ELKHART – The Elkhart County Health Department has released its first-ever Community Health Assessment.
Data is being pulled since 2019 for this in-depth assessment to better understand community needs and how the health service can help. Although the health department regularly keeps track of this information, this is the first time it has published the information collected.
The assessment explores a myriad of conditions and concerns for Elkhart County residents, including diabetes, obesity, heart disease, suicide, access to care, cancer, environmental health, diseases foodborne, pregnancy health, STIs, substance use, vaccines, and COVID-19, among other concerns.
The Ministry of Health is working on its action plan this summer and hopes to have a three-year strategic plan by the fall.
Based on the results, the Elkhart County Health Department designated three priority areas: infant mortality, mental health and sexually transmitted diseases.
Melanie Sizemore, health administrator for the Elkhart County Health Department, which organized the assessment, said infant mortality would be their primary focus, given the high infant mortality rate in the county.
“It’s a worrying topic,” she said. “If we dig deeper than the general subject of infant mortality, we see that it’s like 23.4 is the death rate in the black community, compared to 7.7 deaths per thousand in the white community. We have a very different problem depending on the race.
Still, the average infant mortality rate in the state is 6.6, while in Elkhart County the rate is 6.9. While infant mortality rates among whites have declined, rates among blacks have increased.
The 2020 Healthy People target was 6.0, but Elkhart County has maintained a constant infant mortality rate from 2018 to 2021, with 14 infants under age 1 dying in 2021, not meeting that threshold. It should be noted that Hispanic-Latino death rates have been maintained at around 6 deaths per thousand (the 2020 target) since 2017.
She said low-income families are at higher risk of infant deaths, but many can be preventable. The assessment also notes that the 46516 postcode, which contains the town of Elkhart and parts of Dunlap, had the highest mortality.
Some infant deaths, she acknowledged, are not preventable, such as birth defects, but studies have shown that things like deaths from sudden infant death syndrome are preventable. Babies must always be placed on their back to sleep, with nothing in the crib, which does not always happen.
“If we don’t work on it, it could get worse and we clearly don’t want that to happen,” Sizemore said.
Mental health was also seen as a priority, Sizemore said, particularly among children, where suicide rates doubled in the past year, with Elkhart County’s rate in 2020 nearly twice as high as the Indiana rates for children.
This increase is partly a consequence of the COVID-19 pandemic. With a 2020 Healthy People benchmark of 10 per 100,000, Elkhart County experienced 16.5 per 100,000.
“When I looked at other community health assessments from other health departments across the country, mental health also ranks high in their rankings,” Sizemore said. “And when we say that, we also have to say that we don’t have enough people trained in mental health to be able to work with people within our community. Not everyone has access to these services and they can be very expensive, so we need to find a way that everyone who needs them can access them.
Nationally, the National Institute of Mental Health determined that “poor mental health days” have increased by 15% since 2017.
“We’re gradually going up,” Sizemore said.
The health department does not offer mental health services but plans to partner with local mental health services to make changes.
The third area of concern according to the health assessment is the increase in sexually transmitted infections, with a significant increase in HIV, chlamydia, gonorrhea and syphilis.
Over the past year, HIV has doubled in Elkhart County, making that number an all-time high.
“Within our community, a prevalence of even 25 people, that’s significant because it can spread quickly if you don’t take precautions,” Sizemore said.
Compared to 95 per 100,000 in 2013, the 2021 metric is 110 per 100,000.
Chlamydia, although declining last year, has seen an overall increase over the past decade.
Sizemore explained that the health department attributes the increase to hookup apps and discovered it through contact tracing. She added that the issue is particularly relevant in the gay community.
“Most of them are treatable, but when you look at HIV it’s a lifelong disease that you will always have and it can get worse and can be fatal,” Sizemore said. “Even the treatable ones people tend to ignore and if you don’t take preventive measures you can eventually end up with HIV – not that it turns into that – just that you don’t protect yourself as you should.”
Testing is available at the health department for $25, but other places offer free testing and the health department recommends regular testing.
Other considerations based on community health assessment include youth vaccinations and overdoses.
Other key points from the study included:
Elkhart County has 17% adults and 12% uninsured children. Some of them also have disabilities for which they cannot get treatment due to a lack of insurance and the ability to afford treatment.
Elkhart County is seeing a decrease in cancer-related deaths, but a significant increase in heart disease-related deaths.
The teen pregnancy rate (aged 15-19) has fallen by 44% between 2011 and 2021.
An opioid overdose caused 87 deaths between 2014 and 2019 in Elkhart County.
The Indiana Department of Health estimates that 891 Elkhart County residents have died, with COVID-19 a contributing factor, while the known death rate is 313 per 100,000.
Local hospitals conduct community health needs assessments, which Sizemore says are similar but may not reflect those affected by social determinants of health, low socioeconomic status, or other related issues. The Community Health Assessment considered hospital assessments from Goshen Hospital and Elkhart General, but it is not a combined project. Data also comes from the state Department of Health, Center for Disease Control, and local databases.
To view the Community Health Assessment Report, visit https://health.elkhartcounty.com/en/echd-news/community-health-needs-assessment/