This document provides an overview of Pend Oreille County, Washington, including its demographics, economy, health infrastructure, and key health issues. Pend Oreille County has a small, isolated, and rural population with higher rates of poverty, unemployment, and certain health issues compared to the state average. Two high priority health issues are diabetes and fall-related injuries among older residents. The document proposes implementing a fall prevention program in Pend Oreille County based on an effective model from Tucson, Arizona to address the issue of falls through home assessments, safety installations, and education. It suggests engaging community stakeholders to identify additional priorities and gain support for interventions.
2. Pend Oreille (pronounced pond-ə-ray) County is located in the northeastern-most corner of Washington State.
3. Pend Oreille County Overview Small Town and Isolated Rural community Population - 12,859 Total Area - 1,425 sq. miles The county seat and largest city is Newport. Major industries include light manufacturing, value-added wood products and recreational products Known for its beautiful scenery and recreational opportunities for tourists
4. Pend Oreille County Overview - Demographics Gender Female - 50.1% Male - 49.9% Age Under 18 – 20.9% Over 65 – 16.5% Race/Ethnicity White - 90.8% American Indian/Alaskan Native – 3.0% Hispanic/Latino – 2.7% Multi-racial – 2.4% Asian/Pacific Islander – 0.6% Black/African American – 0.3% Source 2000 U.S. Census Data
5. Pend Oreille County Overview - Economy Poverty Rate (2008): Pend Oreille Co. 18.8% WA State 11.3% Median Household Income (2007): Pend Oreille Co. $35,788 WA State $55,771 Unemployment rate (first quarter of 2010): Pend Oreille Co. 16.3% WA State 10.2% Total Employment Growth (first quarter of 2010): Pend Oreille Co. -4.7% WA State -1.8% Source: U.S. Department of Labor
7. Pend Oreille County - Health Care Infrastructure Over 75% of the county is more than 30 minutes away from both Acute and Obstetric (OB) care TIME TO OB CARE TIME TO ACUTE CARE
8. Pend Oreille County - Health Care Infrastructure Designated a Health Professional Shortage Area for both Primary Care and Mental Health Served by a single Level IV trauma hospital in Newport Nearest pediatric trauma center of any designation is in Spokane which is 48 miles south of Newport Two clinics - One Community Health Clinic in the north-central town of Ione Two rural health clinics in Newport
10. What are the leading health concerns in Pend Oreille County? Chronic diseases that many Americans face: diabetes cardiovascular disease Health concerns that many other rural communities face: Increase smoking rates Higher suicide rates Higher intentional and unintentional injury rates - but unlike residents of urban communities they have fewer resources with which to manage their illnesses.
11. High Priority Health Issues in Pend Oreille County Two examples of very different health issues: Diabetes is an important chronic health concern facing many Americans including the residents of Pend Oreille County Fall-related injury and death is a health concern that is specific to residents of Pend Oreille County
12. A High Priority Health Issue in Pend Oreille – Diabetes In Pend Oreille and Washington State, one in 14 adults have diabetes (2010). Source: Washington Department of Health (2010)).
13. A High Priority Health Issue in Pend Oreille – Fall-Related Injuries and Deaths Pend Oreille has 1.5x the incidence of both fall-related hospitalizations and fall-related deaths relative to WA State (2003-2007). Source: Washington Department of Health (2009).
14. A Model for Community Level Interventions – Prevention of Fall-related Injuries and Deaths Many communities across the U.S. are attempting to address the issue of fall-related injury and death especially in elders The interventions that have been proven to be effective by the Centers for Disease Control (2009) comprise the following: Home assessment by professionally and/or community-trained individuals Client education on fall prevention strategies Clinical assessment of patient medications, physical health and mental functioning Home repair and safety device installation
15. The Fall Prevention Program in Tucson, Arizona An Effective Fall Prevention Programs Identified by the CDC Collaborative program between the University of Arizona (UA) and local/state government Home Assessment – conducted by fire department personnel, every client receives a Safety Bag containing: smoke alarms, nightlights, flashlights, batteries, counter mat, pot holders, timers, double-sided carpet tape, installation of grab bars, bathtub appliqués, oven sticks, light bulbs, reflective tape, and a non-skid rug Home Repair – if necessary clients are referred to a subsidized home repair program Clinical Assessment – student nurses from UA or a public health nurse conduct a fall risk assessment and provide clients with education and resources on fall prevention Follow-up – the nurse (or student nurse) makes referral to appropriate community organization for follow-up
16. The Implementation of a Fall Prevention Program in Pend Oreille County – Assessment Home Assessor Options Trained local volunteers High School Students interested in a career in Health sciences AmeriCorps participants (preferably those hired from the Pend Oreille County community) Clinical Assessor Options WSU nurse students Pend Oreille Co. Grant-funded public health nurses
17. The Implementation of a Fall Prevention Program in Pend Oreille County – Home Repair and Safety Device Installation Secure a grant to pay currently unemployed residents to do home repairs and install safety devices in the homes of elders who have had their initial assessment Also a program could be implemented in the high school or community college to train interested individuals
18. The Implementation of a Fall Prevention Program in Pend Oreille County – Follow-up Follow-up could be conducted by student nurse, trained community members or social workers A program could be initiated to train elders on fall prevention education providing individuals with a social outlet and out-of-home physical activities.
