The Community Health Assessment survey conducted this past winter indicates Curry County is maintaining the status quo, despite increasing difficulties in finding good health care, the challenges inherent in an aging population and trends seen in recent years such as the legalization of marijuana, the housing market and wage inequities.
The survey is conducted to increase understanding of key health issues facing the community to better plan services and identify health care strengths and challenges in Curry County, the document reads. The data will also contribute to a continuum of studies that in the future will depict trends — also helpful in evaluating health care and other community values.
This year was the first time all the agencies worked together with a goal to reduce duplicity and share resources.
Health assessments aren’t just an evaluation of a population in time, the report noted. Other variables — economic stability, physical environment, education, food community, health care systems and health behaviors — also play into the health of a community.
“The Community Health Assessment has limitations, too,” the report acknowledges. “It is not meant to cover every possible factor. It is not meant to be a complete list of all community health needs or health data. It is not a rigorous research study designed to evaluate services or community organizations, but to provide a macro view of data, identify strengths, assets and challenges and engage the community to address them.”
According to those involved, the next step is to prioritize health issues and interventions and explore how to complement and integrate work already being done.
Not a lot has changed since the last time a survey was conducted; they are required by the IRS to be conducted every three years.
The median age of a Curry County resident is 55, much older than the statewide mean of 39. And it’s expected to increase, too, with those 60 and older representing 40 percent of the population by 2030. Sixteen percent of the population is 17 or younger, compared to 21 percent in the rest of the state.
Of significance is that 17.5 percent of residents here are veterans — for whom health care is a major issue — compared to 10 percent statewide. And Curry County has a higher percentage of people with disabilities than other counties: 26 percent to 14 percent.
The environment is a major plus in the eyes of those surveyed — with the exception of the smoke from last summer’s Chetco Bar Fire — but the health of homes wasn’t viewed as positively, with some respondents citing mold and a lack of repairs in many houses.
“HUGE lack of affordable housing for the working class just adds to our problems,” one survey participant wrote. “Even making above minimum wage, a person has to pay a large percentage of their income just to have a roof over their head that is often sub-par and leaving them with little to meet other requirements for living. In this community, one is LUCKY to find something under 50 percent of your income. This is outrageous and sets our community up for failure in the long run.”
Almost half of housing in Curry County is used by second-homeowners or rented out for vacationers. Availability of housing was second only to poverty among the biggest concerns for the focus group and survey participants.
Homeless-student numbers are on the rise, too.
“We see more grandparents living with their kids and their kids’ kids, or single parents living with other families,” one survey participant wrote. “It affects large swaths of youth who don’t have a bed or regular room of their own.”
Curry County has about 140 students without a regular living situation, a number that is up from about 95 in 2013. Brookings-Harbor School District has seen a huge jump, going from none in 2014 to about 110 in 2016. Port Orford-Langlois, on the other hand, has seen that number crash, from about 68 in 2014 to none in 2016.
Curry still fares better than 17 other counties in Oregon in poverty rankings.
It all ties into economic stability, the study indicates.
Curry County’s average family income between 2012 and 2016 was $60,802; the mean — half above and half below — was $50,241, both figures substantially lower than income levels in the rest of the state. Most wages go to people making $40,000 or less, the report reads.
“Income and income inequality is directly linked to an individual’s health,” it continues. “It has shown to increase risk for poor health and risk of death.”
Curry County — perhaps unsurprisingly for an older, less affluent population — has a higher percentage of people on publicly-funded insurance, and some 66 percent are on Medicaid, Medicare or both.
It represents a trend seen state- and nationwide.
Curry County’s isolated location makes it even more difficult to get to specialized medical help.
“The Oregon Office of Rural Health designates Curry County a medically underserved area and an area with shortages of mental, dental and health professionals, the report reads.
“Access to doctors is a huge problem,” one survey respondent said. “I have been trying to get an appointment for a prescription refill for more than six months, and can’t get anyone to even call me back.”
It was a common refrain; many respondents said it was frustrating to have a provider leave or to have to travel a hundred miles to the Rogue Valley for basic medical care.
Screenings — with the exception of blood-sugars, likely due to the high number of diabetics here — and prenatal care aren’t as available here, either, which puts a strain on younger families.
And many who do need care take their business out of county: the first-most visited hospital by Medicaid patients from Curry County is Sutter Coast in Crescent City, followed by Bay Area Hospital in Coos Bay and Asante in Medford.
