Editor’s note: This is the first in a series of articles exploring the results of the Jasper County Community Health Needs Assessment.
Mental health and substance misuse ranked as the highest community health needs in the latest Community Health Needs Assessment (CHNA) for Jasper County. Jasper County Health Department Administrator Becky Pryor shared the results of the assessment with the board of health at its Jan. 9 meeting.
Along with MercyOne Newton Medical Center, the Jasper County Health Department conducted the overview of the county starting in May 2024. A 43-question survey was available for citizens to share their personal experiences throughout the month with 373 responses collected in that time.
The CHNA Advisory Committee also held a community town hall meeting in September to gain additional data. At the meeting, 82 local partners convened for a data presentation and prioritization workshop. Attendees were briefed on four different broad health topics based upon the results of primary and secondary data analysis. They included access to medical care, mental health or substance use disorders, active living, healthy eating, and lifestyle, and social, economic and environmental factors.
The participants were able to engage in table discussions following each presentation and delve further into information made available on the topics. Each group then identified the top two issues related to each need along with submitting individual responses for the top three strengths and top three gaps related to health in Jasper County.
After all data was collected, the advisory committee then ranked the identified significant health needs based on the number of people impacted, impact on vulnerable populations, importance to the community and feasibility of change. MercyOne Newton Medical Center, the Jasper County Health Department and the advisory committee reconvened in December to develop an action plan from the assessment to develop a Community Health Improvement Plan.
“There is a team that worked on all of this, I was a part of that team, and we put in a lot of blood, sweat and tears into this,” board of health chair Julie Smith said. “Becky has put a lot of time into organizing this report. She does a great job. It is very thorough and I do feel like Jasper County has a lot of needs but we also have a lot of resources that people aren’t aware of ... we justneed to make sure they know how to get to them.”
MENTAL HEALTH AND SUBSTANCE ABUSE
Ranked first in priority, mental health and substance abuse issues once again top the list for Jasper County. Secondary data indicates there are significantly less mental health providers in Jasper County than in Iowa or the United States.
Additional factors contributing to mental health and substance abuse leading needs are:
• The mental health professional shortage and mental health and substance use treatment and inpatient were two of the top concerns identified at the community town hall.
• More than 30 percent of survey respondents reported fair or poor mental health.
• Mental health was rated the No. 3 priority by survey respondents, and substance misuse was rated fifth.
• Mental health was rated the second highest needed improvement in Jasper County by survey respondents, and substance misuse was rated third highest.
• Almost 80 percent of survey respondents reported knowing someone who talked about/attempted/died by suicide.
• Almost 75 percent of survey respondents reported that they have been personally impacted by substance misuse.
According to Centers for Medicare and Medicaid Services (CMS), Jasper County has 66.11 mental health providers per 100,000 population, much less than the State of Iowa at 136.69 per 100,000 and the United States at 183.75 per 100,000
Mental health providers include licensed clinical social workers and other credentialed professionals specializing in psychiatry, psychology, counseling, or child, adolescent or adult mental health. Jasper County has 25 providers with a CMS National Provider Identifier.
“This is really alarming to me — lack of healthcare professionals,” Pryor said. “That would be doctors, mid-level providers, nurses, people that need training in order to work. Working with DMACC in Newton we thought would be a great resource to start with. Also, working with the medical schools in Iowa, Des Moines University and Dubuque to try to more providers here.”
With the county, 14.3 percent of adults reported poor mental health in the past month and 18.2 percent of adults aged 18 and older reported having depressive disorder. Both are within .12 percent of the state averages.
Jasper County’s rate of suicide is 20.8 per 100,000. It is higher than state average of 17.1 per 100,000 and the national 14.5 per 100,000 rate.
Healthy People 2030 has identified reducing suicide rates as a leading health indicator and said suicide rates have increased in almost every state during the last two decades. This indicator is relevant because suicide is an indicator of poor mental health.
Children’s mental health had themes of access to care — more providers and services — and training and support for school staff.
In Jasper County, it was found 74.2 percent of those surveyed said they have been personally impacted by substance misuse, with 28 percent reporting the issue impacts them a lot or a great deal. Of those affected, alcohol was named as the leading substance abused at 14.09 percent, followed by tobacco products at 9.12 percent, E-cigarettes or vaping at 7.18 percent, marijuana or THC at 7.18 percent, CBDat 5.18 percent and prescription drugs not prescribed to the user at 1.38 percent.
For alcohol consumption in Jasper County, 19 percent of adults report binge or heavy drinking. That number is slightly less than the state at 19.72 percent but exceeds the Healthy People 2030 target of 25.5 percent.
According to the Center for Disease Control, since 2009 an increasing proportion of drug overdose deaths have been caused by opioids, with overdose deaths involving opioids increasing 15 percent from 2020 to 2021. In Jasper County, there were 108 suspected drug overdose visits in 2022.
Jasper County does have a higher than average percentage of addiction and substance abuse treatment providers. The county rates at 31.74 percent per 100,000 population while the state is at 22.38 percent and nation at 28.28 percent.
To address the issue, the county named four objectives to begin work on during the next couple of years.
1. Increase the number of mental health and substance misuse providers in Jasper County by Dec. 31, 2027. Work to complete this task includes having Capstone Behavioral Health explore options for students and interns, explore opportunities to partner with substance treatment providers, explore recruitment and retention for mental health providers and launch a marketing campaign to recruit providers.
2. Work with the county’s five school districts to increase mental health counselors and substance misuse prevention programs by Dec. 31, 2027. Capstone will work with schools to explore options for mental health services and employee and family resources and school resource officers will work with schools to explore evidence-based prevention programs in schools.
“We know that schools are desperate to have more mental health providers and more education about preventing substance misuse in the schools,” Pryor said.
3. Provide and increase the access and outreach to the distribution of mental health resources to the public by Dec. 31, 2026. The county will coordinate with Jasper County Cares Coalition to launch a social media campaign of available resources and offer materials for the Jasper County Cares Resource Table and online Resource Guide.
4. Promote the Mental Health America screening link by Dec. 31, 2025. The county will activate a media and social media campaign about the screening link, MercyOne Newton will promote the link to providers and Capstone will discuss screening tools including the PHQ9 and GAD7 with Jasper County Cares Coalition.