19. TIME OUTSo What Does the Pend Oreille County Community Identify as Its High Priority Health Issues? How do we know that the residents of Pend Oreille County want to make changes in the area of fall prevention or any of the other health concerns we have identified? Looking beyond the data – how do we engage the community in identifying health priorities and implementing change? Town Hall Meetings Surveys Asking Health Care Providers Newport, WA
20. Using the Protocol for Assessing Community Excellence in Environmental Health (PACE-EH) community engagement tool PACE-EH was developed as a tool for community assessment and health intervention Main features (from Public Health Grand Rounds): requires that scientific data is collected and made available during all decision-making sessions. involve as many of the community leaders as possible to create public health partnerships that work to share institutional strengths. (As we well know, work is much more effective when done in collaboration with organizations and individuals in their communities) http://www.publichealthgrandrounds.unc.edu/places/handout_PACEHuse.pdf
21. Using the Protocol for Assessing Community Excellence in Environmental Health (PACE-EH) community engagement tool Source: http://www.publichealthgrandrounds.unc.edu/places/handout_PACEHuse.pdf
22. NEXT STEPQuestions for Community Stakeholders and Leaders Do you feel the health resources (such as health workers or clinics) exist to address these concerns? How could it be improved? What non-health interventions (such as job opportunities or better housing) do you feel would aid in improving these health concerns? Do you feel community members would be in willing to work to make changes in these areas? Do you want outside support in making health changes? If yes, what kind?
23. NEXT STEPSQuestions for Community Stakeholders and Leaders Do you feel the health infrastructure exists to address these concerns? How could it be improved? What types of non-health interventions do you feel would aid in improving these health concerns? Do you feel community members would be in willing to work to make changes in these areas? Do you want outside support in making health changes? If yes, what kind? Sand Point, WA
24. References County Health Rankings. (2010). Snapshot 2010: Pend Oreille. Retrieved from http://www.countyhealthrankings.org/washington/pend-oreille Department of Health and Human Services. “Community Health Status Indicators” Retrieved from http://communityhealth.hhs.gov/Demographics.aspx?GeogCD=53051&PeerStra t=42&state=Washington&county=Pend%20Oreille Department of Health and Human Services. “Find Shortage Areas: HPSA by State & County” Retrieved from http://hpsafind.hrsa.gov/HPSASearch.aspx Google Maps. (2010). Retrieved from http://maps.google.com/ Indiana Business Research Center. (2010). STATS Indiana – Overview of Pend Oreille County. Retrieved from http://www.stats.indiana.edu/uspr/a/usprofiles/53/us_over_sub_pr53051.html Parra, E.K., & Stevens J.A. (2000). U.S. fall prevention programs for Seniors: Selected Programs Using Home Assessment and Home Modification. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Retrieved fromhttp://www.cdc.gov/ncipc/falls/default.htm Public Health Grand Rounds. (2007). Protocol for Assessing Community Excellence in Environmental Health. Retrieved from http://www.publichealthgrandrounds.unc.edu/places/handout_PACEHuse.pdf U.S. Bureau of the Census. (2010). Pend Oreille County Quick Facts. Retrieved from http://quickfacts.census.gov/qfd/states/53/53051.html
25. References 9. U.S. Department of Labor Bureau of Labor Statistics. (2010). Local Area Unemployment Statistics. Retrieved fromhttp://www.bls.gov/lau/laucntycur14.txt Washington State Department of Health. (2006). Access of Hospital-Based Perinatal and Neonatal Care, 2006. Retrieved from http://ww4.doh.wa.gov/gis/pdf.neon)tt.pdf Washington State Department of Health. (2006). Access to the Nearest Acute Care Hospital in Washington, 2006. Retrieved from http://ww4.doh.wa.gov/gis/pdf/acute_tt.pdf Washington State Department of Health – Diabetes Control and Prevention Program. (2010). Chronic disease profile: Pend Oreille County. Retrieved from http://www.doh.wa.gov/cfh/diabetes/publications/2010-profiles/Pend-Oreille-10.pdf Washington State Department of Health – Injury & Violence Prevention Program. (2009). Washington State Injury Data Tables. Retrieved from http://www.doh.wa.gov/hsqa/emstrauma/injury/data_tables/default.htm
