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HealthCenterSchoolSeniorCommunityEagleCountyCommunityHealthImprovementPlan2017 2IntroductionThe2017CommunityHealthImprovementPlanCHIPwasdevelopedinpartnershipwithcommunityorga-nizationsandcitizensinanefforttoaddresshealthconcernsinEagleCounty.TheprocesswasledbyEagleCountysPublicHealthAgencyincooperationwiththeCountysDepartmentofEnvironmentalHealth.Com-munityhealthimprovementplanningfulillsarequire-mentoftheColoradoPublicHealthActandisalsoconsideredabestpracticeintheield.TokeeppacewithemergingpublichealthchallengestoaddresstheleadingcausesofdeathanddisabilityandtoimproveprotectandpreserveourenvironmentandnaturalresourcestheColoradoDepartmentofPublicHealthandEnvironmentinitiatedanefforttoachievemeasurableimpactquicklyinafewareas.Colorados10WinnableBattlesarepublichealthandenvironmentalprioritieswithlarge-scaleimpactonhealthandtheenvironmentandwithknowneffectivestrategiestoaddressthem.EagleCountyshealthimprovementpri-oritiesareconsistentwithColoradosWinnableBattlesincludingobesitypreventioninjurypreventionmentalhealthandsubstanceabuseandcleanair.Thisdocumentprovidesanoverviewofdemographicsandasummaryofthecountyshealthindicatorswhichcanbetrackedovertime.ThereisalsoareportonprogresssincethelastcommunityhealthimprovementplanentitledHealthyEagleCounty2010.Finallycommunityprioritiesareprovidedwitharoadmaponhowtoimprovethetophealthissuesoverthenextiveyears.TableofContentsIntroduction22017HealthPriorities3CountyOverview4ProgressontheHealthyEagleCounty2010Plan6CommunityHealthAssessment8HealthyLiving14IndependentlyAginginPlace20ConnectiontoPreventativeCare24MentalHealthandSubstanceAbuse28RadonAwarenessandMitigation32Sources36ImplementationGuidesHealthyLiving40IndependentlyAginginPlace43ConnectiontoPreventativeCare45MentalHealthandSubstanceAbuse47RadonAwarenessandMitigation51Acknowledgements53 32017HealthPrioritiesThefollowinghealthprioritieshavebeenidentiiedfortargetedresourcesandcommunityfocusthrough2017.HealthyLivingHealthyLivingencompassesthebehaviorsthatsupportgoodnutritionandphysi-calactivityforalifetime.Suchhabitshelppreventtheearlyonsetofchronicdiseasessuchasheartdiseaseandcancer--thetwoleadingcausesofdeathinEagleCountyandnationwide.IndependentlyAginginPlaceTheCentersforDiseaseControlandPreventiondeinesaginginplaceastheabilitytoliveinonesownhomeandcommunitysafelyindependentlyandcomfortablyregardlessofageincomeorabilitylevel.EagleCountywilltakeintoconsiderationtransportationhousinghomehealthandcommunitydesignwhenmakingdecisionsthatimpacttheagingpopula-tion.Preventionmeasurestoreducefallsandchronicconditionswillbeimplementedforresidentstoageindependentlyintheirhome.ConnectiontoPreventativeCareEagleCountyresidentscontinuallylagbehindColoradotheUnitedStatesandHealthyPeople2020inreceivingpreventativecareservices.Withoutaccessibleafford-ableprimarycareindividualsoftenforgopreventativecareanddelayseekingmedicalattentionre-sultinginworsenedmorbidityandmortalityincreasedlong-termhealthcarecostsandadiminishedqualityoflife.MentalHealthandSubstanceAbuseMentalhealthisanessentialcomponentofoverallhealthandwell-being.EagleCountyisnotimmunetotheincreasingratesofmentalillnesssuicideandsub-stanceabuse.Healthcarepublichealthnon-proitorganizationsandprivatepractitionershavecometogethertocreateacommunitywhereindividualsfamiliesschoolsandworkplacestakeac-tiontopromoteemotionalhealthandreducethelikelihoodofmentalillnesssuicideandsubstanceabuse.RadonAwarenessandMitigationRadonisacolorlessodorlessgasthatcanpermeatehomesandleadtolungcancerwithlong-termexposure.AccordingtotheFederalEnvironmentalProtectionAgencyEagleCountyhasmoderatepotentialforindoorexposure.EagleCountywillworkwithneighboringGarieldandPitkincountiestomitigateradonexposureintherespectivecommunities. 4CountyOverviewEagleCountyColoradoislocatedintheheartoftheRockyMountainsapproximatelytwohourswestofDenver.TheCountyissurroundedbytheWhiteRiverNationalForestandismorethan80percentpublicland.VailPassattheeastendofthecountyhasanelevationhighof10662ft.DuringthewintertheareastopographycanbeisolatingfromneighboringcountieswhichareaccessibleonlybymountainpassestothesouthandeastandtheGlenwoodCanyontothewest.ThecountyishometotheinternationallyrenownedskiresortsofVailandBeaverCreek.Tourismandsecond-homeownershiparethemaineconomicdrivers.EagleCountyhascharacteristicscommontobothruralandwinterresortcommunitiesincludingalargeserviceindustryworkforcewithasigniicantspanish-speakingpopulationahighcostoflivingandextremeweatherconditions.MostmajorpopulationcentersarelocatedalongI-70intheEagleRiverValleyincludingVailMinturnAvonEdwardsEagleandGypsum.TheTownofBasaltandunincorporatedElJebelarelocatedalongHighway82intheRoaringForkValleyFigure1.ThedistancebetweenthetwovalleysseparatedbytheGlenwoodCanyondisconnectstheseareasandcanmakeservicedeliveryachallengeforcountygovernmentFigure1.DemographicsPopulationEagleCountyhasgrowninpopulationby25percentoverthelast10yearsto56145residentsin2012.Thepopulationisprojectedtoincreasebyanother27percentin2020to71076Figure2.EthnicityEagleCountyhasamuchhigherpercentageofLatinoresidentsat30.4percentthanColoradoat20.9percent2011.1InfactLatinostudentsmadeup51percentofenrollmentintheEagleCountyRE50SchoolDistrictin2010.2ThemajorityofLatinoresidentslivinginEagleCounty79percentidentifyashavingaMexicanheritage.3ForeignBornEagleCountyhasasigniicantlyhigherpercentageofforeign-bornresidentsthanthestateasawholeat20percentand9.7percentrespectively2007-2011.4Thirty-onepercentofEagleCountyresidentsspeakalanguageotherthanEnglishathomemostcommonlySpanishwhichisalmostdoubletheColoradopercentageat16.7percent2007-2011.5MedianAgeEagleCountyspopulationisstillrelativelyyoungwithamedianageof35.2yearscomparedtoColoradoat36.4andtheUSat37.12012.67Howeverthecountyhasexperiencedademographicshiftsince2000whenthemedianagewas31.WithBabyBoomersgettingolderandmoreretireesmovingintothecountythemedianageisprojectedtopeakat40.7in2029.Theolderadultpopulationasdeinedas65isanticipatedFigure1.MapofEagleCounty 5toincreaseby169between2010and2020whichwillrankEagleCountyasirstisinthestateforgrowthinthisdemographic.8Socio-EconomicStatusEconomicsEagleCountyhasasigniicantlyhighermedianincomelevelthanthestateat70914and57685respectively.9Alsothepercentageofresidentslivinginpovertyislowerat10.3percentinEagleCountyand12.5percentinColorado.10HoweverEagleCountyscostoflivingishighsothatevenresidentsthatlivewellabovetheFederalPovertyLevelFPLmaynotmakeenoughincometomeettheirbasicneeds.Theself-suficiencystandardinEagleCountyforoneadultandonepreschooleris374FPLmuchhigherthantheColoradoaverageof251FPL.11UnemploymentEagleCountysunemploymentratehistoricallybetween3and4percentbegantoincreasedra-maticallyin2008correspondingtothenationalrecession.ByJune2012itreached9.2percentsurpassingthestateat8.4percentFigure3.12EducationLevelIntermsofeducationalachievementEagleCountyhasasigniicantlyhigherpercentageofadultsages25andolderthatarebachelorspreparedthanthestateasawholehoweverEagleCountyhasalowerpercent-ageofadultsthathaveatleastahighschooldiploma.Thismaybeduetotheachievementgapbyethnicityforlocalhighschoolstudents.In201166percentofLatinostudentsgraduatedinEagleCountycomparedto88percentofCauca-sianstudentsFigure4.13AlthoughColoradohasthesamedisparityEagleCountyhasahigherproportionofLatinostudents.IndicatorEagleCountyColoradoHighschoolgraduateorhigherpercentofpersonsage2587.889.7Bachelorsdegreeorhigherpercentofpersonsage252007-201146.936.3HighSchoolGraduationRatebyRaceEthnicityLatino6660HighSchoolGraduationRatebyRaceEthnicityCaucasian8881Figure4EducationalLevelbyRaceandEthnicityEagleCountyandColorado2011 6ProgressontheHealthyEagleCounty2010PlanHealthyEagleCounty2010wasthecountysirstcommunityhealthimprovementplanledbyEagleCountyPublicHealthanddevelopedbyacommunitysteeringcommitteebetween2005and2007.Theplanprovidedhealthpri-oritiesstrategiesandgoalstobereachedbytheyear2010includingImprovingAccesstoHealthCareIncreasingOralHealthResourcesIncreasingMentalHealthandSubstanceAbuseTreatmentServicesReducingMotorVehicleCrashInjuriesReducingPrematureDeathsfromChronicDiseaseThecapacitytoimprovethepublicshealthintheseareashasincreaseddramaticallysinceplanningbeganin2005.Thefollowingsectionhighlightstheprogressofeach2010priorityarea.ImprovedAccessToHealthCareInresponsetotheCountyshighrateofuninsuredresidentsHealthyEagleCounty2010focusedonincreasingac-cesstoprimaryhealthcare.FamilyPlanningIn2007EagleCountysBoardCountyofCommissionersBOCCapprovedacounty-operatedTitleXFamilyPlanningprogramtoprovidepregnancytestingbirthcontrolbreastandcervicalcancerscreeningsandsexuallytransmitteddiseasetestingandtreatment.Theclinichasbeenoperatingforiveyearschargingclientsbasedontheirabilitytopay.Thisistheonlycomprehensivereproductivehealthsafetynetclinicinthecounty.Itisfundedwithdollarsfromfederalstateandlocalgovernmentaswellasclientfees.CommunityHealthCentersThelonger-termstrategyoftheplanwastoexpandthehealthcaresafetynetbydevelopingaFederallyQualiiedHealthCenterFQHCaSchoolBasedHealthCenterSBHCorboth.Suchmodelsareeligibleformultiplestreamsoffederalfundingandwillseepatientsregardlessofinsur-ancestatus.Communitypartnershaveworkedforyearsonbothmodelsandaimtobeginprovidingbasicservicesin2013.Thelonger-termgoalistooffermorecomprehensiveservicessuchasdentalcareandmentalhealthatthesefacilities.ReducedNumberOfMotorVehicleCrashInjuriesHighwayImprovementsMotorvehiclecrashesMVCusedtobeoneofthetopleadingcauseofdeathamongbothadultsandadolescentsinEagleCounty.DuringtheplanningprocessEagleCountyPublicHealthandEagleCountyPublicSafetyCouncilworkedwiththeColoradoDepartmentofTransportationCDOTtostudymotorvehiclecrashesonI-70andstrategiestoreducethem.During2008-2009CDOTinstalleda33-milewildlifefencefromGypsumtoVail.Thefencewasdesignedtopreventvehicle-to-animalcollisionsandhasbeentremendouslysuccessful.Duringtheiveyearspriortofenceinstallationtherewasayearlyaver-ageof100vehicle-to-animalcollisionsonI-70plus82motorvehiclecrashhospitalizationsand10deathscountywide.14Afterfenceinstallationthenumberofanimalcollisionsdroppedtoanaverageof37peryearhospitalizationsfelltoayearlyaverageof34andtherewereonlytwodeathsfrommotorvehiclecrashescountywidebetween2010and2011.15SeatbeltOrdinanceAlsoasaresultoftheplantheBoardofCountyCommissionerspassedaprimaryseatbeltordinancegivinglocallawenforcementtheabilitytocitedriversfornotwearingtheirseatbeltasopposedtopullingthemoverforanotherviolationirst.Primaryseatbeltlawsincreaseregularlyseatbeltusagesigniicantlyreducingtheriskofseriousinjuryordeathinacrash. 7IncreasedOralHealthResourcesHealthyEagleCounty2010estimatedthatoverhalfofcountyresidentslackeddentalinsurance.Likemanyruralareasservicesfortheun-and-underinsuredhavebeenchallenginganddisjointedforalongtime.Theplanrecom-mendedprogramsforchildrensuchasamobiledentalvanaschool-baseddentalsealantsprogramandluoridevarnishclinicstotemporarilyillthegaps.Theluoridevarnishclinicswerenotsustainedafteraninitialthree-yeargrantandtheschool-basedprogramdidnotgetoffthegroundbutthemobiledentalvanprojectwassuccessfulforseveralyears.Eventuallyitevolvedintoayear-rounddentalvoucherprogramthroughtheleadershipoftheEagleCountySmilesCoalition.TheCoalitionraisesfundstopaylocaldentiststoserveeligiblechildren.IncreasedMentalHealthandSubstanceAbuseTreatmentServicesTheplanidentiiedaneedforadetoxcrisisstabilizationcenterinEagleCounty.Priorto2007intoxicatedindividu-alswereheldinjailovernightsometimescalledthedrunktankeventhoughtheyhadnotcommittedacrime.Lawenforcementoficersreportedinteractingwiththesameindividualstimeandtimeagain.AsastopgapmeasurelocallawenforcementagenciesMindSpringsHealthFormerlyColoradoWestRegionalMentalHealthCenterandEagleCountyPublicHealthreplicatedaPitkinCountyprogramtotransportintoxicatedindividualstothedetoxcentersinFriscoandGlenwood.Theprogramalsoofferedtreatmentreferralandcarecoordinationuponrelease.In2010MindSpringsHealthopenedalocaldetoxcenterintheVailPoliceDepartmentandhassincehadasuccessfultreatmentengagementrateof23percent.ThisfarexceedstheColoradoDepartmentofBehavioralHealthstargetof3percentaccordingtoKristaMcClintonRegionalDirectorofMindSpringsHealth.ReducedPrematureDeathsFromChronicDiseaseSmokingunhealthyeatinghabitsandalackofphysicalactivityallcontributetoheartdiseaseandcancertwoofEagleCountysleadingcausesofdeath.HealthyEagleCounty2010recommendedstrategiestoinluencebehaviorchangeintheseareasincluding1anindooroutdoorsmokingban2abuiltenvironmentthatpromotesphysicalactivityand3schoolwellnesspoliciesthatreduceaccesstounhealthyfoods.SmokingBansAnindooroutdoorsmokingbanwaspassedbytheBoardofCountyCommissionersBOCCandTownofAvonin2006.SeveralmonthslatertheColoradoIndoorAirActpassedwhichexpandedtheindoorportionofthebanthroughoutthecountyandstate.BuiltEnvironmentTheplanincludedshoulderwideningforbicyclesafetyonHighway6andcontinuedconstructionoftheCountystrailsystemECOTrails.ShoulderwideningfromEdwardstoEaglebeganin2008andwascompletedin2012throughapartnershipbetweentheCountyandCDOT.Since2006theECOTrailsystemhasexpandedbysevenmilesincludingEagletoGypsumalongHighway6inEagleareasinMinturnandEagleVailandwestofGypsum.SchoolWellnessPoliciesDuring2010theEagleCountyRE50SchoolDistrictstartedtheFreshApproachprogramwhichincludesamenuofmade-from-scratchitemsandfreshproducetoreplacehighlyprocessedfoodoptionsinschoollunches.Theprogramhasbeenimplementeddistrict-wideandwaswellreceivedbyfacultystudentsandparents.FinallytheplanrecommendedstrategiestosavelivesforthosealreadyinadiseasestateAEDProgramAnAEDprogramwasestablishedbytheEagleCountyPublicSafetyCouncilandcoordinatedbytheWesternEagleCountyAmbulanceDistricttopurchasestrategicallyplaceandmaintainAEDdevicesaroundthecounty.Accordingtotheliteraturemostpatientswillsurviveacardiaceventifdeibrillationisachievedwithinthreeminutes.AEDsaredesignedtobeoperatedbythelayperson.FederallyQualifiedHealthCenterTheplandocumentedtheissueofuninsuredresidentsandtheresult-inglackofscreeningspreventivecareanddiseasemanagementforthispopulation.TheplanrecommendedaFederallyQualiiedHealthCenterFQHCtoaddresstheissue.MountainFamilyHealthCenterswithFQHClocationsinBlackHawkandGlenwoodSpringsCOappliedforfundingtoopenalocationinEagleCounty.IntheFallof2013fundingtowardsopeningaFQHCinwasapprovedandisscheduledtobefullyoperationalinJanuary2014.Thislocationwillprovideanadditionalaccesspointforinsuredpersonsandconnectunin-suredresidentsandthosecoveredunderpublicinsuranceplanswithpreventativeservices. 8CommunityHealthAssessmentAcommunityhealthassessmentisakeytoolindevelopingaplantoimprovethepopulationshealth.Thetoolconsidersindicatorsofhealthonthecountylevelovertimeandcomparesindicatorstothestateandnation.Anassessmentalsotakesintoaccountthecommunityperceptionsofhealthissues.ItisthistypeofinformationthathelpsformthehealthprioritiesofthecommunityhealthimprovementplanCHIP.LeadingCausesOfDeathInEagleCountytheeightleadingcausesofdeathareresponsiblefor75percentoftotaldeaths.Theseincludecancerheartdiseaseunintentionalinjuriessuicidecerebrovasculardiseasestrokechronicliverdiseasecirrho-sischroniclowerrespiratorydiseaseemphysemaasthmachronicbronchitisandAlzheimersdisease.Sixoftheeightaregenerallypreventablethroughahealthylifestylethatincludesdietandexercisenotsmokingwearingaseatbeltandlimitingalcoholconsumption.Figure5comparesEagleCountysleadingcausesofdeathwithColoradoandtheUS.16Cancerandheartdiseasecontinuetobethetwoleadingcausesnationwideandlungcanceristheleadingtypeofcancerdeath.HoweverbecauseofEagleCountysrelativelyyounghealthyandactivepopulationtheCountyhascomparativelylowerratesoftheseandotherchronicdiseasesFigure6.ColoradohassimilardemographiccharacteristicstoEagleCountywhichpartiallyaccountsforunintentionalinjuryandnotachronicdisease-realteddeathasthethirdleadingcauseofdeathatthestateandlocallevel.EagleCountyandColoradohavesimilarratesofsuicidesigniicantlyhigherthanthenationalsuicideratewheresuicideisnoteveninthetop15leadingcausesofdeathnationally.EagleCounty2009-2011Colorado2009-2011UnitedStates20111.Cancer2.HeartDisease3.UnintentionalInjuries4.Suicide5.CerebrovascularDisease5.ChronicLiverDiseaseCirrhosis6.ChronicLowerRespiratoryDisease6.AlzheimersDisease1.Cancer2.HeartDisease3.UnintentionalInjuries4.ChronicLowerRespiratoryDisease5.CerebrovascularDisease6.AlzheimersDisease7.Suicide8.Diabetes1.HeartDisease2.Cancer3.ChronicLowerRespiratoryDisease4.CerebrovascularDisease5.UnintentionalInjuries6.AlzheimersDisease7.Diabetes8.InluenzaFigure5LeadingCausesofDeathbyNumberofEventsEagleCountyColoradoandUnitedStatesDeathratetiedbynumberofevents 9Figure6comparesdeathratesforEagleCountysfourleadingcausesonthelocalstateandnationallevelandillus-tratesthelowerratesofchronicdiseaseanddisparityinthesuiciderate.Adeathrateisthenumberofdeathsinagiventimeperioddividedbythenumberofpeopleinthepopulation.Itisexpressedasper100000population.Figure7illustrateslocaltrendsintheleadingcausesofdeath.Deathsfromheartdiseasehavebeendecliningforseveralyearsmirroringanationaltrend.TheCentersforDiseaseControlandPreventionCDCcitesareductioninsmokingbetterdiseasemanagementforpatientswithhighbloodpressureandhighcholesterolandimprove-mentsintreatmentforheartdiseaseasthemaincontributorstothedecline.17CancerdeathshavealsobeguntodeclineinEagleCountywhichisconsistentwithratesatthestateandnationallevel.AccordingtotheCDCbetterscreeningtreatmentadvancesandpreventioneffortstoreducesmokingandotherunhealthybehaviorsarethecontributingfactors.18Thedecreaseinunintentionalinjuriesismainlyduetoasignificantreductioninmotorvehiclecrashdeaths.Thisisalsoanationaltrend.AccordingtotheNationalHighwayTransportationandSafetyAdministrationsafervehiclessaferroadwaysseatbeltandchildsafetyseatlegislationandgraduateddriverslawsforteenagerareresponsibleforthereduction.19Since2006ColoradohassignificantlyenhanceditsgraduateddriverslicenselawstheCountypassedaprimaryseatbeltordinanceandtheColoradoDepartmentofTransportationinstalledafenceonI-70topreventanimal-to-motorvehiclecollisions.Thesemeasureshavecontributedtoasignificantdecreaseatthecountylevel. 