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Community Health Needs Assessment

St. Vincent Healthcare CEO Steve Loveless, right, opens a Community Health Needs Assessment press conference at the Billings Public Library with RiverStone Health CEO John Felton, left, and Billings Clinic interim CEO Randy Gibb.

The overall health and mental health of Yellowstone County residents is worse than it was a dozen years ago, even though they have access to more treatment and are seeking it out, a recent report shows.

Officials from The Alliance — a partnership between RiverStone Health, St. Vincent Healthcare and Billings Clinic — and the Healthy by Design Community Coalition on Monday released the findings of the 2016-17 Community Health Needs Assessment, a regular study and survey of the health, behaviors and needs of the county's population. 

Officials framed it as an overall assessment of the community's health and as a resource that organizations, businesses and residents can use as a jumping-off point for health-focused conversations and efforts.

"We don't get here easily, and we're not going to get better easily, but we also know that this community is spectacularly good at coming together and finding solutions to problems," said John Felton, RiverStone president and CEO.

The report keys in on mental health, substance abuse and combined factors of nutrition, healthy weight and physical activity as the most pressing health issues in Yellowstone County.

It interviewed 400 county residents — with consideration taken to make sure they match the county's overall population demographics — using a 25- to 35-minute questionnaire that covered a wide range of health issues in the community. They also surveyed nearly 200 key community members including health care providers and public health and government representatives.

Officials also compared the new numbers to past health needs assessments conducted on 2005-2006, 2010-2011 and 2013-2014.

Among the report's findings is an indication that more people reported a lower grade of health than in the initial study, with 15.4 percent saying their overall health was fair or poor compared to 10.4 in the first study.

Mental health

On the mental health side, the report notes that about a quarter of Yellowstone County adults have been diagnosed with depression while nearly a third reported having a period of two or more years in which they felt depressed most days, both higher than national numbers.

In addition, 35 percent have sought out mental health help, which is higher than the national average, but the county's suicide rate of 22.8 per 100,000 people remains near the Montana average of 23.4, and both are much higher than the national average of 12.7.

"Despite that fact that people are seeking mental health treatment at a higher rate, we're not really impacting the suicide rate," said Dr. Randy Gibb, interim CEO of Billings Clinic.

It's an opportunity, he said, to begin asking questions about ways to approach suicide and mental health issues using hard data from the survey.

Obesity

The report also indicates that nearly two-thirds of county adults are overweight and a third are considered obese. Both those figures are near national numbers. About 30 percent reported they eat the recommended daily servings of fruit and vegetables.

The obesity and overweight rates of children in Yellowstone County of 14 and 28.8 percent are both above the national averages.

"We all need to work together to find solutions to being healthier," Felton said.

Substance abuse

Substance abuse also plays a major role in the community's health, the report indicates. More than 45 percent of the people surveyed reported that their lives had been negatively effected by substance abuse. Three out of five adults drink, and one out of five are considered to be excessive drinkers, according to the survey.

Running through each of the various categories within the assessment, income disparity is a major factor in the community's health. In many cases, low-income residents are more likely to have poorer health or higher health risks, the report says.

"There's a clear correlation between income and health that we're continuing to work on," Felton said.

The report also looks at topics ranging from access to health care to tobacco use, from cancer and other disease rates to injury and violence prevention.

St. Vincent CEO Steve Loveless called it "a great coming together of the medical community" while Heather Fink, Healthy by Design community health improvement manager, described the assessment as a collection of information that can be used by anybody in the community.

"There's an opportunity for this data to be owned by the community," she said. "There's always an opportunity to look at health. It's one piece of information that allows us to start a conversation."

Editor's note: This article has been updated to properly attribute the quote at the end of the story to Heather Fink. An earlier version attributed it to Steve Loveless

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