


Cumulative Percent



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Number of fruits and vegetables yesterday


Cumulative Percent



Worry about food running out


Cumulative Percent

Valid Often 7 1.7 1.7 1.7 Sometimes 59 13.1 13.1 14.8 Rarely 51 11.3 11.4 26.2 Naver 329 73.4 73.8 100.0 Total 446 99.4 100.0


Used community food shelf


Cumulative Percent



Days of moderate exercise


Cumulative Percent

Valid 0 40 8.9 9.1 9.1 1 52 11.6 11.9 21.1 2 96 21.3 21.8 42.9 3 83 18.5 19.0 61.9 4 49 10.9 11.2 73.1 5 52 11.6 11.9 85.0 6 34 7.5 7.7 92.7 7 32 7.1 7.3 100.0 Total 438 97.4 100.0


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Seat belt


Cumulative Percent

Valid Always 377 83.9 83.9 83.9 Most of the time 58 12.9 12.9 96.7 Sometimes 7 1.6 1.6 98.3 Seldom 4 1.0 1.0 99.3 Never 3 .7 .7 100.0 Total 449 100.0 100.0

ChildSeat


Cumulative Percent

Valid Always 124 27.5 27.6 27.6 Never 5 1.1 1.1 28.7 No children 319 71.0 71.3 100.0 Total 447 99.6 100.0

Missing System 2 .4 Total 449 100.0 Domestic fear


Cumulative Percent



Cigarette smoking status


Cumulative Percent

Valid Non-smoker 376 83.8 85.2 85.2 Current smoker 65 14.5 14.8 100.0 Total 441 98.3 100.0

Missing -9 8 1.7 Total 449 100.0

Cigar smoking status


Cumulative Percent

Valid Non-smoker 424 94.5 98.1 98.1 Current smoker 8 1.8 1.9 100.0 Total 433 96.3 100.0

Missing -9 16 3.7 Total 449 100.0

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Smokeless status


Cumulative Percent

Valid Non-user 415 92.5 96.3 96.3 Current user 16 3.6 3.7 100.0 Total 431 96.0 100.0

Missing -9 18 4.0 Total 449 100.0

Marijuana status


Cumulative Percent

Valid Non-user 438 97.5 98.3 98.3 Current user 7 1.6 1.7 100.0 Total 445 99.1 100.0

Missing -9 4 .9 Total 449 100.0

Use other illegal drugs


Cumulative Percent

Valid Never 445 99.1 100.0 100.0 Missing System 4 .9 Total 449 100.0

Abuse Rx drugs


Cumulative Percent

Valid Never 444 98.9 100.0 100.0 Missing System 5 1.1 Total 449 100.0

Any alcohol drinking in past 30 days


Cumulative Percent

Valid No drinking 175 39.0 39.2 39.2 Any drinking 272 60.7 60.8 100.0 Total 448 99.7 100.0


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Chronic drinking - Gender specific


Cumulative Percent

Valid No drinking or not chronic 411 91.5 91.8 91.8 Chronic drinking 37 8.1 8.2 100.0 Total 448 99.7 100.0


Binge drinking - Gender specific


Cumulative Percent

Valid No drinking or no binge 328 73.1 73.3 73.3 Any binge drinking 120 26.6 26.7 100.0 Total 448 99.7 100.0


Drinking behavior


Cumulative Percent

Valid No drinking 175 39.0 39.2 39.2 Drinking, not heavy - gender specific 236 52.5 52.7 91.8

Heavy drinking - gender specific 37 8.1 8.2 100.0

Total 448 99.7 100.0 Missing System 1 .3 Total 449 100.0

D&D car or truck


Cumulative Percent

Valid Yes, I drove 15 3.3 3.4 3.4 Yes, I rode 13 2.9 2.9 6.3 No 414 92.2 93.7 100.0 Total 442 98.4 100.0


D&D motorcycle


Cumulative Percent

Valid No 426 94.8 100.0 100.0 Missing System 23 5.2 Total 449 100.0

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D&D boat


Cumulative Percent

Valid Yes, I drove 2 .4 .4 .4 Yes, I rode 2 .4 .4 .8 No 418 93.2 99.2 100.0 Total 422 93.9 100.0


D&D snowmobile/ATV/jet ski


Cumulative Percent

Valid Yes, I drove 2 .4 .4 .4 Yes, I rode 0 .1 .1 .5 No 424 94.4 99.5 100.0 Total 426 94.8 100.0


Suicidal thoughts


Cumulative Percent



Suicide attempt


Cumulative Percent

Valid Yes 1 .2 .2 .2 No 443 98.8 99.8 100.0 Total 444 99.0 100.0


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Weight status according to BMI


