Cass County health assessment shows concern over mental health, tobacco use

Aug. 31—Mental health, substance abuse and tobacco use were among the top concerns of area residents according to a recent survey of Cass County residents.

Healthcare providers and community leaders gathered Tuesday for an online presentation describing the results of the Cass County Community Health Needs Assessment. Assessments must be completed in communities every three years and cover topics such as accessibility to healthcare, types of care provided, health concerns among residents, and trends in various conditions and diseases.

By using the data compiled in the Community Health Needs Assessment, healthcare professionals in Cass County can prioritize issues with the widest scope and severity that they have the greatest ability to impact. Feedback from community partners will also help determine which issues should be prioritized for the good of the community.

This year's assessment for Cass County was completed by Logansport Memorial Hospital and its research partner PRC, Inc.

The data was obtained through assessments and surveys distributed to community members. Bruce Lockwood, senior vice president of PRC, Inc., presented the data and emphasized only a small fraction of the information collected could be shared, and the final report is being put together for the hospital. He also said the presentation may focus on negative data, but there are many positive findings as well.

Lockwood went into detail about 13 various "areas of opportunity" health issues facing Cass County residents including access to health care services, cancer, diabetes, heart disease/stroke, infant health/family planning, injury/violence, mental health, nutrition/physical activity/weight, potentially disabling conditions, respiratory disease, septicemia, substance abuse, and tobacco use.

According to data collected from key informants, four of the top health issues respondents identified as top concerns include mental health, substance abuse, tobacco use, and nutrition, physical age and weight, respectively. A total of 74.4% of respondents identified mental health as a major problem while 23.3% labeled mental health a moderate problem.

Additionally, 24.5% of Cass County residents reported their health as "fair" or "poor," which Lockwood said is significantly less favorable than statewide and nationwide statistics. Many of the individuals experiencing fair or poor health in Cass County are over the age of 65 years old and/or low income. Indiana's average number of respondents with fair or poor health is 15.9%, while the national average is 12.6%.

The data also showed that Cass County residents faced some crucial barriers to accessing medical care over the past year. Nearly 7.9% of Cass County adults lack health insurance coverage. Of those who sought medical care, one in four people struggled with access. Around 21.4%, or about one in five people, struggled to get an appointment. Another 14.9% of respondents struggled to find a doctor to visit, and similar numbers of respondents did not seek medical care because of inconvenient office hours or the high cost of prescriptions.

Lockwood then discussed the leading causes of death in Cass County during 2020. Cancer, one of the county's areas of opportunity, is at the top of the list. Cancer causes approximately 19.8% of the deaths in Cass County. He said there are a particularly high number of lung cancer cases that resulted in a high number of deaths and a lower-than-average number of cervical cancer and colorectal cancer screenings within the county.

The second leading cause of death was tied between heart disease and COVID-19, which each caused 14.7% of the deaths in 2020. High blood pressure and high cholesterol can both lead to heart disease, and 45% of Cass County adults responded that they have been told they have high blood pressure. Out of the most common risk factors for heart disease and strokes, Lockwood said the majority of Cass County residents have at least one of those risk factors.

Another important area of opportunity in Cass County is diabetes and kidney disease. Residents' responses indicated that around 16.3% of adults are struggling with diabetes. The strongest correlation between the disease and Cass County residents was age. Lockwood said the majority of respondents who have been diagnosed with diabetes are 65 years old or older.

The assessment also looked at infant health and family planning within the county, specifically the infant mortality rate and teen birth rates. At 8.9%, Cass County has one of the highest infant mortality rates in the entire state.

"It is significantly above what we see at state and national levels," Lockwood said.

Cass County's teen birth rate is also staggeringly high at 34.6%. Indiana's teen birth rate is 23.1% and the national average is 19.3%.

Lockwood said there has been a "sharp incline" in unintentional injury deaths. The number one cause of unintentional injury deaths is poisoning/drug overdoses at over 30%, surpassing motor vehicle deaths.

In terms of mental health, Cass County residents are also struggling. The percentage of people who indicated "fair" or "poor" mental health rose from 7.8% in 2013 to 18.8% in 2022. The assessment found that younger women are more at risk of poor mental health. Cass County's suicide mortality is also higher than state and national levels.

Nutrition, physical activity and weight is another category addressed in the assessment. According to respondents' body mass indexes, 72.4% of Cass County adults are either overweight or obese. About 44.1% of adults are obese, which is higher than state and national averages. There has also been an increase in childhood obesity.

Additionally, higher numbers of low-income respondents and respondents between the ages of 40 and 64 years old indicated that they find it difficult to find affordable fresh produce.

About 26% of residents indicated that they are limited in mobility due to disabling conditions, and 46.8% of residents are currently dealing with three or more chronic conditions that affect their health. The majority of residents struggling with three or more chronic health conditions are at least 65 years old. The assessment also noted that mortality due to Alzheimer's Disease are increasing throughout the county.

Respiratory disease and COVID-19 have also affected Cass County residents. The assessment found that the age adjusted mortality rate for COVID-19 within the county is 137.3 deaths for each 1,000 residents, which is much higher than state and national averages.

Two of the last areas of opportunity assessed were substance abuse and tobacco use. Lockwood noted that the percentage of respondents who admitted to using illicit drugs within the past year was very low, but higher than in previous years. About 3% of respondents indicated using illicit drugs, but Lockwood said that number is "certainly underreported."

Drug overdoses have been the most prolific reason for accidental deaths, and respondents indicated that substance abuse, whether their own or a family member's, is a factor in about 35% of Cass County residents' lives.

Respondents also indicated that 19% of adults within the county smoke cigarettes and 6.8% of adults vape, although vaping is more popular among young adults. Out of adult smokers, nearly one in four people are considered low-income.

Byrd said the hospital will publish the full report of data and work over the next few weeks to determine which issues will receive highest priority over the next three years.