10LeadingCausesOfInjuryHospitalizationsFigure8illustratestheleadingcausesofhospitalizationsduetoinjury.Slipstripsandfallsfromstepsorstairsarebyfartheleadingcauseofhospitalizationsnationwide.Adultsages55andolderaremorepronetobecomingvic-timsoffallsandtheresultinginjuriescandiminishtheabilitytoleadactiveindependentlives.FortypercentoffallhospitalizationsinEagleCountyaretoadultsoverage55.20InjuryCauseAverageNo.PerYear1.Sliptripfallfromstairs592.Skisnowboard333.Motorvehiclecrash204.Strikingagainstbyobjectspersonse.g.sports145.Suicideattempt116.Bicycling107.Fallfromladderbuildingstructure88.Motorcyclecrash79.Poisoninge.g.drugsalcohol5Skiandsnowboardinjuriesarethesecondleadingcauseofhospitalizationduetoinjuryatanaverageof33peryear.Thisnumberhasbeenconsistentovertime.Injuriesfrommotorvehiclecrasheshavedecreaseddramati-callyfromanaverage60peryear2006-2008to20peryear2009-2011.ThisisduetoseatbeltandgraduateddriverslicenselawsandtheI-70wildlifefencethatpreventsanimal-to-vehiclecollisions. 11LeadingTypesOfCommunicableDiseaseColoradosStateBoardofHealthdetermineswhichconditionsanddiseasesarerequiredtobereportedtostateandlocalhealthdepartments.Figure9liststhecommunicablediseasesreportedinEagleCountywithmorethaniveannualcasesfrom2009-2011.2122Figure9LeadingTypesofCommunicableDiseaseAverageNumberperYearEagleCounty2009-2011CommunicableDiseaseMethodofTransmissionAverageNo.PerYear1.ChlamydiaSexuallyTransmitted782.HepatitisCBloodneedlestransfusioninfectedmother143.CampylobacterFecal-oralincludingcontaminatedfoodandwater104.HospitalizedFluPerson-topersoninhalation105.GiardiaFecal-oralincludingcontaminatedfoodandwater76.SalmonellaFecal-oralincludingcontaminatedfoodandwater6Chlamydiaisconsistentlythemostcommonlyreportedcommunicablediseaseatthestatelocalandnationallevels.Chlamydiaisahighlycontagioussexuallytransmitteddiseaseandmaynotshowsymptoms.Ifleftuntreateditcanleadtoinfertilityinfemales.EagleCountyprovidesSTDtestingandtreatmentonaslidingfeescale.HepatitisCisthesecondmostcommonlyreportedcommunicablediseasewhichoccursataconsistentrateovertime.ThehepatitisCvirusisspreadthroughinfectedbloodmostcommonlythroughneedlesharinganeedlestickinhealthcaresettingsandaninfectedmothertobaby.Priorto1992andbloodsupplyscreeninghepatitisCwasalsospreadthroughbloodtransfusionsandorgantransplants.TheCentersforDiseaseControlandPreventionrecommendsthatallpersonsbornduring1945through1965betestedforhepatitisCinfection.MostoftheothercommunicablediseasesregularlyfoundinEagleCountyarespreadviathefecal-oralroutethroughinfectedwatere.g.riversandlakesorfood.Inbothcasesthesourceislikelyfarmanimalswildlifeorhumans.Pasteurizationofdairyproductsadequatetreatmentofwatersuppliesandrestaurantinspectionsarekeypublichealthstrategiestopreventoutbreaksofthesediseases.Goodhandhygieneandsafefoodpreparationarealsoimportanttopreventillness.InluenzaorluismorecommonthananyofthereporteddiseasesinEagleCountybutitisonlyreportablewhenanindividualishospitalized.Inluenzaisacontagiousvaccine-preventablerespiratoryillnessthataffectsbetween5and25percentofthepopulationonanygivenyearandcanleadtopneumoniaorothercomplicationsincludingdeath.Theelderlychronicallyillpregnantwomenandyoungchildrenareparticularsusceptibletolifethreaten-ingcomplications.Inanaverageyear4-6EagleCountyresidentsarehospitalizedwiththeluhoweverin2009H1N1anewinluenzastrainresultedin22hospitalizations. 12BehaviorialAndOtherHealthRisksRISKBEHAVIORECTeensCOTeensUSTeensECAdultsCOAdultsUSAdultsSmoking18161814.518.421.1Notwearingaseatbelt8.57.06.7Lackofrecommendedlev-elsofphysicalactivityiii52535021.238.2SOURCES2011-2012HealthyKidsCOSurvey-RE50Schools2011HealthyKidsCOSurvey2011YouthRiskBehaviorSurvey2010-2011BehavioralRiskFactorSurveil-lanceSystem2010-2011Behav-ioralRiskFactorSurveillanceSystem2011Behavior-alRiskFactorSurveillanceSystemFigure10PercentageofAdultsandAdolescentsEngaginginBehaviorsthatPutTheirHealthatRiskEagleCountyColoradoandUnitedStatesVariousYearsManyoftheleadingcausesofdiseaseandinjurycanbepreventedthroughbehaviormodiication.Forexamplemosthealthexpertsagreethatquittingsmokingisthesinglebestthinganindividualcandotoimprovetheirhealthregularexercisecansupportoverallyhealthandmentalwellbeingwhilepreventingordelayingonsetofchronicdiseaseandwearingaseatbeltisthemosteffectivewaytopreventdeathandseriousinjuryinacarcrash.Figure10providesthepercentageofadultsandyouththatengageinbehaviorsthatputthematriskhealth-wise.MaternalAndInfantHealthFigure11providesanoverviewofbirthstatisticsmaternalandinfanthealthindicators.ThefertilityrateiiiandteenfertilityrateinEagleCountyarenearlyidenticaltothestate.Fertilityrateshavebeendecliningatthenationalstateandlocallevelforthepast10years.Improvementsincontraceptivetechnologyaccesstolonger-termcontracep-tionmethodsincludingthroughTitleXFamilyPlanningclinicsandareductioninthenumberofimmigrantwom-engivingbirthsincetherecessionarereasonscitedbythePewResearchCenter2012.23Disparitiesinmaternalandinfanthealthstatisticsareapparentbyethnicity.InEagleCounty90percentofteenmothersareLatinas.24Infantsborntoteenmothersareatincreasedriskofprematureandlowweightbirths.25AlsoLatinasofallagesaremuchlesslikelytoaccessprenatalcarewithintheirsttrimesterinEagleCountyandColora-do.Prenatalcarehelpspreventbirthcomplications.EagleCountyissimilartoColoradointhepercentageofteensthatreportedeverhavingsexualintercourseandthepercentageoflowweightbirths.2627EagleCountyhashigherratesofbreastfeedinginitiationandbreastfeedingafternineweeksthanthestate.28i.AdolescentIndicatorThepercentageofstudentswhowerephysicallyactivefor60minutesperdayoniveormoreofthepastsevendays.ii.AdultIndicatorThepercentageofadultsaged18yearsthatget30minutesofmoderateactivityperdayon5daysweekor20minutesofvigorousactivityperdayon3daysweek.iii.Afertilityrateisthemeasureofbirthsamongfemaleswithinapopulation.Thefertilityrateiswrittenasthetotalnumberoflivebirthsper1000femalesages15-44inthepopulationwomenofchildbearingage. 13Indicator2009-2011EagleCountyColoradoFertilityRate64.61000pop.64.71000pop.TeenFertilityRate32.41000pop.32.71000pop.PercentageofTeensthatEverhadSexualIntercourse4041PercentageLatinaBirthsPercentageLatinaTeenBirthsPercentageFirstTrimesterPrenatalCare499077305977PercentageFirstTrimesterPrenatalCareLatinasLowBirthWeight 14HealthyLiving-ActionPlanStrategiesActivitiesOutcomesGoalPreventchronicdiseasethroughthereductionofoverweightandobesityriskfactorsObjectivesIncreasethecommunityscapacitytoidentifybarriersandaddressgapsinhealthyeatingandactivelivingthroughbuildinganeffectiveCoalition.Increaseeffortstoimprovehealthequity.PartneringAgenciesRecreationFacilitiesNon-profitOrganizationsHealthCareProvidersTransitProvidersMediaLocalBusinesesChambersofCommerceTownandCountyGovernmentsHealthyCommunitiesCoalitiontofacilitateandempowerthecommunityintoactionforlifelongwellness.Communitymembersandleadersparticipateinhealthyeatingandactivelivinginitiatives.EngagecommunitypartnerstoaddresshealthinequityamonglowsocioeconomicstatusandLatinopopulations.HealthyCommunitiesCoalitionworkgroupsimplementevidence-basedstrategiesthatsupporthealthyeatingandactivelivingsuchaspolicydevelopmentandchangesthatprioritizeHEALviatheLiveWellHEALCitiesandTownsCampaign.Increasenumberofengagedcommunitypartnersworkingonhealthyeatingandactiveliving.Engagedisparatepopulationsinthehealthyeatingandactivelivingpromotionandawarenessthroughtheimplementationofacommunityhealthworkerprogram.30evidence-basedstrategiesimplementedthatsupporthealthyeatingandactiveliving5townsadoptresolutionandjoinLiveWellHEALCitiesandTownCampaign.EffectivenessofCoalitionandcommunitypartnershipsareevaluatedonbuildingactionaroundhealthyeatingandactivelivingchangeandenablingmorecollaborationtotakeplaceamongcommunityorganizations.Increaseawarenessofhealthyeatingandactivelivingandimproveself-efficacyforchronicdiseaseprventionthroughtrainingadiverseworkforcehealthpromotionandcommunityhealthworkermodel. 15HealthyLiving-QuickFactsWhyisitaPriorityOverweightandobesitycostColroadoshealthcaresystemapproximately874milliondollarsin2003.RisinghealthcarecostsimpactusallincludinginEagleCountywhereatleast23ofresidentsareuninsured.ReducingtheburdenofchronicdiseaseisgoodforthewellbeingofEagleCountyresidentsinadditiontothefiscalhealthofEagleCounty.WhoisatRiskAlthoughmanypeopleareattractedtotheregionforrecreationalopportunitiesthislifestyledrivesupthecostoflivingwhichthendisproportionatelyaffectslower-incomeresidentsinEagleCounty.Povertyandobesityareinextricablylinkedduetofoodinsecuritythatlow-incomehouseholdscommonlyexperience.Limitedfinancialresourcesoftencausefamiliestopurchasethelargestquantityoffoodthattheycanaf-fordwhicharemostoftentheleastnutritiousfoods.Approximately30ofEagleCountyresidentsareofHispanicorLatinoorigin.Hispanicstendtoexperiencedisproportion-atelyhigherratesofoverweightandobesity67ofColoradoHispanicsareoverweightorobese.Ourchildrenandyoutharealsoatrisk.Householdswithchildrenaremorelikelythanthosewithoutkidstoexperiencefoodinsecurityandfamilieswithchildrenunder6yearsofarethemostlikelytobefood-insecure.Growingbrainsandbodiesneedanadequateamountandvarietyofvitaminsandnutrientstodevelopintohealthyadults.Inadditionourchildrenareespeciallyvul-nerabletojunkfoodmarketingandnegativeinfluencesontheirhealthatschoolandathome.WhatcanwedoCommunityCreateahealthinallpolicesphiloso-phythatsupportshealthyeatingandactivelivingforadultsandchildren.OrganizationsCollaborateonstrategiesandprogramsthatencouragehealthyeatingandactiveliving.Shareresourcesandtoolstostrengthenthecapacityandreachofprograms.Employerscanprovideemployeeswithworksitewellnessprograms.FamiliesandIndividualsTakeownershipofyourhealth.Main-tainahealthydietlowinsugarsaltandsaturatedfats.Eatmorefruitsandvegetables.Get30minutesormoreofmoderateexercisesuchaswalkingeveryday.Beachampionforhealthyeatingandactivelivingamongyourfamilyfriendsworkplaceandsocialnetwork.InformationgatheredfromCDPHEChildHealthSurvey2009httpwww.chd.dphe.state.co.ustopics.aspxqMaternal_Child_Health_DataFinkelsteinEAFiebelkornICWangG.Statelevelestimatesofannualmedicalexpendituresattributabletoobesity.ObesRes.20041211824.ColoradoHealthInstituteDataRepositoryCountyProfilesOver55ofhouseholdsinEagleCountyareaffectedbychronicdiseasessuchasdiabeteshighbloodpressureandcardiovasculardiseaseoverweightandobesitydirectlyleadstotheonsetofthesediseases.55InEagleCounty46ofadultsand18ofchildrenages2-14areoverweightorobese.AlthoughtheadultoverweightandobesityrateislowerthanforColorado56theratescontinuetoincreasejustliketherestofthestateandthenation.BecauseoftheserisingtrendsEagleCountyhasprioritizedhealthyeatingandactivelivingstrategiestoreduceobesityratesreversetheburdenofchronicdiseaseandkeepourcommunityhealthyandthriving.46 