Joint Community Health Needs Assessment and Implementation Strategy

Southern Illinois community members, partners, healthcare providers and leaders participated in the 2024 Community Health Needs Assessment survey. Utilizing the data collected, existing plans and goals, input from the community members, community partners and health care providers, the CHNA Advisory Team held a facilitated discussion and prioritization process. After receiving input from SIH Senior Leadership, 3 priority health issues were selected.

Community input was received through the following methods:

• Community Health Needs Assessment Survey - 613 respondents throughout the seven-county service area
• Key Stakeholder Survey - 90 people participated, including various physicians and key leaders within the community
• Focus Groups and Interviews - 37 individuals provided feedback about issues affecting health outcomes
• SIH CHNA Advisory Team - The 52-member team reviewed the data, provided input and shared their perceptions of overall impact, magnitude of the problem, severity, and ability and interest of the community to address the issues, and voted on priority health issues to be addressed.
• SIH CHNA Implementation Planning Teams - Three teams were formed with 56 individuals participating. (Multiple individuals participated in more than one planning team.)
  
  

SIH obtained input from 127 community leaders representing public health, public schools, local government officials, social services, neighborhood groups and various non-profit organizations through a combination of focus groups, interviews and key stakeholder surveys. SIH took into account input from individuals and groups representing medically underserved, low income, and minority populations.

Primary input was also obtained by conducting a community health survey distributed to members of the community through the Healthy Southern Illinois Delta Network (HSIDN), a 500+ member coalition working to improve health in Southern Illinois, SIH Patient and Family Advisory Council, homeless shelters, NAACP – Carbondale branch, food pantries and faith communities. The survey was also translated into Spanish and shared at Spanish-speaking religious gatherings, local orchards that employ Spanish speaking individuals and through the Southern Illinois Migrant Council and many others.

SIH has defined its “community” ss Franklin, Jackson, Saline, Williamson, Johnson, Perry and Union Counties in Southern Illinois, representing it’s primary and secondary service areas. This allows SIH to focus resources on addressing significant identified health needs, targeting areas of greatest need and health disparities. Although SIH has defined the “community” as these seven counties, many initiatives/efforts extend to the lower 16 counties due to our rural nature with limited resources. These 16 counties are often referred to as the “Illinois Delta Region” due to poorer health outcomes than the rest of the state.

According to the U.S. Census Bureau American Community Survey 2018-2022 5-year estimates, SIH’s CHNA community has a total population of 233,199. The percentage of population by combined race and ethnicity is:

• 85.9% Non-Hispanic White
• 5.9% Non-Hispanic Black
• 3.3% Hispanic or Latino
• 1.5% Non-Hispanic Asian
• 3.4% Non-Hispanic Other Race
  
  

Within SIH’s CHNA Community, 24,503 households, or 25.2% of households, have housing costs that are 30% or more of the total household income and are classified as “cost-burdened households.” The structure of housing and families and the condition and quality of housing units and residential neighborhoods are important because housing issues like overcrowding and affordability have been linked to multiple health outcomes, including infectious disease, injuries and mental disorders.

Having access to care is more than just affording to go to the doctor – it includes having access to the resources needed to travel to your appointment. 12.4% of adults in SIH’s CHNA Community reported they have not been able to visit a doctor due to the cost, whether it’s too expensive or they can’t afford the time off work. Additionally, many individuals struggle to find transportation to and from their appointment.

Limited access to care presents barriers to good health. The amount and availability of physicians and Advanced Practice Providers impacts patient access to receiving quality care. While the rate of healthcare providers within SIH’s CHNA Community is consistent with state and national averages, approximately 45% of the population live in rural areas where access is to primary care is limited. 40.4% of the population is living in an area affected by a shortage of primary care physicians.

“Our goal is to create better awareness of what's available to patients through their insurance, as well as partner with some of the community transportation services to provide better access into the clinical and hospital sites,” says Sara Malone, MD, SIH Vice President of Ambulatory & Physician Services and primary care physician.

Goals to Address Access to Care:

• Identify and respond to social drivers of health (SDOH) such as transportation, housing, etc.
• Increase community resource connections identification and referrals.
• Increase access to primary care providers and specialists.
• Enhance collaborations to increase access to care.
• Implement efforts to reduce patient appointment cancellations due to lack of transportation.
• Increase the number of individuals who are gainfully employed in Southern Illinois through economic development initiatives.

According to the National Alliance on Mental Illness, 403,000 adults in Illinois have a serious mental illness and approximately 145,000 youth have depression. 17.9% of adults (approximately 39,600 people) over 18 identify as having poor mental health, compared to 15.4% in Illinois and 15.8% in the United States.

The rate for deaths of despair (including deaths due to intentional self-harm or suicide, alcohol-related disease and drug overdose) is much higher in SIH’s CHNA Community than compared to state or national benchmarks.

One of the primary goals to increasing behavioral health care in Southern Illinois is reducing stigma. By increasing understanding and awareness, families and communities can better recognize when someone needs help and connect them with critical – and often life-saving – care. Education breaks down barriers and opens the door to support, making it easier for everyone to seek the help they deserve without fear or shame.

“Our goal is to have the same feeling about mental health like any other health issue,” says Naeem Qureshi, MD, SIH Medical Director of Behavioral Health and psychiatrist. “If they have chest pain, they to go to the ER or call their doctor.”

Goals to Address Behavioral Health:

• Reduce stigma and increase access to care in responding to mental health challenges and emergencies.
• Increase awareness and access to mental health and substance misuse services in the community.
• Implement program to reduce stigma surrounding mental health.

Healthy diets and physical activity contribute to healthy lifestyles and overall well-being. Current behaviors impact future health and well-being, and many indicators can be linked to significant health issues, such as obesity and poor cardiovascular health.

SIH’s CHNA Community has a significant number of adults diagnosed with chronic illnesses. Over 37% of the population (83,166 adults) have high blood pressure. Over 70% of Medicare beneficiaries have been diagnosed with 2 or more chronic conditions. Adults in SIH’s CHNA Community self-reported to smoke at a higher rate than state and national benchmarks. 

“There are high rates of chronic illness and some disproportionately high rates in our area compared to other parts of Illinois and the United States,” says Matthew Winkleman, MD, SIH Medical Director of Population Health and primary care physician. “A lot of those things are driven by behavioral choices. We have high rates of smoking in our area, high rates of obesity, and those influence other chronic conditions like hypertension, diabetes, and stroke. There's a lot of work to be done to help influence that and improve the health of the community.”

Goals to Address Chronic Disease Prevention, Management and Treatment:

• Increase tobacco use prevention and cessation throughout the region.
• Reduce diabetes, high blood pressure and obesity through targeted interventions and outreach
• Collaborate with local organizations to reduce food insecurity.