Grays Harbor County Public Health has partnered with Harbor Regional Health, the Community Wellness Center and Summit Pacific Medical Center, and has contracted with Rural Health Innovations, to conduct a comprehensive county-wide health assessment and create a Community Health Improvement Plan.

According to Grays Harbor County Public Health Director Mike McNickle, the online survey, which launched yesterday, is the first of a three-phase effort to collect data and information from Grays Harbor County residents.

“We’re going to host a number of focus groups. The Rural Health Institute is going to be here between Aug. 11 and 15,” McNickle said. “Then we’re also going to do key informant interviews. We’re going to have about 16 to 20 people who are health related, folks who have a direct link to decision making at the health level to get their input on what are the needs of the county.”

McNickle said the plan is to complete the information gathering by Aug. 15 and deliver a draft presentation at the Third Annual Grays Harbor County Public Health Symposium at Grays Harbor College on Oct. 10.

The health assessment aims to focus on the individual resident and try to understand a person’s current health status, what they believe is important to overall health, and what can be done to improve their well-being.

“One of the questions we’re trying to get to is what are your biggest concerns? Health means different things to different people. What’s your blood pressure, your A1C? What’s your weight? What’s your depression level?” McNickle said. “But other people would say health to me means is a community safe to drive through or walk downtown? Are there fresh fruits and vegetables available? What are the activities? What are the art scenes? There’s all kinds of different versions of health. We get to look and see with a big enough survey sample, what does this community actually see as health and what does that mean to us? Are those things actionable?”

An individual’s health ties into the overall health of the community, especially as it relates to the economy, economic and workforce development. McNickle believes health is a key part of the county’s ecosystem.

“You can’t have health separate from housing separate from the economy separate from transportation separate from leisure and travel,” McNickle said. “All those things are all tied together. You can’t silo them.”

Grays Harbor County is in the middle of several infrastructure projects with more on deck. The county also has the highest percentage of people in the 25-54 age group in Washington state who are not currently employed. These two factors are causing workforce development to be a key concern with the health assessment.

“There are a lot of factors that go into working as a person. If you’re single, where am I going to live? How am I going to get there? What are my hours and how much can I afford to live here? What are my health benefits? When you look at the social determinants of health … housing, the economics of the area, all those different determinants that go into what a person feels to be healthy are all critical,” McNickle said. “As you look at economic development, how’s the health of the population? We still have a very high rate of fentanyl (use). We have a higher rate of obesity. We have a high rate of diabetes. All those things play into the workforce being healthy enough to actually go to work. Do we have enough daycare for people who have children? What educational things are there for people to do here. What do your kids do if they’re not into sports, how do you keep them out of trouble? Those are the kinds of other considerations that go into a healthy workforce.”

As the data is collected and action plans are created and executed, one of the continuing efforts of Grays Harbor County Public Health is to identify and try to fill gaps in health care access.

“The last Community Health Assessment and Community Health Improvement Plan talked a lot about substance use disorder and mental health. We worked with Josh Martin (CEO of Summit Pacific) and others and took some of our treatment sales tax money and gave them over $900,000 and (they) put together a mental health clinic,” McNickle said. “Other issues were access to healthcare. So, our initiative was to build the North Beach school-based health center and now we have a school-based health center in Oakville. All of the school districts really want us to come and do that. After holding events at Wishkah and Ocosta, (we) found out that some of those kids had never seen a doctor ever. That’s where public health needs to step up. Everyone needs to have some level of health. We’re not primary care, but we can do things like vaccines and testing and make sure that your kids can play sports. We do sports physicals, those things that are within our wheelhouse. Those are the things we’re going to focus on.”

McNickle went on to say that healthcare access is a problem in the Grays Harbor community and that lack of access is exacerbated by a shortage of healthcare professionals in the region.

Regardless of the information gathered and any action plans that may be created as a result, individuals must choose to take steps to improve their health or proactively manage any chronic illnesses or conditions they may have. Seemingly, many adults don’t continue with exercise and/or healthy lifestyles after high school, college or stints in the military.

“Adults don’t like to be told what to do, and it feels like the government’s always pointing the finger or your doctor’s always yelling at you about this, or your wife or your partner or your kids. ‘Dad, you need to stop eating all that, quit smoking or drinking’ or whatever it is. At some point, though, it’s a personal choice,” McNickle said. “If you don’t understand the consequences, that’s where the line is. Once you have that understanding, you still have to choose. That’s where we come in. Once you’re at that decision point we’ll provide you all the information. It’s still your choice, but if you are interested and you really want to make a change, we’re more than happy to help you get on your journey.“

McNickle mentioned diabetes, obesity and substance abuse as three of the biggest health concerns in Grays Harbor County. Substance abuse then ties into mental health as well.

“That’s why we have to take this holistic approach to people and address them from a mental and physical health standpoint. We have a big depression problem in this community,” McNickle said. “That drives poor eating choices. It drives addiction choices. Those are the kind of things where you have to address them in order and holistically. Otherwise you’re just treating the symptom and not the problem.”

According to McNickle, the goal is to use the data from the assessment to create a Community Health Improvement Plan.

“That will be presented to the community, the Board of Health, the Board of County Commissioners, and all of our stakeholders. Those things that we own that are our wheelhouse and we have some say or control over, we’ll start working on and then those other things we’ll leverage our partners to see if they can start doing those things as well,” McNickle said. “We’ll develop an outreach plan and then follow up quarterly or yearly. Not everything is going to work, but those that do work, we need to celebrate those.”

The Community Health Assessment Survey is available online and you must be at least 18 years of age and live in the area served by Grays Harbor County Public Health. To access the survey, go to https://ruralcenter.research.net/r/VXFNBSC