16HealthyLivingThecommunityhasidentiiedhealthylivingasaCommunityHealthImprovementPlanCHIPpriorityforthenextiveyears.Healthylivingencompassesbehaviorsthatsupportgoodnutritionandphysicalactivityforalifetimetopreventtheearlyonsetofchronicdiseases.ThereareseveralreasonswhythisisimportantFouroutoftenoftheCountysleadingcausesofdeatharepreventablethroughdietandexerciseincludingheartdiseasecancercerebrovasculardiseaseleadingtostrokeanddiabetes.Manychronicdiseasesaremanageablethroughappropriatemedicalcareandbehavioralmodiicationtopreventearlydeath.TheLatinocommunity30percentofEagleCountyresidentshaveanincreasedprevalenceofoverweightandobesityincreasingtheirriskofchronicdisease.Programswhichtargetchildrenandadolescentscanestablishhealthyeatingandexercisehabitsearlyinlifeandleadtolong-termhealthybe-haviorinadulthood.TheHealthyLivingstrategiesincludefocusonthereductionofhealthdisparitiesandanincreaseinhealthequity.Healthdisparitiesaredifferencesinthepersis-tenceofdiseasehealthoutcomesoraccesstohealthcarebetweenpopulationgroups.29HealthEquityisachievedwheneverypersonhastheopportunitytoattainhisorherfullhealthpotentialandnooneisdisadvantagedfromachiev-ingthispotentialbecauseofsocialpositionorothersociallydeterminedcircum-stances.30IndicatorsTheresultsofpoornutritionandinactivitycanbemeasuredbytheprevalenceofoverweightandobesitywhichhaveincreasedsigniicantlyintheUSoverthepast20years.Thisincreaseparticularlyinchildrenhasalarmedhealthoficials.In2004theUSSurgeonGeneralstatedthattodayschildrenmaybetheirstgenerationtohaveashorterlifeexpectancythantheirparents.31OverweightandObesityAdultsIngeneralEagleCountyadultsages18andold-erareleanerthantheirstateandnationalcounterpartsat46percentoverweightorobesecomparedto56percentinColoradoand69percentnationally.32EvenwiththecomparativelyloweroverweightandobesityrateschronicdiseaseisstilltheleadingcauseofdeathinEagleCountyandpreventioneffortswillhaveapositiveimpactlocally.AdolescentsAlowerpercentageofEagleCountyivandColoradohighschoolstudentsareoverweightthantheirnationalcounterpartsat10percentand11percentrespectivelycomparedto15percentnationally.EagleCountysrateofobesityamonghighschoolstudentsis4percentcomparedto7percentinthestateand13percentnationallyFigure12.333435iv.TheindicatordoesnotincludestudentsinBasaltHighSchoolwhichispartoftheForkValleySchoolDistrict. 17ChildrenTheWomenInfantandChildrenWICprogramisareliableconsistentdatasourceformeasuringweightinchildrenlessthaniveyearsofage.WICisasupplementalnutritionprogramthatserveschildrenunderage5withafamilyincomeatorbelow185FPL.ThemajorityofEagleCountyWICclientsareLatino92percent.InEagleCounty15.5percentofWICchildrenages2-4areconsideredoverweightand10.8percentareconsideredobese.TheseiguresaresimilartoColoradoandthenationasawholeFigure13.36LatinosDatafromtheFederalOficeofMinorityHealthindicatethatLatinosaremorelikelytobeoverweightandobesethanCaucasians.37AccordingtoanindicatorthatincludesEagleGarieldSummitGrandandPitkincountiesv41.5percentofLatinosareover-weightcomparedto33.1percentofCaucasians.Twenty-sixpercentofLatinosareobesewhichistwicetheper-centageofCaucasians13.6percentFigure14.38Althoughtherearemanyreasonsforthesedisparitieshealthinequitiescanbeattributedtolowerincomesgreaterfamilydemandsandlessaccesstorecreationalopportunitiesandhealthyfood.39Figure13.PercentageofWICChildrenAges2-4thatareOverweightorObeseEagleCountyandColorado2011andUnitedStates2010IndicatorEagleCountyn251ColoradoUSPercentOverweight15.514.216.1PercentObese10.810.014.4v.Thisindicatorisnotmeasuredbyraceorethnicityonacountylevel. 18HealthyBehaviorsBehavioralindicatorsrelatedtophysicalactivityandnutritionareregularlymeasured.ThefollowingisasummaryofindicatorsforEagleCountyColoradoandtheUS12.3percentofEagleCountyadultsreportednotparticipatinginanyphysi-calactivityoutsideoftheiremploymentduringtheprevious30dayscom-paredto18.2percentinthestateand23.9percentnationally2009-2010.404148percentofEagleCountyhighschoolstudentsreportedlyarenotmeetingthephysicalactivityrecommendationof60minutesperdayoniveormoreofsevendays2011-2012comparedto47percentinthestate2011and50percentnationally2011.42434469.5percentofEagleCountyadultsreportednotmeetingtherecommendedleveloffruitandvegetableintakeofiveormoreservingsperday2009-2010comparedto75.0percentinthestate2009-2010and76.6percentnationally2009.454624percentofEagleCountystudents2011-2012reportedwatchingTVforthreeormorehoursperdayonanaverageschooldaycomparedto21percentinthestate2011and31percentnationally2011.47484920percentofEagleCountyhighschoolstudentsdrankoneormoresodasperdayduringthepastsevendays2011-2012comparedwith23percentinthestateand28percentnationally2011.CommunityCapacityThefollowingsectionillustratessomeofthemajorlocalprogrammingaimedatpreventingandreducingtheeffectsofchronicdisease.50EagleCountyPublicHealthdevelopedtheHealthyCommunitiesCoalitionagroupofovertwentyengagedcommunityorganizationsthatpromotepoliciesandactivitiesforhealthyeatingandactiveliving.TheCoali-tionusesastrategiesbasedmodelwherebymemberschooseevidence-basedstrategiesthroughaprioriti-zationprocessandcreateactionplansforimplementationandachievement.EagleCountyPublicHealthrecentlyreceivedathree-yeargranttoimplementtheEstoySanoinitiativetargetingtheSpanish-speakingcommunitywithhealthyeatingawarenessandeducationinadditiontohealthyfoodaccessprogramsandpolicy.ColoradoStateUniversityExtensionCSUExtensionpro-videsanumberofoutreachandeducationalprogramstohelpparticipantslearnaboutnutritionfundamentalshowtomakehealthierfoodchoicesfortheirfamiliesbemorephysicallyactivemakenutritiousrecipesandhowtostretchtheirfooddollars.TheEagleCountyRE50SchoolDistrictsFreshApproachprogramprovidesmade-from-scratchschoollunchesandfreshproducebarsinelementarymiddleandhighschools.Thesemealsreplacethehighlyprocessedfoodsfoundinmostschoolcafeterias.EagleCountyRE50SchoolDistrictprovidestheUniversalBreakfastProgramatAvonElemen-taryJuneCreekElementaryandBerryCreekMiddleSchoolallowingallstudentsinthoseschoolstoreceiveahealthy 19breakfasteverymorningatschool.CommunitygardensarelocatedthroughoutthevalleyincludinginWestVailEagle-VailMinturnAvonCMCEdwardsandEagle.Thesegardensareopportunitiesforcommunitymemberstogetgrowandharvesttheirownfood.InadditiontheProduceforPantriesprogramencouragescoumminutygardenparticipantstodonateextraproducetolocalfoodpantries.AnumberoforganizationsarededicatedtoyouthsuccessachievementhealthandempowermentthroughavarietyofprogrammingandpartnershipsincludingbutnotlimitedtoTheYouthFoundationtheeduca-tionalarmoftheVailValleyFoundationSOSOutreachWalkingMountainsandtheEagleRiverYouthCoali-tion.VailRecreationDistrictAvonRecreationCenterandWesternEagleCountyMetroRecreationDistrictpro-videampleopportunitiesforphysicalactivityforadultsyouthandchildrenthroughorganizedsportsit-nessclassesprivateinstructionandyouthprograms.VailValleySalvationArmyandUnitedMethodistChurchprovideemergencyfoodassistancetocommunitymembersthroughfoodpantries.VailValleyPartnershipVVPistheeconomicdevelopmentleaderandadvocateforbusinessesinEagleCounty.TheVVPmanycollaborationopportunitieswithlocalbusinessesforhealthrelatedeffortsincludingworksitewellness. 20IndependentlyAginginPlace-ActionPlanStrategiesActivitiesOutcomesGoalCreateanenvironmentthatenablesolderadultstoindependentlyageinplace.ObjectivesCommunitycollaborativedevelopsstrategiesthatsupportsolderadultstoageinplace.IncreasethenumberofolderadultsparticipatingincommunityprogramsthatmanagechronicconditionsandreduceinjuriesduetofallsWellandWiseProgram.PartneringAgenciesRecreationFacilitiesNon-profitOrganizationsHealthCareProvidersCommunityandEmergencyRespondersTransitProvidersMediaGovernmentFacilitateandfosterOlderAdultCollaborative.Developaregionalcollaborativepreventativesystemforchronicdiseaseself-managementandfalls-prevention.Collaborativeplanninggroupassessestargetpopulationneedsgapsandservicesanddevelopslong-termstrategicplan.BuildpartnershipswithpatientcenteredmedicalhomescreateareferralsystemandmechanismforpaymentfromhealthcareproviderstoWellandWiseprogramchronicconditionself-managementandfallspreventionclasses.5-yearplanforaginginplaceisinitiatedandCollaborativeiseffectiveincoordinatingservicesforOlderAdults.Fourpatient-centeredmedicalhomesrefereligiblepatientstoWellandWiseprogram.Paymentreimbursementsysteminplace. 