By Jordan Brooks

jordan.brooks@middlesboronews.com

Bell County Health Department along with Eastern Kentucky University held a preliminary health forum earlier this month with the intention of learning more about the health and specific needs of Bell County residents. The information gathered will be used to develop plans for future health improvements to the community.

This health forum assisted with gaining a better comprehension of the community’s viewpoint on the health condition of Bell County through a strategic analysis of the health outcomes and various health factors that influence the overall health status.

Participants engaged in a brainstorming process to devise policies and programs that are presently being addressed by the county or require attention, taking into consideration the social and economic factors, as well as the physical environment of the county.

Demographics

A total of 281 people completed the survey for Bell County that was promoted online and through social media from Sept. 19 to Oct. 30.

According to the survey, Bell County’s population of 25,568 is split 50-50 male and female. A total of 6.1% those 5 and under, 21.4% are 18, 19.8% are 21 and older, and 41.4% of the population were found to be median age.

A total of 94.1% of Bell Countians were white, 2.8% were African American, 0.4% were Asian, 0.2% were Native Hawaiian and Other Pacific Islander, 2.2% were two or more races, and 1.4% were Hispanic or Latino.

Bell County was ranked among the least healthy counties in Kentucky, with a life expectancy of 70.6 years old, about eight years less than the national average life expectancy sitting at 78.5 years old.

Health Factors

The forum first presented health outcomes, or markers of health that may be the result of outside factors.

Diabetes prevalence in adults over 20 in Bell County is comparatively high at 14% compared to the national average of 9%. In terms of mental health, 22% of Bell County residents reported 14 or more poor mental health days per month in 2020, compared to the national average of 14%. Additionally, 42% of adults in Bell County reported getting less than seven hours of sleep and an average of six and a half mental health days within 30 days.

Some results presented at the forum were health problems participants were well aware of, such as the a high percentage of smoking (32%) and obesity (44%).

However, 40% of Bell Countians reported having no leisure time, but 88% of the population was found to have access to exercise opportunities. About 22% lack access to healthy food, and 10% of Bell residents have limited access due to low income and distance from grocery stores. In comparison to the state average of 19% who drink to excess, only 15% in Bell County engage in binge drinking. Similarly, alcohol-related driving deaths are lower in Bell County at 13%, compared to the national rate of 27%.

When looking at clinical access to care, the need of mental health providers in Bell County greatly outweighs the actual number of mental health providers, with the ratio of the population in the county to mental health providers being 2,930 to one.

During the forum organizers also discussed the social determinants of health, or the non-medical factors that influence health outcomes are the conditions in which people are born, grow, work, live, age, and the wider set of forces and systems that shape the conditions of daily life.

During this section of the forum, topics of discussion were education, income and social vulnerability.

In Bell County, 75% of adults 25 and older have a high school diploma or equivalent. Additionally, 42% of individuals aged 25 to 44 have some college education. In terms of grade school performance, Bell County third graders score slightly below the national average in reading and math, with scores of 3 (national average is 3.1) and 2.9 (national average is 3) respectively.

It was found an average Bell County household takes home $31,000, and the hourly wage needed to cover basic household expenses in Bell County alone 2022 is $36.21 an hour. While the gender pay gap is slightly smaller in Bell County compared to the national average, women’s earnings in 2021 were 85% of men’s earnings. It was found that 73% of children in Bell County qualify for free or reduced school lunch. In Bell County, households with two children spend 31% of their income on essential child-rearing expenses, and 27% of children in Bell County live in single-parent households.

Social vulnerability refers to the resilience of communities when confronted by external stressors on human health such as natural or human-caused disasters or disease outbreaks. Reducing social vulnerability can decrease both human suffering and economic loss. Bell County was found to have a high social vulnerability, or, the ability a community has to bounce back after a disaster. Namely, after the pandemic as the results of the study were gathered in 2020.

In Bell County, there are 63% of owner-occupied housing units, and as of the 2021-22 academic year there are 380 Bell County children preschool age to grade 12 who are homeless. A total of 19% percent of households experienced either overcrowding, high housing costs, lack of kitchen facilities or lack of plumbing facilities. While at least 14% of households in the county spent half of their income or more on housing.

Community Status Assessment Results

Out of the surveyed population, 43% of Bell residents rated themselves as somewhat unhealthy, 23% very unhealthy, 20% somewhat healthy and 14% very healthy.

When asked to rate their own mental health, 27% respondents reported their mental health being fair or poor.

When asked to rate their own physical health, 28% respondents reported their mental health being fair or poor.

Out of the 281 respondents, six percent do not have housing or are worried about future housing.

Out of the survey respondents, the top three most concerning risk factors in Bell County that have the biggest impact on health are substance abuse, lack of living wage, and poor eating habits.

In the past 12 months, when asked about unmet needs, the surveyed population had a variety of answers, with 31% saying they had trouble paying for utilities, 19% saying they ran out of food before they could buy more. 36% of the surveyed population wrote in their own answers with various unmet needs reflecting struggling to meet basic needs, afford healthcare, and struggling with mental health and stressors.

When asked about what populations have the greatest health challenges in Bell county, the surveyed group answered: older people, people with disabilities, and people of low income.

When asked what are the top three strengths of Bell County that help make citizens healthier, the surveyed group answered good jobs and a healthy economy, access to healthcare, and voted that Bell County is a safe place to raise children.

When asked the top three most concerning health problems in Bell County, the surveyed group answered mental health issues, obesity, and overdose.

Out of the 281 that responded, most respondents had completed high school or higher.

Based on the results of the survey, health officials drafted the following statement that reflects values of Bell countians: “A healthy and safe Bell County is a community with accessible substance abuse treatment and harm reduction, including syringe exchange. Bell County prioritizes mental health, combat loneliness among the elderly, reduces homelessness, and offers resources for smoking cessation and nutritional education. Physical activity options that promote well-being, creating a united and thriving environment for all.”

During the health forum, participants voted on what they believed to be the most important health issues in Bell County. The issues voted on were previously discussed and previously identified as issues during the forum by participants. Mental health was determined to be the most important health issue in Bell county, followed by autism, obesity, trauma, and drug use.