Cumulative Percent

Valid Not overweight 126 28.0 29.0 29.0 Overweight but not obese 129 28.6 29.7 58.8 Obese 178 39.7 41.2 100.0 Total 433 96.4 100.0

Missing Unknown weight and/or height 16 3.6 Total 449 100.0

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Appendix C: Key informant interview February 2013

1. What are the top three health concerns facing people in Freeborn County?

Affordable health care/cost of health care 11111 Medical assistance cuts 1 Access to dental care 11 Affordable Rx Unable to get health insurance Can’t afford health insurance Youth mental health 111 Nutrition – kids and junk found, homebound adults, access to food outside city Food deserts Obesity 11 Drugs Alcohol Second hand smoke Diabetes Long lines at clinic; preference, if you have insurance Heart issues Flu Need more information about shot clinics and Mayo Clinic Health System programs -- and in all languages Sudanese interpreters needed Interpreting process too long Need Open Door Clinic Non-English speaking patients intimidated/discriminated against at clinic – feel as if they’re being mocked Public Health not effective – visits only last five minutes

2. What are the top three economic concerns facing people in Freeborn County?

Lack of skilled workforce 1 Lack of jobs for unskilled workforce 11 Homeless 1 Lack of affordable housing – affordable housing unsafe 11 Lack of education, graduation rates low Lack of transportation to get or keep jobs 11 Lack of childcare options Little preparation for kindergarten with home providers or relatives caring for children Gas prices High taxes

3. What are the top three educational concerns facing people in Freeborn County?

GED test now can’t be done in sections – have to do it all at once. People give up since it’s too hard, time-intensive all at once. Need parenting education High school dropouts

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Waiting list for Head Start Kids not reading, ages 2 – 4 Mediocre teachers in public schools Kids don’t want to go to school Challenging for 8th graders now that they’ve been moved to high school—distractions, socialization, etc. Lack of direction for kids in summer; gap in learning and have to start again in fall Dropouts are pushouts College unaffordable High school drop outs

4. What are the top three mental health concerns facing people in Freeborn County? Parents medicating children, rather than parenting or taking time to work with them (ADHD) Rx for children’s behavior medication too easy to get Undiagnosed depression, anxiety 11111 Little to no children’s or adolescent mental health services or affordability of services 111111 Stress on children to succeed, no matter what Constant connection to phones, Facebook, etc. Lack of sleep affects school and behavior Three-month wait for mental health professionals appointment 11 Finding help you can trust Kids get bored and into bad things or act out No local mental health professionals who see children 1111 Can’t get in to mental health professionals, when needed 1111111

5. What are the top three chemical health problems facing adults in Freeborn County?

Kids selling Ritalin Second hand smoke 111 Drug use up with economic downturn Alcohol Heroin Meth Marijuana

6. What are the top three chemical health problems facing youth in Freeborn County? Minn. Student Survey shows chemical use up for 6th graders in every area Marijuana use not taken seriously by law enforcement or patients – few consequences 111 Access to prescription drugs, use of others’ prescription drugs 11 Ditch weed Little kids smoking at bus stops Parents drug, alcohol and tobacco use; kids have access Lack of adult role models Alcohol Heroin Meth Marijuana

7. What are the top three environmental concerns facing people in Freeborn County?

Safe, affordable housing No recycling options in apartment buildings

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Garbage dumped in streets to save money Littering Pollution Lack of recycling Water safety 11 Watershed

8. What are the top three housing concerns facing people in Freeborn County?

Affordable housing 111 Affordable housing unsafe or in country with no transportation options People can’t afford security deposits needed for 1st/last month Couch-hopping; homeless Multi-families under one roof Landlords not felon-friendly Waiting list for decent housing 111 Slum lords who don’t care for property 111 Expensive rent 111111

City ordinances not enforced 11 Only homeless shelter 50 miles away Need more public housing 11 Old houses should be fixed up Renters piling up garbage; not paying for trash removal 11

9. What are the top three safety concerns facing people in Freeborn County? Neighbors not looking out for neighbors People not locking their doors Sexual predators moving to community Older kids picking on younger kids at park

10. What are the top three transportation concerns facing people in Freeborn County?

Limited options outside City 11 Taxi $8 for one person, extra $3 for each stop 11 Bus route limited – works for seniors, but not working poor

11. What are the top three concerns facing seniors in Freeborn County?

No rural meal delivery No evening bus service Senior living options outrageous Rx prices Lack of transportation 111 Staying in homes on fixed income Too proud to ask for assistance, food stamps Can’t afford to keep up their homes Affordable health care