21WhyisitaPriorityPromotingaginginplaceinEagleCountywillimprovethehealthandqualityofyearslivedbyourresidentsandinadditionitisfiscallyresponsiblefortheCounty.In2009directhealthcareexpendi-turesforchronicconditionsintheUStotaledmorethan262billion.ForColoradansalreadydiagnosedwithachronicconditionincreasedopportunitiesforlearningeffectivemanagementofconditionswillimproveindividualsself-efficacyinmaintainingactivelives.TheStanfordSuiteofSelf-ManagementProgramsdemonstratedacost-savingsratioof110.Fallsandfalls-relatedinjurieshaveenormousper-sonalandeconomicconsequencestoindividualssocietyandthestatehealthcaresystem.InColora-dotheaveragelengthofstayforolderadultshospi-talizedduetofallingwas4.7dayswithachargeofmorethan23000.Reducingtheburdenofchronicdiseaseandde-creasingfallswillprovideEagleCountywithcostsavingsandcanalsoencourageeconomicdevel-opment.Forexamplebycreatingthesystemsandresourcestoallowseniorstoageinplacemil-lionsofdollarscanberetainedinourcommunity.WhatcanwedoCommunityCreatepoliciesthatsupportaginginplace.Insurethattransportationaffordablehousinghomehealthandcommunitydesignaretakingintoaccountanagingpopulation.Makingthehealthychoicetheeasychoice.OrganizationsCollaborateonstrategiesthatencourageaginginplaceincludingfalls-preventionandchronicconditionself-managementprograms.Shareresourcesandtoolstostrengthentheca-pacityandreachofprograms.Createpartnershipstopoolresourcesandpur-chasingpower.FamiliesandIndividualsVolunteerandgetinvolved.Manyprogramsexistforassistancetoseniorsandthatencour-ageaginginplace.Prioritizehealthyeatingandactiveliving.Seekingpreventativecarefromyourmedicalprovider.InformationgatheredfromColoradoDepartmentofPublicHealthandtheEnvironmentColoradoActionPlanforOlderAdultWellnessAPublichealthStrategy2007.ColoradoDepartmentofPublicHealthandEnvironmentColoradoHealthInformationDatasetQueryInjuryHospitalizations2009-2011.Availableonlinewww.chd.dphe.state.co.uscohidtopics.aspxqInjury_HospitalizationsIndependentlyAginginPlace-QuickFacts1691840TheCentersforDiseaseControlandPreventiondefinesaginginplaceastheabilitytoliveinonesownhomeandcom-munitysafelyindependentlyandcomfortablyregardlessofageincomeorabilitylevel.WithBabyBoomersgettingolderandmoreretireesmovingintoEagleCountytheseniorpopulationasdefinedas65isanticipatedtoincreaseby169between2010and2020whichwillrankEagleCountyasfirstinthestateforgrowthinthisdemographic.Topromoteaginginplacepreventionmeasurestoreducefallsandchronicconditionsshouldbeimplemented.Seventypercentofalldeathsofpeopleover65arecausedbychronicconditions.Poordietandphysicalinactivityaremajorcontributorstodisabilitiesthatresultinarthritisdiabetesosteoporosisobesitycardiovasculardiseaseandfalls.InColorado18ofpeopleovertheageof65areobeseand25havenoleisuretimephysicalactivity.Slipstripsandfallsfromstepsorstairsarebyfartheleadingcauseofhospitalizationsnationwide.Adultsages55andolderaremorepronetobecomingvictimsoffallsandtheresultinginjuriescandiminishtheabilitytoleadactiveindependentlives.FortypercentoffallhospitalizationsinEagleCountyaretoadultsoverage55. 22IndependentlyAginginPlaceCommunitypartnershaveidentiiedindependentlyaginginplaceasaCommunityHealthImprovementPlanCHIPpriorityoverthenextiveyears.EagleCountysfastestpopulationgrowthwillberesidentsolderthan60.Thelargestareaofgrowthisexpectedinthe75andoldergroup.Theincreaseinolderadultsisexpectedtoshowlargerincreasesthanatthestateornationallevel.Thegrowthintheolderadultpopulationwillbringopportuni-tiesandchallengestothemountainregion.51PromotingindependentlyaginginplaceinEagleCountywillimprovethehealthandqualityoflifeofourresidents.Additionallyitisiscallyresponsibleforthecounty.Chronicconditionssuchasdiabetesheartdiseaseandarthri-tisanddisabilitiesduetofallsdisproportionatelyaffectolderadults.Theseconditionsaccountforsevenoutoftendeathsandmorethanthree-quartersofallhealthcarecostsintheUS.52Forresidentsalreadydiagnosedwithachronicdiseaseincreasedopportunitiesforlearningeffectivemanagementofconditionswillimproveindividualsself-eficacyinmaintainingactivelives.TheStanfordSuiteofSelf-ManagementProgramsdemonstratedacost-sav-ings10dollarssavedforeverydollarspent.Fallsandfalls-relatedinjurieshaveenormouspersonalandeconomicconsequencestoindividualssocietyandthestatehealthcaresystem.InColoradotheaveragelengthofhospitalstayforolderadultshospitalizedduetofallingwas4.7dayswithahospitalbillofmorethan23000.ReducingtheburdenofchronicdiseaseanddecreasingfallswillprovideEagleCountywithcostsavingsandwillalsoencourageeconomicdevelopment.Forexamplebycreatingthesystemsandresourcestoallowolderadultstoageinplacedollarscanberetainedinourcommunityasthecurrenteco-nomiceffectsofolderadultsleavingEagleCountyisestimatedtobe43millionperyear.53Olderadultswhoaresupportedbytheircommunityinremainingindependentarelikelytoexperienceanimprovedqualityoflifehavefewerhospitalvis-itsandlowerratesofdisability.54Itisinthecommunitysbestinteresttosupportaginginplacesothatolderadultsareabletoliveindependentlyforaslongastheywishtodoso.55IndicatorsSeventypercentofalldeathsofpeopleover65arecausedbychronicdisease.Poordietandphysicalinactivityaremajorcontributorstodisabilitiesthatresultinarthritisdiabetesosteoporosisobesitycardiovasculardiseaseandfalls.InColorado18ofpeopleovertheageof65areobeseand25havenoleisuretimephysicalactivity.Slipstripsandfallsfromstepsorstairsarebyfartheleadingcauseofhospitalizationsnationwide.Adultsages55andolderaremorepronetobecomingvictimsoffallsandtheresultinginjuriescandiminishtheabilitytoleadac-tiveindependentlives.FortypercentoffallhospitalizationsinEagleCountyaretoadultsoverage55.56.57CommunityCapacityCastlePeakOlderSeniorCareCommunityisbeingplannedlocallytoaddresslong-termcareneedsforolderadultsinEagleCountyincludingnewfacilitiesforassistedlivingandskillednursingcare.CastlePeakOlderadultCareCommunityisscheduledtoopenin2014.EagleCountyParamedicServicesCommunityPara-medicProgramhelpsresidentsmanagechronicdiseasethroughhomevisitsorderedbythetreatingphysi-cian.Theparamedicstakesvitalsignsprovideseducationandassuresthatallmedicationsarebeingtakenproperly.TheOlderAdultCollaborativeisagroupofolderadultservicesprovidersinEagleCountywhomeetonaquarterlybasistocreateastrategicplanonhowbesttoillgapsinservicesfortheolderadultpopulation. 23HomeHealthandcaregiverservicesinEagleCountyprovideinhomecaretoensurethatolderadultscanageindependentlyintheirownhomesforaslongastheywishtodoso.EagleCountyPublicHealthsHealthyAgingProgrampro-videsolderadultswithevidencebasedprogramsandservicestohelpthemageindependentlyintheirownhomes.Chronicdiseaseself-managementandfallspreventionprogramsarepopulationbasedpreventionprogramstoassistolderadultstoindependentlyageinplace.EagleValleyOlderAdultLifeisalocalnon-proitcurrentlyoperatingasocialadultdaycareprogramtwiceperweek.ThisprogramisgearedtowardsolderadultswithAlzheimersorotherformsofdementia.Thisprogramisalsokeyingivingcaregiverstimeawayfromtheiroftenround-the-clockduties.TheAlpineAreaAgencyonAgingAAAAisthedesignatedregionalplanningandserviceagencyforolderadultservicesinEagleGrandJacksonPitkinandSummitcounties.TheyalsoadministerOlderAmericansActfundingwhichisintendedtoassistolderAmericanstoliveindependentlyandwithdignityintheirowncommunities.EagleCountyishometomanyhighqualityrehabilitativeservicessuchasphysicaloccupationalandspeechtherapyamongothers.Theseoutpatientservicesallowolderadultstogainimprovementswhereneededandhelpkeepthemlivingindependentlyforaslongaspossible.ConceptualRenderingofCastlePeakSeniorCareCommunity 24ConnectiontoPreventativeCare-ActionPlanStrategiesActivitiesOutcomesGoalConnectallresidentstopreventionfocusedprimarycareresourcesandservices.ObjectivesIncreasetheuseofpreventativecareservicesbasedonrecommendedhealthindicatorscreeningsfrombaselinedata2007-2009toHealthyPeople2020benchmarks.IncreasetherateofindividualswithhealthinsurancecoverageinEagleCountyfrom77percentto85percent2010nationalaverageby2017.PartnersEagleCountyGovernmentHealthcareProvidersCommunityHealthOrganizationsIdentifyandsupportopportunitiestoenhanceorexpandprimarycaretounderservedpopulations.Increasepublicawarenessofhealthinsuranceoptions.IncreasepublicawarenessoftheimportanceofregularpreventivecaretopositivehealthoutcomesInvestigatetheestablishementofacommunitycarecollaborativeinEagleCounty.UseHealthCoverageGuidestopromoteConnectforHealthColoradoandprovidein-personassistancetopersonsapplyingforinsurance.PromotethepreventativehealthservicescoveredbyinsuranceplansthroughtheAffordableCareAct.Increasedaccesstoqualityhealthcareoptions.CoordinatedregionalimplementationoftheAffordableCareAct.Increaseduseofpreventativehealthcareservices. 