Every three years each local health department is required by the Mo. Dept of Health and Senior Services to collect and analyze data provided by research done both locally and through various state agency websites.  This past year, surveys were sent out to various stakeholders within the community to complete. These were then sent to an independent contractor to be analyzed. After determining the three top priorities that were selected by stakeholders, a focus group was selected. As in 2005, the group was chosen from the Washington County Partnership. It is called the Washington County Health Coalition. It is comprised of school officials, C2000 Partnership staff, Vista Coordinator, Washington County Memorial Hospital representative, MC+ Coordinator, Rural Parish Workers, and the health department staff.

After reviewing the Wash. Co. Community Assessment primary and secondary data, the Health Coalition selected top three priority health problems for Washington County for 2009. These include 1) Abuse and Neglect, 2) Alcohol and Substance abuse, and 3) Smoking and Health. It is not unusual that these three behavioral risk problems could co- exist in a community. When families are stressed due to low economic conditions, lack of transportation, and other social issues, they often turn to less healthy behaviors. The Wash. Co. Health Department, the Health Coalition along with other state and local partners will develop evidence based strategies to address these issues.  

According to the latest Community Assessment, child abuse and neglect rates in Washington County are higher than the state rates. The 2007 county rate was 6.45 (per 1000) as compared to the state rate of 4.61. Rates prior had been declining since 2004 but increased slightly from 2006-2007. The majority of Washington County cases of child abuse and neglect were related to physical abuse, neglect, and sexual maltreatment. The Mo. Department of Health and Senior Services Assault Injury Profile indicated 63 emergency room visits in Wash Co were recorded as child abuse during the 1996-2006 time periods. This is equal to a county rate of 0.9 as compared to the state rate of 0.6.

In addition, the same report also records the number of incidents of Adult Abuse. For the 1996-2006 time periods, there were 96 emergency room visits for a county rate of 0.5 as compared to the state rate of 0.2. We know that “children who are abuse and neglect victims are at increased risk for risky behavior: (Source: Felitti et al. 1998)

There were 33 deaths in Washington County during the 1996-2006 time period that were alcohol/drug induced according to the Mo. Department of Health and Senior Services Leading cause of Death Profile. In addition, the Mo. State Highway Patrol statistics indicate an increasing number of arrests due to narcotics during the 2003-2007 time periods. This is why the second priority problem to be addressed for the next three years continues to be the high rate of alcohol and drug abuse that continues in Washington County. The Community Outreach Prevention Education Program has been working on this issue for the past three years to reduce binge drinking in youth. There has been data collection done through surveys and other sources along with discussion on why people in Wash. Co choose to abuse alcohol and use drugs. Along with education, non alcoholic activities for youth and adults have been provided. Furthermore, training has been provided to the Potosi Police Department along with equipment to crack down drunk driving. The incidence of DUI arrests and drug related arrests fell in 2007. In the next three years, we will continue to address this issue by working with other partners to continue to work with COPE and Wash Co. Partnership 2000 to find funding for healthy recreational activities, including a skateboard park, bicycle trails, a youth center and positive, healthy activities for youth. These have been planned but not finished due to lack of funding.   

Finally, Washington County has the highest incidence rate of lung cancer and childhood asthma (ages 1-4) emergency room visits in the state. According to the Mo. Dept. of Health and Senior Services, 34.7% of Washington County residents smoke. The National Institute on Drug Abuses reported that 528 people in Washington Co. died from smoking related problems from 1996-2006. This puts the county rate at 214.6 as compared to the state rate of 157.6.  It is a well known fact that tobacco is leading preventable cause of death in the United States. It attributes to heart disease, stroke, cancer, asthma, and other respiratory diseases. The health department, along with the Wash. Co Memorial Hospital Wash Co Partnership 2000, School Health Advisory Council and other stakeholders are committed to reducing the number of ER visits from childhood asthma and other respiratory diseases by joining forces to obtain MFH Asthma grant (WCMH) and the MFH Tobacco Grant (Wash. Co. Partnership). The health department will assist by providing tobacco cessation classes and doing in home environmental assessments to determine triggers that are causing problems with asthma as well as providing education materials and referrals to appropriate agencies.   

The Washington County Health Department realizes that these are not the only issues affecting residents of our county. Lead and other environmental hazards continue to need to be addressed. (The health department has done extensive lead testing in the past five years on children. Significant gains have been made in reducing the number of childhood elevated lead levels through screening, referral, and education. This has been accomplished by working with EPA, DNR, and DHSS).

Nuisance ordinances and sanitation issues need to be tackled by policy makers in order to prevent disease and promote health. More work needs to be done to provide safe drinking water and sanitation service for all residents in Wash. Co. By working together as a community, we can achieve these goals.

In addition, obesity and the lack of physical activity remain very high among all age groups. The current economic downturn is just contributing more to the problem because fresh fruits and vegetables are often expensive and families on a low income often can’t afford them and turn to cheaper “filler” foods with a lot of calories. The family garden has become a thing of the past but with funding and assistance from local and state participants, Wash. Co residents could start community gardens to share their produce and increase the number of Farmer’s Market sites to include more farmers and home grown products, and provide income for local residents.

The Washington County Health Department has been committed to tackling tough problems for over fifty years. We have always assessed what the problems are and committed time and energy into problem solving to find solutions. When a problem has been solved or a better solution occurs, we switch our focus to the next barrier. We will continue to serve the residents in Wash. County in this next decade by educating ourselves on the best practices and utilizing our resources as efficiently as possible. It does however, take residents, businesses, schools, and government to work together to make a healthy community.