Fort Loudoun Medical Center, in coordination with the Loudon County Health Department and the Loudon County Health Improvement Council, has released the 2020 county health needs assessment detailing problems within the community.
The assessment, which started in 2010, is performed every three years and is a requirement for FLMC to remain a tax-exempt, nonprofit organization, Gary Young, Covenant Health community outreach manager, said.
“It’s been a good process for several reasons,” Young said. “It gives the hospital a chance to get outside its four walls and participate with the members of the public health sector and to occasionally get a snapshot of what the health of the community is and what are the things that we’re doing well and what are the opportunities out there for things that we could be doing better.”
A steering committee comprised of members from the three health entities determines the scope of the assessment, designs the survey and gathers data. The committee chooses who needs to be at the table for focus groups made up of county leaders, residents and minority representation, Teresa Harrill, health department director, said.
Young said the assessment is a great tool to see the challenges faced within the county in real time. Organizations are free to use the assessment to better understand the needs of the people they serve.
“You begin to understand that health is not about illness,” Young said. “Illness is a consequence of not having health. Hospitals take care of illness, so we have learned through this process that it is important to get out in front of these things, listen to the community, listen to the leaders. And if we want to see less things coming in our hospital and our health department, then let’s listen to what people’s health issues are and let’s start doing something about them.”
Kate Galyon, Loudon County Schools Coordinated School Health coordinator and health council member, said it’s important health leaders are involved with the community.
“We kind of know some of those health issues that are out there but getting our community voice and seeing what they see as an issue is important, and it also helps with that buy-in with our community,” Galyon said. “… I think it definitely allows the component of the hospital, the health department, the health council and the schools to see what our community is saying is an issue.”
The top four health priorities listed in the assessment are substance abuse disorders, chronic disease management, mental health and tobacco.
Other issues deemed severe by survey participants include heart disease, lack of physical activity, access to affordable health care and COVID-19 impact.
The top 10 issues in the county in order are substance abuse and addiction, youth tobacco use, cancer, adult tobacco use, heart disease, access to affordable health care, lack of physical activity, access to mental health care, impact of COVID-19 and mental illness.
According to the assessment, residents expressed dissatisfaction with the county’s response to access to prenatal and postnatal care, lack of affordable housing and homelessness, mental illness, access to resources for people with criminal records, elder abuse and neglect, access to mental health care, impact of COVID-19, teen pregnancy, access to reliable and affordable transportation and substance abuse and addiction.
“Even though we ended with four primary issues, we came up with probably a dozen significant findings for the assessment,” Young said. “We just needed to narrow it down into some things we could probably get some traction on. Ultimately, this isn’t just an exercise and doing data and having people come to a meeting. You’re also required at the end of the process to come up with an action plan to focus on what your organization is going to do.”
The main problems are generally consistent throughout the years, Young said, but there are variables, which move within each issue.
“Three or four years ago, if someone had used the term vaping to me, I would have no clue as to what they were talking about,” he said. “That is something that now has just exploded in the high schools. Now it’s like we used to talk about tobacco cessation. Tobacco now is not just smokeless and cigarettes. It’s all these Juuls and these substances that you can vape. Cigarettes is kind of like, ‘Well, that’s what my grandpa does’.”
Young also pointed to opioids. With prescriptions harder to get, the issue has now shifted to heroin usage because of a cheap price and easy access. Although different substances, both fall under the same issue of substance abuse.
“For years, we’ve had tobacco use being part of the conversation,” Galyon said. “There’s been so much invested into anti-smoking and anti-dipping campaigns, but here came this vaping. It was and even now we have students that — we know it all fits underneath that same umbrella. But the kids, if you say smoking leads to these diseases or you could have these long-term effects, they will look at you and say, ‘I don’t smoke,’ but it all falls under that umbrella.”