25WhyisitaPriorityThehighnumberofpersonsinEagleCountywithnohealthinsurancehasimplicationsforindividualhealthandsocietalcosts.Millionsofuninsuredpersonsforgosomeneededhealthcareduetocostconcernswhichcanleadtopoorerhealthandpoten-tiallytogreatermedicalexpendituresinthelongterm.Additionally40ofadultshaveachroniccondition.Whenindividualsareuninsuredwithachronicconditiontheyarethreetimeslesslikelytoseekmedicalcarefortheirillness.Thislackofpreventativecareanddelayinseekingmedicalattentionincreaseslong-termhealthcarecostsleadstopoorhealthandanearlydeath.Accesstoprimarymedicaloralvisionandbehavioralhealthservicesareimportantinmaintaininggoodoverallhealth.Thisisespeciallytrueforchildren.Asof201216ofEagleCountyResidentsareinsuredunderpublicinsuranceplansMedicaidMedicareorCHPandthenumberofMedicaidre-cipientsisexpectedtoincreaseduetoMed-icaidexpansion.ManyMedicaidrecipientsandallCHPrecipientsarechildrenundertheageof18.InEagleCountythereisanextremelylimitednumberofprovidersthatacceptpublicinsuranceplansespeciallyintheoralvisualandmentalhealthfieldscre-atingadisparityforlow-incomechildrenandfamilies.ManypublicinsuranceenrolleesareforcedtravelasignificantdistanceoutsideofEagleCountytoreceivecareorreceivelimitedornoroutinecareuntiltheirconditionbecomesanemergency.WhoisatRiskYoungorperceivedhealthyindividu-alsthatchoosetonotenrollinahealthinsuranceplan.Everyoneissusceptibletounexpectedillnessorinjurysuchasaskiinginjuryorcaraccident5.Thoseenrolledinapublicinsuranceplanwithseverelylimitedlocalpro-viderssuchasCHPparticipantsorMedicaidenrollees.EvenwiththeimplementationoftheAffordableHealthCareActmanyEagleCountyresidentswilllikelybeleftun-insuredastheymaynotbeeligibleforMedicaidortheColoradoHealthBenefitExchange.WhatcanwedoCommunityPromotetheColoradoHealthBenefitEx-changeConnectforHealthColorado.Supporttheestablishmentofacommu-nityhealthcollaborative.EmployersProvideemployeeswithworksitewell-nessprogramsthatincludephysicalactivityandnutrition.Provideaffordablehealthinsuranceop-tionsforemployees.HealthcareprovidersProvidesomepreventativecareineachpatientvisit.Centrallylocateprimaryandpreventa-tivecaresitestoallowforeaseofaccessbyallpatients.Contractwithpublicandprivatehealthinsuranceplanstoprovidehealthser-vicestoallcommunitymembers.FamiliesandIndividualsSignupforandmaintainhealthinsur-anceevenifyouhaveapre-existingcondition.Formoreinformationwww.connectforhealthco.comand1-855-PLANS4YOU855-752-6749.EagleCountyoffersin-personassis-tanceinnavigatingthehealthinsurancemarketplace.ContactaHealthCover-ageGuideathealthassistancenetworkeaglecounty.us.Ifyoudontcurrentlyhaveaprimarycareproviderfindone.Stayup-to-datewithyourpreventativeservicesbyseeingyourprimaryhealthcareprovideratleastonceperyear.Preventativecareshouldincludeim-munizationscholesterolandbloodpres-surescreeningsmentalhealthchecksandcancerscreenings.Takeownershipofyourhealth.Main-tainahealthydietlowinsugarsaltandsaturatedfats.Eatmorefruitsandvegetablesandget30minutesormoreofmoderateexercisesuchaswalkingeachday.Quitsmokingorneverstart.CalltheColoradoQuitLineat1-800-QUIT-NOW784-8669orvisitwww.coquitline.org.InformationgatheredfromUSCensusBureauSmallAreaHealthInsuranceEstimate2010-2011CenterforDiseaseControlandPrevention.November2011MMWR591-7.VitalSignsHealthInsuranceCoverageandHealthCareUtilization---UnitedStates2006--2009andJanuary--March2010.Availableonlineathttpwww.cdc.govmmwrpreviewmmwrhtmlmm59e1109a1.htms_cidmm59e1109a1_wDepartmentofCarePolicyAndFinancingMedicaidClientCaseloadbyCountyReportshttpwww.colorado.govcsSatellitecPagecid1223462090259pagenameHCPF2FHCPFLayoutConnectiontoPreventativeCare-QuickFacts237x10TwentythreepercentofEagleCountyresidentsareuninsuredcomparedto17inColoradoand15intheUnitedStatesUninsuredindividualsareseventimeslesslikelytoseekmedicalcareOvertenpercentofEagleCountyResidentsareinsuredthroughCHPorMedicaid 26ConnectiontoPreventativeCareTheneedforaccessibleaffordablepreventativecareinEagleCountyisstunning.Morethan28percentofresidentsofthismountainousruralcountyhaveincomebelow200FPLandofthose48percentareuninsured.58InthewholeofEagleCountyanastounding23percentofresidentshavedonothavehealthinsurancecomparedto17percentuninsuredinColoradoand15percentuninsurednationally.59Thosewith-outhealthinsuranceoftenforgopreventativecareanddelayseekingmedicalattentionresultinginworsenedmorbidityandmortalityincreasedlong-termhealthcarecostsandadiminishedqualityoflife.60EagleCountyisfederallydesignatedasaMedicallyUnderservedPopulationLowIncome.viWhilecommunitylead-ershavelongrecognizedtheneedforaffordableprimaryoralandbehavioralhealthcarethisdesignationisduetounusuallocalconditionswhichareabarriertoaccesstoortheavailabilityofpersonalhealthservices.TheincreasednumberofuninsuredandunderinsuredpersonsinEagleCountyandlackofaccessibleaffordablehealthhasimplicationsforindividualhealthandsocietalcosts.IndicatorsRateofUninsuredTwenty-theepercentofallEagleCountyresidencedonothavehealthinsurance.61The2011WorkforceReportcompiledbytheEconomicCouncilofEagleCountyshowsover59percentofalljobsinEagleCountyareintheservicesectorandconsistoflow-payingfrequently-seasonalpositionswithnohealthbeneits.InOctoberof2013theAf-fordableCareActwillgointoeffectandisexpectedtovastlyimprovetherateofuninsured.PreventativeCareAccesstoprimarymedicaloralvisionandbehavioralhealthservicesareimportantinmaintaininggoodoverallhealth.62TheBehavioralRiskFactorSurveillanceSystemconsistentlyratesEagleCountybehindColoradotheUnitedStatesandHealthyPeople2020goalsforpreventativecareservicessuchasvaccinationcoveragetimelyprenatalcarecancerscreeningsoralhealthobesityrateselderandadulthealthandmentalhealthandsubstanceabuse.63vi.MedicallyUnderservedPopulationMUPisadesignationbytheUSDepartmentofHealthandHumanServices-HealthResourcesandServicesAdministration.ThedesignationinvolvesapplicationoftheIndexofMedicalUnderserviceIMUtodataonanunderservedpopulationgroupwithinanareaofresidencetoobtainascoreforthepopulationgroup.PopulationgroupsrequestedforMUPdesig-nationshouldbethosewitheconomicbarrierslow-incomeorMedicaid-eligiblepopulationsorculturalandorlinguisticaccessbar-rierstoprimarymedicalcareservices.InEagleCountytheMUPdesignationappliestothelow-incomeincome 27CommunityCapacityIn2012approximately16percentofEagleCountyresidentswerecoveredunderpublicinsuranceplanssuchasCHPMedi-careorMedicaid.Nationally69percentofhealthcareprovidersacceptnewMedicaidMedicarepatients.InEagleCountyamere17percentofprimarycareprovidersacceptnewMedicaidMedi-carepatients.64Oftheapproximate36dentistsinEagleCountyonlytwoacceptnewMedicaidpatients.Asof2012novisionhealthprofessionalsacceptMedicaidMedicareinEagleCounty.65EagleCountyisdesignatedasaHealthProfessionalShortageAreaformentalhealth.ManypublicinsuranceenrolleesareforcedtravelasigniicantdistanceoutsideofEagleCountytoreceivecareandiftheyareunabletotravelforcaretheyareforcedtoreceivelimitedornoroutinecareuntiltheirconditionbecomesanemergency.66EffortstoimprovecapacityforuninsuredandunderinsuredpopulationsincludedeterminingthefeasibilityforaCommunityHealthcareCollaborativeandtheintroductionofcommunityclinicssuchasaDoctorsplusKidsCareCliniclocatedatAvonElementarySchool. 28MentalHealthandSubstanceAbuse-ActionPlanStrategiesActivitiesOutcomesGoalToincreaseawarenessofmentalillnessasanimportantpublichealthproblemandtheimportanceofmentalhealthpromotionandmentalillnessprevention.ObjectivesIncreaseby25frombaselinethenumberofEagleCountyresidentsaccessingselfguidedmentalhealthandsubstanceabuseresources.Increasethecommunityscapacitytoidentifymentalhealthneedsandlinktomentalhealthservicesandresources.Implementpoliciestodecreaseandpreventyouthaccesstoalchoholandothersubstances.PartneringAgenciesMentalHealthProvidersNon-profitOrganizationsLawEnforcementGovernmentHealthCareProvidersPromoteselfguidedmentalhealthandsubstanceabuseresources.Developaworkinggroupofmentalhealthprovidersandreferralagencies.Integratementalhealthscreeningintocommunitybasedsettings.CreatemoreeffectivelinkagesbetweentheLatinopopulationandthementalhealthsystem.Policyplanningmobilizationandimplementation.Pursuedevelopmentofcommunity-basedpopulation-levelenvironmentalstrategies.IntegrateandpromoteselfguidedresourcessuchasMyStrength.comManTherapy.orgColoradoQuitLine.Developprioritiesandstrategicplanforcoalitionsecurefundingtoimplementplan.Traindiverseworkforcesandcommunitymemberstoidentifypersonsinneedofadditionalmentalhealthscreeningandreferral.ImplementcommunityhealthworkermodelinEagleCounty.Supportdevelopmentofasocialhostordinance.Exploreimpactandpotentialstrategiesrelatedtomarijuanausepreventionandreduction.Increaseawarenessofmentalwell-beingthroughtrainingdiverseworkforcehealthpromotionandcommunityhealthworkermodel.Supportfullintegrationofmentalhealthpromotionandmentalillnesspreventionandtreatmentwithotherdiseasepreventionprograms.Decreaseinyouthaccessandconsumptionofalcoholandotherdrugs. 