More residents here die of diabetes than in the rest of the state. In 2016, that death rate stood at 53 per 100,000 people. It is on the decline, at about 39 deaths per 100,000.
Teen births are bucking the state trend and going up in Curry County, with 2.5 children born for every 1,000 teens in 2011 and increasing to 6.5 in 2016.
Children and health
Education is key to many quality of life issues, and Curry County does well when it comes to getting its kids off to a good start.
“Children here have benefited from early learning programs like Head Start,” the survey indicates. “The rate of students enrolled is significantly higher than the state, a clear strength of the community.
Curry County has 35.2 children per 10,000 students enrolled in Head Start, compared to 8.8 statewide.
But from there, it slips. Test scores in Curry County and graduation rates are lower than the state average, but only by a slim margin, the study shows. And the county has fewer people with college degrees, as well.
•Food and food insecurity have been big issues in Curry County, with 20 percent of eighth-graders here saying they ate less than they thought they should because there wasn’t enough money to buy food. Only 14 percent of eighth-graders statewide agreed.
“Access to healthy foods has improved since 2013,” the study said, garnering it a 6.9 rating on an index with zero being the worst.
Curry County isn’t a lot fatter than the rest of Oregon, with 66 percent considered to be of a healthy weight, 22 percent as overweight and 13 percent as obese.
“People spend tons of money at Dairy Queen, McDonalds, KFC and Taco Bell, then they sit in their car at the port and pig out,” said one survey participant. “Health begins in the mindset.”
Obesity in Curry County only started to taper off in 2013.
•On the other hand, a third of people here live in a “food desert,” a low-income area where a large share of people don’t have easy access to a large grocery store. A proportionately similar number utilize the Women Infant Children and SNAP state programs to help purchase food.
Much of it ties back to the workforce, the study indicated.
“When parents are either not working and depressed, or are working multiple jobs, they don’t and can’t prepare a healthy meal,” a focus group participant said. “We need a low-cost walk-in fresh food store, combined with education on quick, low-cost healthy food preparation.”
•Vaccination rates for 2-year-olds are 48 percent, a full 20 percent lower than the rest of Oregon.
•The percentage of people with poor dental health is estimated at 31 percent, compared to 13.6 statewide, with 60 percent of 11th-graders having seen a dentist for any work in the past year.
Community activities — notably those tied to churches — are important to those in the community. Yet a quarter of people here say they don’t have access to social and emotional support.
“We could improve a lot of things by spending more time together, building relationships, solving problems together,” a focus group participant said. “Sometimes, it only takes one person to reach out and reduce isolation.”
Bullying in schools is down statewide and in Curry County, as is violent crime, which hovers far below the state level. And convictions for methamphetamine and heroin, while seeing a spike in 2015, are on the decline.
Curry County has 43 children in foster care, ranking 32nd of Oregon’s 36 counties.
Suicide, too, is on an “alarming upward trend,” the study reads. While it has fluctuated wildly since 2000, the average since then has more than doubled, from about 2.2 people per 10,000 population to 5.5 per 10,000.
A full third of youth are reported to have a mental health condition, compared to 11 percent of adults with a serious condition and another 23 percent of adults with mild to moderate conditions.
Curry Countians, with one of the highest smoking rates in the state also die more often from that behavior — a trend that is slowly dipping, but has been higher than the state rate for more than a decade.
Almost 4 people per 1,000 die of tobacco-related health problems here, compared to about 1.8 statewide, according to state reports.
“Curry County experiences $16.3 million in tobacco-related medical costs and $13.1 million in lost productivity due to premature tobacco-related deaths,” the report reads. “Almost 1,600 people are estimated to have a serious illness caused by tobacco here.”
Alcohol abuse isn’t much better, although binge drinking is just a tad above the state average, at 20 percent of adults indulging in such behavior.
“I’m not a doctor, so I don’t know the answer,” one respondent said, “but my observation of most people is they tend to drink a lot of alcohol.”
Marijuana use statistics aren’t yet available, the report said, but the issue was addressed by participants of the study.
Opioid use — codeine, oxycodone, morphine, methadone — have had negative health effects on entire communities nationwide, and Curry County is no exception.
Again, perhaps because of its average age and number of veterans, the number of prescriptions for pain relievers is the highest in the state; it has declined since 2014 — and medical marijuana use was made legal in 2015.
Yet, almost 26 percent of 11th-graders here say it would be easy to obtain prescription drugs.
The survey will now be used by the various agencies to determine how to strengthen elements in the community healthcare system.