As of 2013, Reynolds County Health Center serves 6,599 residents in 808.48 square miles. Within these square miles there are over 51,000 acres of land belonging to the Mark Twain National Forest and Missouri Conservation Department. Reynolds County residents live in Bunker, Centerville, Ellington, and Lesterville and on small farms and acreages throughout the county. Southeast Hospital, in Cape Girardeau, has bought our only hospital in Ellington and is now known as Southeast Health of Reynolds County along with the clinic that was affiliated with the old facility known as Rains Clinic.
In March of 2014, the United States unemployment rate was 6.8% and the Missouri state rate was 7.4% compared to Reynolds County with a rate of 10.4%, the sixth highest in the state preceded by Shannon Co at 11.2%, Taney Co. & Washington Co at 11%, Stone Co at 10.9% and Hickory Co. at 10.8%. (Updated 03-2014)
According to the 2011 US Census Bureau, the median family income in Reynolds County was $33,382 compared to $47,202 for Missouri and all persons living below poverty 26.9 % compared to state rate of 15.8%. In the same profile 2011, our county children living below poverty was 43.9% compared to state rate of 22.3%. The 2013 Interdisciplinary Center for Food Security states that 65.5% of children in Reynolds County were enrolled in the free and reduced lunch program, compared to 40.9% statewide. Kids Counts 2013 reports (indicators on children only) ranked Reynolds County 96 out of 114 counties and St. Louis City. Their indicators show that Reynolds County ranked 52 out of 114 for infants born with low birth weight & births to teenage mothers ranked 21. This same profile for our county shows child abuse and neglect at 44.7% compared to state rate of 35.9%, food stamp recipients (kids) 52% compared to state rate of 39.1%.
Priority Health Issue and Supporting Data
Following the Community Health Assessment conducted in December 2013 it was determined that our county’s priority health issue is Alcohol/Drug Use and Obesity. This is impacted by lack of exercise, poor eating habits, and risky behaviors. Motor Vehicle Accidents relating to alcohol was another issue of great concern in Reynolds County.
The 2013 Status Report on Missouri’s Substance Abuse and Mental Health Problems show that the primary drug problems are Alcohol, Marijuana, & Methamphetamine. Reynolds County had 13 Drug Court Participants, 26 people on drug paroles, 2 DWI Paroles, and 18 in court ordered treatment. Police Reports shows that in 2011 there were 47 DUI/DWI, 13 Liquor Law Arrests, 65 Drug Arrests, 43 Methamphetamine Lab Incidents, 31 Violent Crimes, 92 Property Offenses, and 11 Domestic Offenses. There were 16 Alcohol related crashes, 1 alcohol crash fatality, & 1 drug crash. 2012 there were 28 admitted for abuse treatments, 11 for alcohol and 9 for marijuana. In 2011, there was 19 alcohol & 28 drug related hospital admissions along with 40 alcohol & 33 drug related ER visits.
Data from the Department of Mental Health Survey of students shows that 37.5% of youth say it’s easy to get cigarettes, 33.9% state it’s easy to get alcohol, 14.2% drink alcohol, 8% easy to get marijuana, 6.3% state they have friends who use one or the other, 8.0% state that marijuana is not a risk to use & 3.7% state it’s easy to obtain coke, meth & ecstasy.
Reynolds County population reported that 34.8% felt their health status was fair to poor while the state rate was 16.9%. No health insurance in our county was reported at 28.5% compared to a 12.3% state rate. County citizens reported 29.2% physical inactivity with the state rate of 23.0%. County residents currently smoking was 32.5% compared to the 26.5% state rate. In our county Overweight (BMI 25-29.9) was 37.2% compared to the state rate of 35.3%. Obesity (BMI >30) was 36.1% compared to 23.4% in the state. Residents in the county reported High Blood Pressure rate of 45.4% compared to the state rate of 28.5%. High cholesterol (35 years or older) was 55.9% in our county compared to the state rate of 37.3%. Diabetes rate is 14.8% compared to the state rate of 7.2%. Activity limitations in our county 36.4% compared to state rate of 17.8%, no leisure activity 32.7% and 90.4% report eating less than five fruits and vegetables a day. These health indicators are tied to lifestyle choices. Data from the Missouri Department of Health & Senior Services Website shows that deaths attributed to smoking from 2001-2011, Reynolds County’s rate was 182.8 compared to the state at 148.47.
This is supported by data from:
- University MO Extension Social Economic Profile
- MO Kids Count 2013
- Missouri Economic Research and Information Center
- MO Division of Behavioral Health – Substance Abuse & Compulsive Gambling
- MO Child Abuse and Neglect Department of Social Services Children’s Division
- MO Department Health and Senior Services
- Missouri Information for Community Assessment
- S. Census Bureau
- MO Department of Elementary and Secondary Education
Best practices, evidence-based strategies that are recommended to improve the health issues:
The Guide to Community Preventive Services recommends:
Informational approaches to nutrition, increased physical activity, and Drug/Alcohol Usage
- Community wide education
- Individual Education
- Organizational Awareness
- System Assessment
Behavioral and social approaches to increase physical activity & decrease alcohol/drug issues
- School-based physical activity & drug/alcohol education & activities
- Social support interventions in community
- Support Individually- adapted health behavior change programs
Environmental and policy approaches to increased physical activity & decreased Alcohol/Drug Isues
- Enhanced access to places of physical activity combined with informational outreach activities
- Point of decision prompts
- Community Policy Changes
- Coalition Gap Analysis of Needs
Supporting healthy weight & choices in private life and worksite settings
- Multi-component interventions aimed at diet, physical activity, and cognitive behavior change with healthy choices
Inventory of public policy, population based strategies, and community physical environment that already exists to support improvement in the priority issue:
- The School Health Initiative Program will be working with 3 schools by using the CDC School Health Index Self-Assessment & Planning Guide for Elementary/Middle/High Schools. The SHI Team will be assessing by using 8 modules consisting of School Health & Safety Policies & Environment Health Education, PE & other PE Programs, Nutrition Services, School Health Services, School Counseling, Psychological & Social Services, Health Promotion for Staff, & Family and Community Involvement with focus the first year on Nutrition & Physical Activity. They will develop a Plan for Improvement and present to the school boards.