12. What are the top three concerns facing the diverse populations in Freeborn County?

New ethnic groups, populations neither understanding, nor following laws – family is law Kids not obeying parents – parents unable to cope Racial profiling Unfair treatment Assuming one mistake means bad behavior forever Working 2nd, 3rd shift and not parenting or spending time with children

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Not always welcomed into community 111 Seldom integrated into community Need caseworkers that speak Nuar Racism in our hospitals, stores and schools “When I was at Wal-Mart, had to show my ID, along with credit card; white person in front of me didn’t have to show ID” Latino police more racist than non-Latino police Need more free culture programs for children, more recreational opportunities for toddlers and older 11 Want more of a sense of community Not a welcoming community 1111

13. Of the issues listed above, what are the top three that are the most important? a. Health 11 b. Economics 111111 c. Education 1 d. Mental health 11111111111 e. Chemical health f. Environment g. Housing 11 h. Safety 1111111 i. Transportation 11 j. Seniors k. Diverse populations 11

14. Are you aware of any activities or initiatives taking place in your community to address any of these problems/issues/concerns? (all of the issues listed above) Neighbors watching out for neighbors Police around some neighborhoods, but not everywhere United Way programs Freeborn County Family Services Collaborative THRIVE early childhood programs Mayo Clinic Health System education programs

15. What resources are you aware of in your community that are available to assist with any of these problems/issues/concerns? (all of the issues listed above) Classes at Mayo Clinic Health System Classes, programs at Brookside

16. Please share any suggestions you may have concerning how current community resources might be redesigned or redirected to be more effective. Promote and advertise more 11 No one knows about Patient Education Center and use of computers at Mayo Clinic Health System

17. Are there any other issues or concerns that are not being met in Freeborn County? a. Yes No If yes, what are those issues or

concerns

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Police favor some people, don’t listen to others; unfair treatment Not enough promotion of activities going on in the community for recreation, children Cost of “Y” , city pool, etc. too high for low-income families No public transportation for people in wheelchairs County assistance for day care not meeting needs; too many rules and few options for care No day care for second or third shift workers

Mayo Clinic Health System would like to thank Goodhue County Health and Human Services and the Public Health/Citizen Advisory Council

for the use of this survey.

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Appendix D: Mayo Clinic Health System inpatient/ER top diagnoses

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Appendix E: BC/BS Growing Up Healthy survey

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Appendix F: Children’s Center parent survey The Children's Center

2012 Parent Questionnaire

Child's Class (please circle):

Milky Way Rainbow Starlight Moonbeam Blue Sky Sunshine

Teddy Bear Busy Bee Kangaroo Club

Kids Klub (School Age)

Please check one appropriate answer - if you mark 1 or 2 please tell how we could make it a 3. Based on the experiences of my child and myself here at The Children's Center, I am able to say that:

3 2 1 Yes

No

____ ____ ____ 1 My child's teacher knows and cares about my child and responds to her/his individual needs.

____ ____ ____ 2 I feel comfortable and at ease leaving my child here each day.

____ ____ ____ 3 My child's teacher listens to me, respects me as a parent, and supports us as a family.

____ ____ ____ 4 I know who to go to with my concerns and feel confident that my concerns will be addressed respectfully and promptly.

____ ____ ____ 5 The communication systems keep me well informed about what is happening in the program each day and what I need to know to plan.

____ ____ ____ 6 The daily conversations and parent-teacher conferences sufficiently inform me of my child's progress.

____ ____ ____ 7 I read the articles/calendars and messages sent home and posted for parents.

What kind of communication is most helpful? Circle all that apply: monthly newsletter activity calendar daily reports website notes on the door

informal conversations with staff parent/teacher conferences menus

parent bulletin boards other: _________________________________

____ ____ ____ 9 The atmosphere here is warm and nurturing.

____ ____ ____ 10 My child is happy and safe here.

____ ____ ____ 11 My child's growth and development have been supported and stimulated by her/his participation in this program.

____ ____ ____ 12 Staff know what they are doing and are enthusiastic about working here.

____ ____ ____ 13 Center policies are clear, fair, and consistently enforced.

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____ ____ ____ 14 Meals served are nutritious and varied.

____ ____ ____ 15 Tuition rates reflect the quality of service we receive.

____ ____ ____ 16 Outdoor spaces are thoughtfully designed and well maintained.

____ ____ ____ 17 Indoor spaces are clean and appealing and meet the needs of the children.

____ ____ ____ 18 Supplies and equipment are adequate and kept in good condition.

____ ____ ____ 19 The curriculum meets my child's needs and is fun for my child.

3 2 1 Yes

No

____ ____ ____ 20 My participation in the program is welcomed - I have a variety of opportunity and choices about how to participate.

