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Pacific County Rural Health Project, University of WA Coursework, Summer 2010

  1. To understand key, high - level county background information  To identify and prioritize county health issues  To identify additional questions for community leaders and stakeholder  To explore strategies for one ( key county health improvement issue
  2. Located in SE portion of Washington State, population 20,900 (U.S. Bureau of the Census, 2010)  Four incorporated cities › Raymond, South Bend, Long Beach, Ilwaco › Populations from 945 to 2,985 (U.S. Bureau of the Census, 2010)  One primary route of three connecting highways › Rural winding roads, majority of county remote to healthcare access
  3. (
  4. Economic Indicator Pacific WA State County 2009 unemployment rates 10.2 – 14.3% 8.9% (U.S. Department of Labor, 2010) Children living in poverty 23% 15% (County Health Rankings, 2010) Families living below the poverty level 9% 7% (U.S. Bureau of the Census, 2000) Median household income $31,209 $45,776 (U.S. Bureau of the Census, 2000) Population with Medicaid coverage 22.9% 33.1% (WA State Department of Social & Health Services, 2010)
  5. Classifications: › RUCA code: Small Town and Isolated Rural (Department of Health, 2001) › Medically Underserved Area (U.S. Department of Human and Health Services, 2010) › Health Professional Shortage Area  Primary Care  Mental Health (U.S. Department of Human and Health Services, 2010)
  6. Willapa Harbor Hospital, South Bend › Level 5 Trauma Designation › Critical Access  Ocean Beach Hospital, Ilwaco › No trauma designation › Critical Access  Neither hospital offer obstetric service, closest obstetric services in adjacent Lewis and Aberdeen counties  50% of county more than 30 minutes from acute care facility
  7. (WA State Dept. of Health, 2006)
  8. Community Health Clinics (Community Health Service, 2010) › Cowlitz Family Health Center, Ocean Park (Medical/Dental) › Shoalwater Bay Indian Tribe, Tokeland (Medical/Dental)  Rural Health Clinics (WA State Dept of Health, 2009) › Ocean Beach Medical Center, Ilwaco › Naselle Clinic, Naselle › Riverview Health Center, Raymond › Pacific Family Health Center, South Bend
  9. Shoalwater Bay Riverview Indian Health Center Tribe,(Medical/De (Medical) ntal) Pacific Family Health Center (Medical) Cowlitz Family Health Center (Medical/Dental) Naselle Clinic (Medical) Ocean Beach Medical Center (Medical)
  10. Willapa Behavioral Health (WA State Department of Social and Health Services, 2010)  Two locations: › North county: Raymond › South County: Long Beach
  11. University of Washington Telehealth Services: › Ocean Beach Hospital, Ilwaco › Willapa Harbor Hospital, South Bend, › Shoalwater Bay Tribe, Tokeland  Rural telehealth services included: › Surgical telementoring › Medicine and cardiology grand rounds and nursing video teleconferences (University of Washington, 2005)
  12. Health Indicator Pacific County WA State Reported Chlamydia infectionsᵃ 1385/100,000 2277/100,000 Adult binge drinkingᵃ 15% 16% Violent crime rateͨ 179/100,000 342/100,000 Access to healthy foodsͨ 50% 47% Food service safetyᵃ 100% 93% Reported child immunizationsᵃ 47% 42% Children with health insuranceᵃ 96% 95% Note: ᵃ Washington State Department of Health (2009) ᵃ Washington State Department of Health (2006) ͨCounty Health Rankings (2010) ᵃU.S. Department of Health & Human Services (2009) * Peer County Range
  13. Health Indicator Pacific County WA State Adult physical activityᵃ 27% 51% Teen physical activityᵃ 42% 42% Adult overweight/obeseᵃ 63% 61% Teen overweightᵃ 33% 25% Obesityᵃ 37.8% 24.2% Adult cigarette smokingᵃ 27% 16% Teen cigarette smokingᵃ 21% 15% Teen alcohol useᵃ 40% 33% Adult poor mental healthᵃ 16% 10% Suicideᵃ 34.3 13.9-34.5*
  14. Health Indicator Pacific County WA State Motor vehicle crash death rateͨ 27/100,000 12/100,000 Child unintentional injury hospitalizationsᵃ 326/100,000 205/100,000 Mortality from unintentional injuryᵃ 54.1 30.2-58.1* Influenza Vaccination (65 yrs or older)ᵃ 71% 72% Infant mortalityᵃ 6.5% 3.3-9.5* Post-neonatal infant mortalityᵃ 3.0% 0.0-5.0%* Adults with unmet medical needᵃ 16% 14% Adults with personal healthcare providerᵃ 76% 79% Adult dental careᵃ 63% 74% Adult with health insuranceᵃ 72% 84%
  15. Adult and teen obesity Adult and teen physical activity Adult access to dental care
  16. Obesity/Physical Activities › What types of outdoor activities are available? › What programs exist to encourage physical activity? › What healthy food education or programs are available or of interest to the community? › What types of resources are desired by the community to promote physical activity and health foods? › What existing resources can be strengthened or advanced? › What resources are need to build on existing strengths, address barriers, or develop new programs?