- Reynolds County Health Center (RCHC) staff will be active participants on the School Health Advisory Boards in local schools.
- RCHC will promote Patients with Arthritis Can Exercise (PACE) classes offered by Whole Health Outreach (WHO).
- RCHC Maternal Child Health (MCH) staff will focus on obesity and will be working with businesses to develop an Employee Health Program
- RCHC will provide through the WIC program breastfeeding information, supplies & Breast Feeding Peer Counselor supported by the Regional WIC Grant.
- RCHC will provide B/P, BS, and cholesterol screenings to the public & Worksites as requested.
- RCHC shall have a bulletin board in the health center with monthly appropriate health information
- MHHC offers health screenings and medication assistance at reduced cost and sliding fee scale to those patients who qualify.
- Whole Kids Outreach (WKO) offers summer camp and after school programs to school age children for improved nutrition and increased physical activity.
- University of MO Extension offers nutrition education Eating from the Garden & Kids in the Kitchen classes to those interested community members.
- RCHC through the MCH grant will offer age appropriate car seats to Reynolds County residents who qualify financially.
- WHO will promote & assist with the community garden in Ellington & Reynolds County Health Center’s garden will be used by Nancy Burns to promote classes with children for Eating from the Garden over the summer months.
- RCHC MCH grant staff has formed a Maternal Child and Family Health Coalition to gather community members together to work collectively towards identifying and solving health issues.
- RCHC staff shall provide Stewards of Children from “Darkness to Light” sexual child abuse recognition and response education to residents and agencies in a five county region to impact abuse and violence prevention.
- Three local schools have added Cross Country to intramural sports and two schools have added track.
Intervention that is planned for implementation:
- RCHC shall actively work with local partners to provide a countywide Health and Wellness Fair in Reynolds County every two years.
- RCHC will continue to promote the Reynolds County Food Banks located in Ellington (SEMO Food Bank), Lesterville, and Black (USDA).
- RCHC shall continue to educate and promote National Sexual Assault Online-Hotline (NSA) to residents who need this information (1-800-656-HOPE).
- RCHC will remain active in Missouri Council for Nutrition and Physical Activity (MOCAN) coalition and keep aware of their progress in policy change for better nutrition and increase physical activity.
- RCHC will explore local sites for the feasibility of a Community Treatment Outreach office for counseling services for residents with alcohol and substance abuse issues.
- RCHC will continue to offer to loan to local schools education materials dealing with alcohol and substance abuse and driving while under influence of alcohol.
- RCHC will continue to partner with agencies, medical schools, and local schools to offer shadowing opportunities to facilitate students considering health and medical careers.
- RCHC will continue promotion of the Alcoholic Anonymous meetings in Reynolds County every Tuesday evening at 6:00 PM at the Reynolds County Courthouse in Centerville.
- RCHC will continue to participate in the WIC Regional Contract with Region G Collaborative to decrease costs.
- RCHC will offer a Breastfeeding Peer Counselor to assist Prenatals in education and support for breastfeeding known to decrease obesity.
- RCHC will maintain website and establish a monthly E-Newsletter to citizens who sign up for the program.
- RCHC will maintain marketing strategy of using Facebook Site to followers to announce educational information and awareness campaigns.
- RCHC will continue to refer clients who need assistance with prescription costs to Missouri Highlands to meet their healthcare needs.
- Youth United for Change group in Ellington will continue to develop their skills to become a voice in the community and within their school for policy change.
- Drug Take Back Box will remain in place at RC Sheriff’s Office to assist the community to have a safe place to dispose of unused and outdated prescriptions to decrease access to drug abusers.
- RCHC will continue to refer infants in need of Safe Sleep Cribs to programs available.
- RCHC will promote and participate annually in the “Active Shooter” Training at Centerville School located across from health Center that we hold a school nurse contract with.
- RCHC will promote and refer citizens 60-74 in need of education in healthier eating and increased activity.
- RCHC will continue the Prenatal High Risk Case Management to all women who meet criteria and choose to participate to be educated on healthy pregnancy and birth outcomes.
- RCHC will conduct “Making the Mark” youth training in RC schools to develop leadership skills & promote active participation in community policy changes.
Target Group/geographic area:
Our target population is the 6,599 residents that live in the 808.48 square miles of Reynolds County.
Outcome the plan is intended to achieve:
Reynolds County residents will have an increased Drug/Alcohol awareness and prevention programs. Reynolds County residents will have increased knowledge of how lifestyle choices directly affect their health and the incidence of chronic disease and in many cases their longevity.
Severe lack of funding in a hurting economy & resistance to change
RCHC small staff
Maintaining commitment and interest levels of community members is difficult.
Reaching county residents with education materials who do not have access to radio, newspaper, and internet is an ongoing challenge.
Public schools are reducing the amount of time available for health education interventions in the classrooms, due to curriculum changes, state requirements and levels of achievements.