29WhyisitaPriorityNewestimatesshowthatbingedrinkingisabiggerproblemthanpreviouslythought.Morethan38millionUSadultsbingedrinkabout4timesamonthandthelargestnumberofdrinksperbingeisonaverage8.Thisbehaviorgreatlyincreasesthechancesofgettinghurtorhurtingothersduetocarcrashesviolenceandsuicide.Thestatessuicidedeathtollhasbeenclimb-ingforthepastdecadegivingColoradooneofthehighestsuicideratesinthenation.Sui-cideisanindiscriminatekillerinColorado.WhilemanymorementhanwomendiebysuicidethesuicideratealsohasincreasedforwomeninmostColoradocountiesandfornearlyeveryagegroup.Researchhasdemonstratedthatsubstanceabusespecificallymarijuanahasthepotentialtocauseproblemsindailylifeormakeapersonsexistingproblemsworse.Infactheavymarijuanausersgenerallyreportlowerlifesatisfactionpoorermentalandphysicalhealthrelationshipproblemsandlessacademicandcareersuccesscomparedtotheirpeerswhocamefromsimilarback-grounds.WhoisatRiskInColoradosubstanceabuseandsuicidearehigheramongcertaingroupsthanothers.Menaremorelikelytobingedrinkthanwomen.Menbetweentheagesof25and54accountforthehighestratesofsuicidedeathsannually.Bingedrinkingismorecommonamongyoungergroupsanddecreasesaspeoplegetolder.Hispanicsandwhitesaremorelikelytobingedrinkthanblacks.Thosewithhigherincomesaremorelikelytobingedrinkthanthosewithlowerincomes.WhatcanwedoCommunityRecognizeandunderstandthediffer-encebetweenmentalhealthandmentalillnessImproveaccesstomentalhealthser-vicesSupporteffortsthatreduceyouthaccesstodrugsandalcoholMobilizecommunitypartnerstoaddresstheconditionsinwhichpeopleareborngrowupliveworkandage.OrganizationsDevotemoreresourcestopreventioneducationscreeningdiagnosisandtreatmentofmentalillnessBuildcommunityinfrastructureandcapacityformentalhealthsupportandservicesOfferevidencebasedMentalHealthFirstAidandQuestionPersuadeReferQPRtrainingforallemployeesFamiliesandIndividualsAttendMentalHealthFirstAidandQPRtrainingopportunitiesAccessfreeself-guidedwebsitessuchaswww.mantherapy.orgorwww.mys-trength.comTalktoyourfriendsandfamilyaboutseekingmentalhealthguidancewhenneededMentalHealthandSubstanceAbuse-QuickFactsInformationgatheredfromColoradoDepartmentofPublicHealthandEnvironmentColoradoHealthInformationDatasetBehavioralRiskFactorSurveillanceSystem.Avail-ableonlinewww.chd.dphe.state.co.uscohidtopics.aspxqBehavioral_Risk_FactorsHealthyKidsColoradoSurveyEagleCountyRE-50SchoolDistrict2011-2012.PreparedbyOMNIDenverCOfortheEagleRiverYouthCoali-tion.Availableonlinewww.scribd.comdoc85966336Eagle-County-ReportNationalInstitutesonDrugAbuse4thLead-ingCauseofDeathSui-cideisEagleCountys4thleadingcauseofdeath87ofwhichweremenaged18-804th60hospi-talizationsforsuicideattemptsbe-tween2007and201160ThepercentofEagleCountyresi-dentsreportingtheirmentalhealthwasnotgoodononeormoredaysduringtheprevi-ousmonth31ThepercentofEagleCountyadultsandadolescentsrespectivelythatreportbingedrink-inginthepreviousmonthcomparedtoColoradoat15.9foradultsand22foradolescents28ThepercentofEagleCountyHighSchoolstudentswhosaiditisveryeasytoobtainalcoholandmarijuana34 30MentalHealthandSubstanceAbuseThroughthecommunityhealthandcapacityassessmentprocesspartnersidentifiedtheneedtobettercoordinateservicesbuildcommunitycapacityandintegrateprimarycarementalhealthandpublichealth.Mentalhealthisanessentialcomponentofoverallhealthandwell-beingandEagleCountyisnotimmunetotheincreasingratesofmentalillnesssuicideandsubstanceabuse.Healthcarepublichealthnon-profitorganizationsandprivatepracti-tionershavecometogethertocreateacommunitywhereindividualsfamiliesschoolsandworkplacestakeactiontopromoteemotionalhealthandreducethelikelihoodofmentalillnesssuicideandsubstanceabuse.IndicatorsMentalHealthStatusTheColoradoDepartmentofPublicHealthandEnvironmentconductsanannualsurveythatasksresidentsabouttheirmentalhealthstatus.ThequestioninparticularisOnhowmanydaysduringthepast30dayswasyourmentalhealthnotgood.InEagleCountyover31percentofresidentsreportedtheirmentalhealthwasnotgoodononeormoredaysduringthepreviousmonth.InColoradoover35percentreportedthesameresult.Figure15breaksoutthepercentagesbynumberofdays.67Figure15Self-ReportedMentalHealthStatusEagleCountyandColorado2009-2010IndicatorForhowmanydaysduringthepast30dayswasyourmentalhealthnotgoodEagleCountyColorado17days23.822.38ormoredays7.912.7TOTAL31.235.0SuicideBetween2007and2011therewere37suicidesinEagleCountynearly87percentofwhichwereinmenages18to87.Therewere60hospitalizationsforsuicideattemptsduringthesametimeperiod.TheCountysageadjustedsuicideratewas20.3per100000populationwhichwasslightlyhigherthanColoradosat17.1per100000.68BingeDrinkingBothadultsandadolescentsinEagleCountyviireportedbingedrinkingmorethantheirstateandnationalcoun-terparts.Figure16displaysthepercentageofadultsoverage18andEagleCountySchoolDistricthighschoolstudentsingrades9-12thatreportedbingedrinkingwithintheprevious30days.Bingedrinkingisdefinedasconsumingfiveormorealcoholicbeveragesononeoccasion.69MarijuanaResearchhasdemonstratedsubstanceabusespecifi-callyofmarijuanahasthepotentialtocauseproblemsindailylifeormakeapersonsexistingproblemsworse.Infactheavymarijuanausersgenerallyreportlowerlifesatisfactionpoorermentalandphysicalhealthrelationshipproblemsandlessacademicandcareersuccesscomparedtotheirpeerswhocamefromsimilarbackgrounds.70Accordingtothe2011-2012HealthyKidsColoradoSurvey34percentofEagleCounty9th-12thgradestudentsindicatedthatmarijuanawasveryeasytoget.Inthatsamesurvey39percentofEagleCounty9th-12thgradersreportedeverusingmarijuanaand43percentofEagleCounty9th-12thstudentsthatusemarijuanasaidthatsomeonegaveittothem.71vii.TheindicatordoesnotincludestudentsinBasaltHighSchoolwhichispartoftheForkValleySchoolDistrict. 31CommunityCapacityThefollowingarelocalprogramsservicesandcoalitionsthatfocusonmentalhealthandsubstanceabusepreven-tion.72MindSpringsHealthformerlyColoradoWestistheWesternSlopespublicmentalhealthserviceproviderandofferstreatmentfordepressionstressandanxietybipolardisorderpersonalitydisorderssubstanceabuseaddictionpainmanagementandfamilytherapy.Servicesareprovidedonaslidingfeescaleforthosewhomeetincomeguidelines.Abilingualtherapistisavailable.MindSpringsHealthalsoofferssuicidepre-ventiontrainingforgatekeepers.TheSamaritanCounselingCenterprovidesprofessionalcounselingandeducationforchildrenadolescentsandadults.Servicesareavailableonaslidingfeescaleforthosewhomeetincomeguidelines.TheSpeakUpReachOutSuicidePreventionCoalitionofEagleCountyprovidesgatekeepertrainingstoteachlaypersonshowtorecognizethesignsofsuicidalideationandlinkindividualstoappropriatecareandhasastategranttotargetmenbyreducingthestigmaofaskingforhelp.TheCoalitionhasrepresentationfromMindSpringsHealththeSamaritanCenterEagleCountyHealthHumanServicesVailResortsyouthserv-ingorganizationsandirstresponders.TheMentalHealthTaskforceoftheImmigrantIntegrationCollaborativeisanewlyconvenedgroupdedi-catedtoaddressingthementalhealthneedsoftheimmigrantpopulationofEagleCounty.ThisgrouphasrepresentationfromanumberoforganizationsincludingEagleCountyHealthHumanServicesBrightFutureFoundationVailValleyMedicalCenterEagleCountyRE50SchoolDistrictandColoradoWest.MindSpringsHealthformerlyColoradoWestoperatesasocialdetoxiicationcenterlocatedattheVailPoliceDepartmentinconjunctionwithseverallawenforcementagencies.SocialdetoxiicationprovidesasafelocationforlawenforcementtobringintoxicatedindividualswheretheyareevaluatedmonitoredandstabilizedbyMindSpringsHealthpersonnel.MindSpringsHealthalsoencouragesandassiststheindividualinaccessingtreatmentafterdischarge.TheVailValleyMedicalCenterVVMChasanSBIRTScreeningBriefInterventionandReferraltoTreat-mentprogramthatwasdevelopedbytheFederalSubstanceAbuseandMentalHealthServicesAdministra-tion.AteverypointofentryintoVVMCshealthcaresystempatientsarescreenedforsubstanceabuseandtobaccouse.IfapatientscreenspositivetheyarereferredtotheSBIRTcoordinatorforintervention.BrightFutureFoundationBFFworkswithdomesticassaultandsexualassaultcasesandprovidespsycho-therapyandvictimsadvocacyprogramsfreeofcharge.BFFoperatesashelterandsafehouseanda24-houradayhotlinemannedbybilingualvolunteers.Wayinderisacasemanagementprogramforyouthages10-18withmulti-systemneeds.ItiscoordinatedthroughtheEagleCountyRE50SchoolDistrict.ChallengeNatureisayouthfoundationprogramformiddleschoolstudentsidentiiedwithSigniicantIden-tiiableEmotionalDisabilitiesSIED.Theprogramusesnatureandoutdooractivitiestopromotethedevel-opmentofpersonalandlifeskillstowardacademicachievementandsuccessfulrelationships.TheEagleRiverYouthCoalitionERYCconductstheHealthyKidsColoradoSurveyayouthbehavioralsur-veyeverytwoyearsthatincludesmeasuresofmentalhealthandsubstanceabuseinmiddleandhighschoolstudentsfromtheEagleCountyRE50SchoolDistrict.ERYCalsooffersseveralpreventionprogramswork-ingwiththeschooldistrictandlocallawenforcement.InadditionERYCcoordinatesayouthleadersgrouppromotingpositiveyouthdevelopment.OthercommunityresourcesincludeEagleCountySheriffsOficeVictimsAdvocateProgramAlcoholicsAnonymousandNarcoticsAnonymousCommunityParamedicsin-homementalhealthassessmentandreferralservicesEagleCountyRE50SchoolDistrictsdrugusepolicyforstudentsinactivitiesincludingrandomdrugtestingatBattleMountainHighSchoolPrivatepractitioners 32RadonAwarenessandMitigation-ActionPlanStrategiesActivitiesOutcomesGoalReducetheriskoflungcancercausedbyradongasexposureObjectivesIncreasethepercentageofradontestkitsdistributedbutnotusedby65by2017andhave20ofthehomesthathaveradonlevelsover4.0pCiLtakecorrectiveaction.Policyisadoptedthatsupportsincreasingawarenessandpromotingradonresistantconstructioninallbuildingsby2017.PartneringAgenciesRegionalEnvironmentalHealthAgenciesEnergySmartIncreaseawarenessofthehealthrisksofexposuretoradon.Provideeducationandtrainingonradonmitigation.Developpolicyandpromoteregulationforradonresistantconstruction.ConductacommunitywideoutreachandeducationcampaignduringNationalRadonActionMontheachJanuary.Secureresourcesanddistributeradontestkitseachyear.Developadatamanagementsystemtotrackkitdistributionusageandremediation.Conductdo-it-yourselfradonmitigationclassesforforhomeownersandcontractors.Increasedawarenssofthehealthrisksofexposuretoradon.Increasedcommunitymemberuseofradontestkits.Evaluatehometestingandmitigationprogramusingdatatrackingsystem.Increasedknowledgeofradonmititgationstrategies.Increaseduseofmitigationstrategiesasappropriate.Expandradonresistantconstructionstandardstoalloccupiedbuildingswhereappropriateespecilallymulti-familybuildings. 