  17. Adult Dental Access › What are the local resources for adult dental care? › What are your non-dental and emergency care providers observing in adult dental issues? › What are the known barriers to adult dental care access? › What resources are needed to increase adult dental care access? › If additional dental providers were available, how could services be offered to increase access?
  18. “Fit and Fun” model (Rural Healthy People 2010 Project, Southwest Rural Health Research Center, 2010)  School and community-based fitness and nutrition strategy  Initially implemented in Gowanda, New York in 1999  Community collaboration with state rural health network organization and five community partners.
  19. Program Components › Healthy Snack Taste Testing › Healthy Choices Sticker Program › Fitness Bucks › Fit & Fun Relay Night › Family Fit & Fun Night  Recommended staffing: › Part-time paid program coordinator, public relations coordinator, finance staff person and clerical support (part-time). › Volunteer program support
  20. Funding required › Initial five-year foundation or other grant funding recommended  Program effectiveness › Student selection of new foods, amount and frequency of student daily physical activity, and number of students and adults receiving information/education and participating in activities.
  21. Work with community to identify additional environmental infrastructure to support and encourage physical activity such as: › Walking paths, bicycling paths, beach routes  Identify and obtain foundation/grant funding for completion of paved trails in north and south county regions (Pacific County Economic Development Council, 2009)
  22.  Protocol for Assessing Community Excellence in Environmental Health (PACE-EH)  Four major components with 13 subtasks › Assess the community › Define the Problem › Take action › Evaluation (National Association of County and City Health Officials)
  23.  Pacific County is a rural county with majority of health indicators performing worse than WA State comparison  Selected Priority health issue: Adult and teen obesity  Recommended intervention: “Fit and Fun” model (Southwest Rural Health Research Center)
  24. Community Health Services (2010). Health care authority funded community clinics in Washington State. Retrieved from County Health Rankings (2010). Snapshot 2010: Pacific. Retrieved from http:// www.countyhealthrankings.corg/print/washington/pacific Mapquest (2010). Pacific County, Washington. Retrieved from ongitude=-123.665001&geocode=CITY Pacific County Economic Development Council (2009). Comprehensive development strategy for Pacific County. Retrieved from 2009%20PCCEDS1.pdf Southwest Rural Health Research Center (2010). Models for practice focus area: Educational and community-based programs. Rural Healthy People 2010. Retrieved from University of Washington (2005). Telehealth services at the University of Washington: Current telehealth activities and partner. Retrieved from /present.php U.S. Census Bureau (2000). Profile of General Demographic Characteristics. Retrieved from U.S. Department of Labor, Bureau of Labor Statistics (2010). Local Area Unemployment Statistics. Retrieved from
  25. U.S. Department of Health & Human Services (2009). Community Health Status Indicators. Retrieved from U.S. Department of Labor, Bureau of Labor Statistics (2010). Local Area Unemployment Statistics. Retrieved from U.S Bureau of the Census (2010). Washington State Department of Health (2006). Access to Hospital-based Perinatal and Neonatal Care. Retrieved from Washington State Department of Health, Rural Health Programs (2009). Federally Designated Rural Health Clinics by County as of July 1, 2009. Retrieved from /Fed_DesignRHCs.pdf Washington State Department of Social & Health Services (2007). DSHS Client Services, July 2006 – June 2007). Retrieved from Washington State Department of Health (2009). Pacific County Public Health and Human Services Department. Retrieved from pacific/access/access1.htm Washington State Department of Social & Health Services (2010). Authorized community mental health agencies. Retrieved from