2021 Knox County Community Health Assessment

Roughly the same percentage of the population 19%  — participated in the 2021 assessment compared to 2018.

MOUNT VERNON -- The 2021 Knox County Community Health Assessment found more respondents visited a doctor for routine check-ups but reported lower rates of several illnesses compared to the previous 2018 assessment.

Some survey respondents delayed health care because of the COVID-19 pandemic, according to the assessment.

While results showed that among respondents COVID-19 was perceived as the most important health issue in Knox County, mental health and substance abuse were noted as other important issues.

Knox Public Health randomly selects county residents to receive a self-administered questionnaire, either on paper or online, every three years. This year, responses were solicited from March 8, 2021 through April 25, 2021. Knox Public Health collected mainly qualitative data.

Respondents reported fewer diagnoses with high blood cholesterol and cancer in 2021, but more respondents reported asthma diagnoses and having four or more poor mental health days in the previous month since they took the survey. Although doctor visits were more frequent among respondents, fewer respondents visited a dentist or dental clinic. 

More respondents reported engaging in frequent physical activity and having fewer barriers to consuming fruits and vegetables. Reports of household issues increased. Compared to 2018, more respondents reported problems with insects, mold and radon.

Roughly the same percentage of the population — 19%  — participated in the 2021 assessment compared to 2018, said Carmen Barbuto, who serves as accreditation coordinator and handles data analysis and performance management for Knox County Health Department. 

In coming weeks, the county will begin creating an updated Community Health Improvement Plan through work groups — which are made up of those who sit on the Knox Health Planning and Promotion coalition. It includes 25 agencies such as the health department, community hospital, area nonprofits, chamber of commerce, county commissioners and local colleges. 

KHPP will use the CHIP to determine how to improve existing and create new health initiatives, Barbuto said. The 2018 CHIP focused on improving chronic disease outcomes, mental health and addiction outcomes and access to care. 

While the COVID-19 pandemic hindered some of the 2018 CHIP plans, Barbuto said she was pleased to see that more respondents had no barriers to consuming fruits and vegetables in 2021 after Knox Public Health implemented initiatives following the 2018 assessment to reduce barriers, such as through creating community gardens and including the Supplemental Nutrition Assistance Program at farmers markets and retailers.

The 2021 CHIP is expected to be completed by September 2021, according to the assessment. 

The Knox Health Planning Partnership contracted Illuminology, a central Ohio based research firm, for primary data collection and analysis. The Center for Public Health Practice at The Ohio State University College of Public Health will lead the creation of the CHIP. 

Kelly Bragg from OSU said her role is not to determine CHIP priorities but to guide the work groups in creating a roadmap that reflects their priorities. 

“The community is ultimately deciding what goes into that plan, what they want to see happen and what they want to see Knox County turn into,” Bragg said.

Part of the CHIP involves figuring out the contributing causes of health challenges found in the assessment, she said.

“We want people to get past thinking, you know, it’s just about personal decisions and lack of knowledge that leads to negative health outcomes,” Bragg said. “We know from a community health perspective that it’s about more than that.”

Overall, the 2021 assessment revealed a lack of healthcare availability among respondents. 

Many residents traveled outside the county for healthcare, especially specialty care, and some reported being unable to access care because of a lack of health care coverage and transportation, among other accessibility issues. 

These health disparities differed among respondents of varying incomes, education levels and ages.

For example, respondents with lower household income were more likely to be limited by health issues in their activities. 

Respondents who had completed less formal education were more likely than respondents who held a bachelor’s degree or higher to have had at least one adverse childhood experience (physical or mental abuse and neglect and household challenges). 

Older respondents tended to have higher chronic disease prevalence and less social and emotional support, as measured in the assessment. 

By determining and addressing the underlying drivers of these health issues, Bragg hopes to create healthier communities overall. 

“We want to change the context in which people live,” Bragg said, referring to the public health mantra “make the healthy choice the easy choice.”

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Emma Davis is a 2021 graduate of the University of Richmond, from which she holds a bachelor's degree in journalism and leadership studies. Emma reports for Knox Pages and Ashland Source through Report for America.

Emma Davis is a 2021 graduate of the University of Richmond, from which she holds a bachelor's degree in journalism and leadership studies. Emma reports for Knox Pages and Ashland Source through Report for America.