Grays Harbor County Public Health has taken the “draft” label off and produced the final report based on the community health assessment (CHA) the department conducted over the summer.
The report also includes the community health improvement plan (CHIP), however, the action plan that follows won’t be published until February. The draft of the report, which was produced by Rural Health Innovations (RHI), was released at the health symposium that was held in October.
Information for the CHA was gathered in several phases — an electronic community survey in English and Spanish, 15 key informant interviews and four-in person focus groups (including one in Spanish), and secondary data from national sources such as U.S. Centers for Disease Control and Prevention, County Health Rankings, and the U.S. Census Bureau.
According to the report, life expectancy in Grays Harbor County (74.6 years) is less than all other areas (76.6-78.8 years). The average number of poor physical health days per month for the counties in the region (4.2-4.7 days) is higher than Washington state (3.9 days). Grays Harbor County reports a higher average of poor mental health days per month (6.2 days) compared to Mason County (5.7), Clallam County (5.8), and the state (5.4).
As for the electronic survey, the top three responses for the question: “What are the three most pressing health concerns in our community?” were access to mental health services 49%, access to primary care 30% and access to alcohol/drug use services 28%.
The report also indicated that Grays Harbor County, along with Mason and Clallam counties, has higher rates of obesity, cardiovascular disease, chronic obstructive pulmonary disease (COPD), and adult smokers than the rest of Washington state.
Grays Harbor County Public Health Director Mike McNickle said his department is working with Summit Pacific Medical Center, Quinault Wellness Center and Harbor Regional Health to take the data from the CHA/CHIP and identify priorities for an action plan.
“We’re building an action plan, we’re working on the identified needs,” McNickle said. “We want to work on increasing access to healthcare, developing a countywide care and coordination plan, and developing a collaborative and comprehensive marketing plan for existing healthcare services.”
According to McNickle, the four partners’ priorities overlap and align with those of the Grays Harbor County Board of County Commissioners (BOCC). The BOCC has held a series of strategic planning sessions during which Commissioners Georgia Miller, Rick Hole and Vickie Raines, along with County Administrator Sam Kim, developed the following vision statement:
“Be the foundation of a thriving community as seen in the pillars of Financial stewardship; Housing; Criminal justice, public safety and public health; Economic development; and Service orientation.”
McNickle says that developing a housing analysis and strategic plan is tantamount to helping alleviate some of the negative health outcomes in the region.
“That’s something else that the Board supports, because they really think we need a housing plan. It’s one of the big issues. If you look at (health assessments) five years ago, housing wasn’t in the top three, but now housing is,” McNickle said. “The other (priority) was working with the community to help develop a plan for economic vitality.”
This new CHA/CHIP report is the first Public Health has produced in the post-COVID era. McNickle indicated early on that he wanted to work with a new dataset that wasn’t COVID-tinged. However, he has found that much of the information hasn’t changed since the last assessment.
“Some of the overlapping issues from the last one to this one are similar. I think the data is then supported and vetted because it shows that there’s a consistency,” McNickle said. “Mental health is still number one. We can also look at the prime age employment gap survey. If you look deeper into the data, mental health is still in there. … Substance use issues, housing, all those things are all starting to come together. You could really make a cohesive argument, a cogent argument that the findings in our community health assessments are supported by all the other work that we’ve done to date.”
With mental health as the top issue residents in Grays Harbor have consistently reported over the years, it’s important to understand what that actually means. The World Health Organization defines it as “… a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn and work well, and contribute to their community. It has intrinsic and instrumental value and is a basic human right.”
McNickle believes depression and anxiety are the two most prevalent issues when it comes to the mental health conditions people in the area are grappling with.
“From what we’re finding, depression and anxiety are leading candidates for what (respondents are) calling ‘mental health.’ So when they report that they’re having bad mental health days, the vast majority of those people are reporting depression and anxiety,” McNickle said. “If you really nailed it down, if you boil it all down, depression and anxiety is probably the baseline, and then you have the higher, more complicated mental health issues. Then you have substance use on top of it, you get yourself quite the pyramid of mental health. I think a lot of people suffer from depression, seasonal depression, especially in this community.”
According to McNickle, the only way to truly understand the mental health of the community is to conduct a qualitative study.
“I think it’d be absolutely fascinating if an academic research (institution) like Washington State or University of Washington actually came in and did this kind of work in this community or a like community and said, ‘Hey, we want to explore what mental health looks like to you. We’re going to explore what this means to you,’” McNickle said. “I think what we’re missing is that qualitative analysis.”
Many residents of Grays Harbor County are dealing with chronic conditions and illnesses such as diabetes. McNickle said that there is only so much Public Health can do and that ultimately, people have to make tough choices and decisions.
“When it comes to chronic conditions, you have to have a conversation with yourself. You have to agree that, ‘yes, I have a problem.’ Once you agree you have a problem, it’s kind of like the 12 steps. Once I agree I have a problem, then I have to agree I want to do something about it,” McNickle said. “Because going to a diabetes class, you’re going to hear about all the things you can do, but we can’t make you do. So it’s about you being willing to make those behavior and lifestyle changes. That’s a hard conversation to have because you have to want it.”
According to McNickle, there are numerous services and resources available to people in the region accompanied by a lack of knowledge of what they are, where they are, and how to access them.
“I think the action plan will be heavy on community work around access, outreach and messaging. Those are the things that we can work on as partners,” McNickle said. “That’s what (respondents are) saying is that (they) don’t know what’s available. That’s on us to make that message available. And the question is, how do we do that better?”
Although the CHIP portion of the report is not an action plan, it did provide the following recommendations:
Poverty reduction, including economic development, job availability and livable wages, stable and safe housing stock, quality education for youth and adults, and generational poverty.
Access to mental health and substance use disorder services, including provider access, provider recruitment and retention, office hours and locations, appointment wait times, health education, stigma reduction, youth third space availability, and generational trauma.
Access to primary care services, including provider access, provider recruitment and retention, office hours and locations, appointment wait times, health education, prevention education, and stigma reduction.
Community health education focused on encouragement and motivation for healthy lifestyles and community connectedness, including communicating available local services and resources, community gatherings for socializing and physical activity, youth events, youth third spaces, adult and youth health education, and youth life skills education.
And identified the following as three top priorities:
Increase access to health care
Develop a county-wide care coordination plan
Develop a collaborative and comprehensive marketing plan for existing health care services
McNickle added that he hopes the action plan will be completed by February. You can access the complete CHA/CHIP report here: https://www.healthygh.org/s/CHA-Final-Report_GHCPH-2025.pdf
