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Example 12: Quality of Life Assessment for Richland County, Montana

In 2007, the Richland County Public Health Department conducted a survey process to evaluate the overall health, safety, and wellness of Richland County residents.  They used an approach called Mobilizing Action through Partnership and Planning, or MAPP. The community assessment looked at social circumstances, environmental conditions, economic development, and county/city growth policies.

DESCRIBE THE MAKEUP AND HISTORY OF THE COMMUNITY:

First, demographic and other statistical information was collected about the physical health of the Richland County residents: Community Health Assessment.

A County Windshield Survey was also conducted. AmeriCore*VISTA members were taken on car tours of each town in Richland County guided by two residents from each town. Discussion topics included health, environment, youth, seniors, local business, housing, protection, transportation/road conditions, and safety. City of Sidney Windshield Survey.

DESCRIBE WHAT MATTERS TO PEOPLE IN THE COMMUNITY:

Several methods were used approaches were taken to learn about the broad array of issues that matter to people in the community.

  • A County Telephone Survey was conducted by the University of Montana’s Bureau of Business and Economic Research, which contacted a random sampling of residents. The topics chosen by area groups for this survey included local housing, business, volunteerism, and the importance of a local school system to their community. Richland County Telephone Survey.
  • To assess the views of youth, the young people of the community were given a chance to voice their opinions on what they liked and what they would change about their communities. They used a methodology called PhotoVoice. Youth were given disposable cameras and asked to take photos of the positive areas of their community and the areas that needed improvement: Richland County PhotoVoice slideshow.
  • The views of the elderly were also assessed. Focus groups were formed to address senior citizens’ accessibility to physical activity. Seniors were asked to comment on what forms of exercise were currently available to them, what barriers existed that prevented physical activity, and what changes and programs they would like implemented in the future. Richland County Senior Focus Group.
  • Written surveys were given out to Richland County residents inquiring about their views on various environmental health topics. The top concerns that surfaced from this survey were: Illegal drugs and alcohol use, road safety and unsafe drivers, crime and domestic violence, oil/gas development, water and air quality, and the quality of medical facilities. Environmental Health in Richland County.
  • Finally, a Local Public Health System Assessment was conducted using the Local Public Health System Performance Assessment Instrument. This instrument evaluated the performance and implementation of ten essential services that the community should do: monitor health status; diagnose and investigate health problems; inform, educate and empower people; develop policies and plans; link people to needed personal health services; assure a competent workforce; evaluate effectiveness, accessibility, and quality of services; and research for new insights and innovative solutions. These ten essential services are guidelines for the optimal performance of the public health system. Richland County Local Public Health System Assessment.
  • In an effort to look to the future, a Forces of Change assessment was performed by members of the organization in charge of this effort, the Communities In Action Steering Committee. This was a brainstorming activity that looked at potential forces of change in the community and the potential threats and opportunities created from each change. Some examples of these factors include political or legislative changes, demographic shifts, or changes in availability of natural resources. Richland County Forces of Change Assessment.

RESULT FROM THESE ASSESSMENTS INDICATING THE PRIORITIES OF THE RESIDENTS OF RICHLAND COUNTY:

Housing needs: Statistics indicate that housing in Richland County has become scarce since the beginning of the oil boom in 2001 due to the influx of transient workers employed in the oil fields. Of those who responded to the telephone survey, 85% said there is not enough housing in Richland County.  Many responders also indicated that the “wrong type” of housing is available, as most of the housing units in the county are single family residences.  The EPHT report states that there are waiting lists for all apartment complexes in the county, and that many families and individuals are living in hotels or motels until permanent housing becomes available.  As the oil boom occurred a year after the most recent census, taken in 2000, most data on this subject is outdated.

Water quality: The County Windshield Survey reported that drinking water is of “fair” to “poor” quality and that bleach and water softener must be added to make the water clean and useable. An exception to this is the town of Lambert, where a new water system was recently installed; water quality here is reported as “very good.” Residents wonder if the water in the county is being regularly monitored and by whom. This is especially a concern because of the recent oil and gas development in the area. Currently, the aquifer along the Yellowstone River, which is the source of the local water supply, is being studied along with water samples from Sidney and Fairview.

Illegal drugs and alcohol abuse: The Environmental Health Assessment and the County Telephone Survey both rated illegal drugs and alcohol abuse as the number one concern among residents of Richland County. Findings, however, show that illegal drug use may not be as prevalent as the public perceives.  The Montana Board of Crime Control reports that the percentage of drug offenses relative to the fluctuating county population has actually decreased since 1998.  According to a 2004 study, marijuana was used more frequently than stimulant drugs, but for 8th and 10th graders, marijuana was used to a lesser degree than the state average. Twelfth grade results were on par with the state average.  Alcohol, on the other hand, affects a large percentage of the population, including among youth under the age of 18. In 2004 it was reported that 66% of youth binge drink (i.e., the consumption of 5 or more drinks per sitting), 78% said they had tried alcohol within the past 30 days, and 94% said they will be a lifetime user of alcohol.

DESCRIBE THE BARRIERS AND RESOURCES FOR ADDRESSING THE IDENTIFIED ISSUES:

The Richland County Health Department directly assessed barriers and resources through the Forces of Change assessment, in which “threats posed” and “opportunities created” were identified for each factor or trend. One identified trend was the increasing amount of truck traffic on the highways due to the oil boom.  This posed a threat, because these conditions were harsh on the roads, creating wear and tear which in turn caused automobile accidents. A potential opportunity resulting from this trend was a reason to lobby the federal government for money for highway maintenance.  Another trend was the increasing use of methamphetamines within the community.  This led to the threat of increased crime and drug addiction.  It created the opportunity to increase law enforcement infrastructure and making resources available for meth users who wanted help quitting. A third trend was the increase in internet accessibility in the community. This threatens local business in the downtown areas of Richland County, as people have access to many the same goods online. However, while this access to other goods may harm businesses, it is also a benefit for the people who can now buy products that were previously not obtainable. Additionally, the internet allows access to higher education that is not available locally. Richland County Forces of Change Assessment.

SELECT AND STATE THE PRIORITY ISSUE (OR ISSUES ) TO BE ADDRESSED BY THE GROUP:

A team of community representatives was formed into the Community Environmental Health Assessment Team, or CEHAT, to guide and facilitate the Environmental Health Assessment. This group recommended some priorities for action and action steps: llegal drugs, alcohol abuse, and domestic violence; water quality; quality of medical facilities; oil and gas development; and unsafe drivers. Environmental Health in Richland County.

These recommendations are a good way to start narrowing down the community’s top concerns. However, these recommendations do not take into account the information from the other seven assessments and may not accurately affect information collected in these other ways. Now that a list of concerns has been compiled, Richland County residents must decided which issues are most critical for the community to address. Only then will the community be able to formulate goals and strategies for success, and then finally put the plan into motion.