____ ____ ____ 21 I am comfortable recommending this program to friends and have done so.

____ ____ ____ 22 Would you be interested in participating in a parent education night?

Please list other agencies your family uses.

________________________________ _______________________________

________________________________ _______________________________

Please take a few minutes to complete the following:

The program could better meet my needs if ….

When my child talks about the center at home, she/he says …

I wish my child's teacher would …

I wish the morning and/or afternoon staff would…

My child's teacher has helped me most by …

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The morning and/or afternoon staff has helped me most by …

Are there any other concerns, comments you wish to express at this time?

Are you aware The Children's Center is a licensed preschool? (please circle) Yes No

Would you like more information about our preschool program? Check out our website at www.alchildrenscenter.org or contact Trisha Whelan our Education Coordinator (email: [email protected], phone: 373-7979)

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Appendix G: Non-English speaking patient survey Non-English speaking patient survey (n=5)

Top rated community concerns: • Youth and drug use • Not a welcoming community • Safety/safe environment

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Appendix H: Senior resources survey Freeborn County On-Line Survey Tally Senior Resources 2=Important 3=Neutral 4=Unimportant 5=Extremely Unimportant Category Item Rank % EDUCATION Kindergarten Readiness 65 as #1 Summer Programs/Youth 67 as #2 Community Ed. Classes 62 as #2 After- School / mentoring 57 as #1 Parenting Skills Ed. 57 as #1 Math proficiency K-7 57 as # 1 INCOME Basic Food need: hungry families 76 as#1 Job Training/Opportunities 67 as #1 Homelessness 71 as #2 Affordable quality child care 52 as #1 Rental Assistance 57 as #2 HEALTH: Improving People’s Health Child abuse / neglect 86 as #1 Oral Health 86 as #2 Eye Care 76 as #2 Teen Pregnancy 71 as #2 HEALTH: Improving Community Health Domestic Violence 48 as #1 Environmental Stewardship 90 as #2 Isolation/loneliness 81 as #2 Communicable Diseases 76 as #2 Suicide prevention 76 as #2 SENIOR CITIZENS Access to good nutrition 62 as #1 Sr. Social Services/forms 76 as #2 Transportation-medical/food 67 as #2 Grandparent raising children 55 as #2 VETERANS & MILITARY FAMILIES Mental Health / Counseling 65 as #1 Family support 57 as #1 Health Care Coverage 57 as #2 Employment / Job training 48 as #2

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KEY FOCUS AREAS Education 43 as #1 Health Improving Com. Health 29 as #2 Senior Citizens 35 as #3 Income 24 as #4 WHEN I VOLUNTEER Do as much as I can 90 Talk to friends/family 47 Interested in being trained 38 Like to focus on youth 28

21 responses TOP 2 REASONS TO VOLUNTEER Benefiting my community 81 See a need & pitch-in 71 Open to new experiences 38 Feels good about myself 33 AGE RANGE 7-15 00 16-30 00 31-50 43 51-65 43 66-80 4.3 81+ 00 Na 8.6 23 RESPONSES MY HOME IS Up to 1,000 pop. 4.3 Farm / acreage 21.7 Town over 1,000 65.2 NA 8.6 23 responses LIVED IN FREEBORN COUNTY All my life 13 Born here, left, returned 8.6 Arrived as adult 56.5 NA 21.7 PREFERENCE GETTING INFO. e-mail 76 Friend/neighbors 38 Non-profit agency 33.3

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Newspapers 28.6 Local website/internet 28.6 HOW LONG TO VOLUNTEER AT A TIME 2-3 hours 65 3+ hours 18.6 1 hour 13 NA 13 21 responses WHEN AVAILABLE AS needed-whenever-wherever 80

Summer 25 Spring 20 Fall 10 Winter 10

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Appendix I: Other data sources

1. 2005 – 2009 American Community Survey S1501 Education S1701 Poverty B25008 Housing B09002 Single Parent

2. US Census Bureau 2010 Data http://quickfacts.census.gov

3. www.cityofalbertlea.org

4. Projected Minnesota Population By County Minnesota State Demographic Center June, 2007

5. www.communityhealth.hhs.gov Community Health Status Indicators, 2009 (most recent)

6. www.healthypeople.gov/2020 7. www.countyhealthrankings.org

http://quickfacts.census.gov/

http://www.cityofalbertlea.org/

http://www.communityhealth.hhs.gov/

http://www.healthypeople.gov/2020

http://www.countyhealthrankings.org/

mayo clinic health system albert lea and austin · 2014. 1. 3. · mayo clinic health system in...

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