33WhyisitaPriorityTheUSSurgeonGeneralandEPArecom-mendallhomesbetestedforradonbecauseitisthenumberonecauseoflungcanceramongnon-smokersandthesecondleadingcauseoflungcancerbehindsmoking.TheEPAidentifiedEagleCountyashavingamoderateradonpotentialwithhomeshavingindoorradonlevelsof2.0-4.0pCiLonaver-age.WhatarewecurrentlydoingForyearsEagleCountyhasmadetestkitsavailabletoresidents.EachJanuaryNationalRadonActionMonthEagleCountyconductsapublicawarenesscampaign.EagleCoun-tysEnergySmartprogramtestsforradoninhomesandmakesreferralformitigation.TheCityofAspensEnvironmentalHealthDepartmentreceivedaregionalgrantfromtheColoradoDepartmentofPublicHealthandEnvironmenttoprovidefreeradonhometestkitstohomeownersinPitkinEagleandGarfieldcounties.Pitkinhasapubliceduca-tionplantestkitfollowupproceduresanddatacollectionandanalysisaspectstotheirprogramthattheycansharewithEagleandGarfieldcounties.WhoisatRiskInColoradosubstanceabuseandsuicidearehigheramongcertaingroupsthanothers.Menaremorelikelytobingedrinkthanwomen.Menbetweentheagesof25and54accountforthehighestratesofsuicidedeathsannually.Bingedrinkingismorecommonamongyoungergroupsanddecreasesaspeoplegetolder.Hispanicsandwhitesaremorelikelytobingedrinkthanblacks.Thosewithhigherincomesaremorelikelytobingedrinkthanthosewithlowerincomes.WhatcanwedoPolicyImplementpoliciesthatsupportradonresistantconstruction.CommunityDevelopadatamanagementsystemtotrackprograminformationincludingkitdistributionusageandremediation.Increaseradonawarenessbyincreasingpublicoutreachandeducationdur-ingNationalRadonActionMontheachJanuary.Distributeradontestkitseachyearandprovideappropriatefollow-up.Conductdo-it-yourselfradonmitiga-tionclassesforhomeownerstoeducateoncosteffectivestepstheycantaketomitigatetheirownhomes.IndividualsTesttheirhomesforradonusingaFreeRadonTestKitavailableatEagleCountyEnvironmentalHealth.Ifthetestreadsover4.0pCiLradonattendclassesonDo-It-Yourselfradonmitigationandtakeactioninmitigatingradon.RadonAwarenessandMitigation-QuickFactsInformationgatheredfromUSEnvironmentalProtectionAgencyACitizensGuideToRadonTheGuideToProtectingYourselfAndYourFamilyFromRadonEPA402K-09001January2009.Availableonlinewww.colorado.govcsSatelliteCDPHE-HMCBON1251617274212UnitedStateEnvironmentalProtectionAgencywebsiteRadonRiskforStates.Availableonlinewww.epa.govradonstatesRadonisacolorlessodorlessgasthatcanpermeatehomesandleadtolungcancerwithlong-termexposure.TheEnvironmentalProtectionAgen-cyidentifiedEagleCountyashavingamoderateradonpotential.EagleCountywillworkwithneighboringGarfieldandPitkincountiestomitigateradonexposureinthesemountaincommunities. 34RadonAwarenessandMitigationRegionalpartnershaveidentiiedradonawarenessandmitigationasaCommunityHealthImprovementPlanCHIPpriorityforthenextiveyears.EagleCountywillworkwithneighboringGarieldandPitkincountiestoraiseawarenessandmitigateradonexposureespeciallywithinthehome.Radonisacolorlessodorlessgasthatformsnaturallyfromthebreakdownofuraniuminsoilrockandwater.RadonisfoundallovertheUnitedStatesandcangetintoanytypeofbuildingincludinghomesoficesandschools.Thegreatestamountofexposuretendstooccurathomewhereapersonspendsmostoftheirtime.Long-termexposurecanleadtolungcancer.73AccordingtotheFederalEnvironmentalProtectionAgencyEPAEagleCountyhasmoderatepotentialforradongastobepresentindoorsatlevelsthatcouldbeharmfultohumanhealth.74Thetestforradonissimpleandinmostcasesmitigationeffortsaresuccessful.Ingeneralwhenatestrevealsaradonlevelof4picocuriesperliterpCiLorhighermitigationmeasuresshouldbetaken.Additionallyhomescanbebuiltwithradon-resistantfeatureswhichwheninstalledatthetimeofconstructionareeasierandlessexpensivethanretroittinglater.75IndicatorsIndoorExposureTheEnvi-ronmentalProtectionAgencyEPAratesthepotentialforindoorradonexposurebasedonanareasgeology.Zone1hashighpotentialZone2hasmoderatepotentialandZone3haslowpotential.EagleCountyisconsideredZone2ormoderatepotentialratedasanaverage2.0-4.0pCiLFigure17.76LungCancerTheUSSurgeonGeneralandEnvironmen-talProtectionAgencyEPArecommendallhomestestforradonasitisthenumberonecauseoflungcanceramongnon-smokersandthesecondleadingcauseoflungcan-cerbehindsmoking.77EagleCountyhad25reportedcasesoflungcancerbetween2007and2009whichwasEagleCountysleadingtypeofcancer-relateddeath.Thecountysage-adjustedincidenceratewas15.7per100000populationlowerthanthestatesrateof44.9per100000.78Exposuretypetobaccoversusradonetc.isnotpro-videdinthedata. 35CommunityCapacity79TheCityofAspensviiiEnvironmentalHealthDepartmenthasreceivedaregionalgrantfromtheColoradoDepart-mentofPublicHealthandEnvironmenttoprovidefreeradonhometestkitstohomeownersinPitkinEagleandGarieldcounties.PitkinCountyhasapubliceducationplantestkitfollowupproceduresanddatacollectionandanalysisaspectstotheirprogramthatcanbesharedwithEagleandGarieldcounties.EagleCountyhasmadetestkitsavailabletoresidentsforseveralyearsandconductsapublicawarenesscampaigneveryJanuaryforNationalRadonAwarenessMonth.EagleCountyalsohasanEnergySmartprogramthattestsforradoninhomesandmakesreferralsformitigation.viii.TheCityofAspenislocatedinPitkinCounty 36Sources1.USCensusBureauStateandCountyQuickFacts2011.Availableonlinehttpquickfacts.census.govqfdstates0808037.html2.ColoradoChildrensCampaignEagleCountyRE50SchoolDistrictFactSheetAugust20113.USCensusBureauStateandCountyQuickFacts2007-2011.Availableonlinehttpquickfacts.census.govqfdstates0808037.html4.Ibid.5.ColoradoDepartmentofLocalAffairsStateDemographyOficeTableProjectedMedianAgebyCounty1990-20406.USCentralIntelligenceAgencyWorldFactBookwebsiteFieldListingMedianAgebyCountry.Availableonlinewww.cia.govlibrarypublicationsthe-world-factbookields2177.html7.NorthwestColoradoCouncilofGovernmentsRuralResortRegionGapsAnalysisofServicesforanAgingPopulationJanuary2011.8.USCensusBureauStateandCountyQuickFacts2007-2011.Availableonlinehttpquickfacts.census.govqfdstates0808037.html9.Ibid.10.UnitedStatesDepartmentofLaborBureauofLaborStatisticsLocalAreaUnemploymentStatisticsMapStatesandCountiesNotSea-sonallyAdjusted.Availableonlinehttpdata.bls.govmapMapToolServlet11.ColoradoCenteronLawandPolicyTheSelf-SuficiencyStandardforColorado2011.12.Ibid.13.AnnieE.CaseyFoundationKidsCountDataCenterEagleCountyRE50SchoolDistrictHighSchoolGraduationRatesbyRaceEthnic-ity2011Availableonlinehttpdatacenter.kidscount.orgdatabystatestateproile.aspxstateCOloc132914.ColoradoDepartmentofTransportationStateHighwayMotorVehicleCrashDatabaseDatarequestMotorVehicleCrashesonI-70MM1891332004-2010.15.ColoradoDepartmentofPublicHealthandEnvironmentColoradoHealthInformationDatasetQueryMotorVehicleCrashInjuryHos-pitalizationsandDeaths2004-2011.Availableonlinewww.chd.dphe.state.co.uscohidDefault.aspx16.USDepartmentofHealthandHumanServicesCentersForDiseaseControlandPreventionNationalCenterforHealthStatisticsDeathsPreliminaryDatafor2011.NationalVitalStatisticsReportsVol.61No.6.Availableonlinewww.cdc.govnchsdatanvsrnvsr61nvsr61_06.pdf17.CentersForDiseaseControlandPreventionPressreleaseCDCreportsunevendeclinesincoronaryheartdiseasebystateandraceethnicityOctober132011.Availableonlinewww.cdc.govmediareleases2011p1013_heart_disease.html18.AssociatedPressCancerratescontinuetodeclineintheUSHealthoficialscreditincreasedscreeningpreventioneffortsMarch292012.Availableonlinewww.nydailynews.comlife-stylehealthcancer-rates-continue-decline-health-oficials-credit-increased-screen-ing-prevention-efforts-article-1.105233819.CentersforDiseaseControlandPreventionTenSigniicantPublicHealthAchievementsUnitedStates2001-2010MotorVehicleSafetyAvailableOnlinewww.cdc.govMotorvehiclesafetymmwr_achievements.html20.ColoradoDepartmentofPublicHealthandEnvironmentColoradoHealthInformationDatasetQueryInjuryHospitalizations2009-2011.Availableonlinewww.chd.dphe.state.co.uscohidtopics.aspxqInjury_Hospitalizations21.ColoradoDepartmentofPublicHealthandEnvironmentDivisionofDiseaseControlandEnvironmentalEpidemiologyColoradoReport-ableDiseaseStatistics200920102011.Availableonlinewww.colorado.govcsSatelliteCDPHE-DCEEDCBON125160775547322.ColoradoDepartmentofPublicHealthandEnvironmentDivisionofDiseaseControlandEnvironmentalEpidemiologySTIHIVSurveil-lanceProgramTable1.EagleCountyChlamydiareportedtotheCDPHEbygenderraceandage2006-20102011dataunpublishedprovidedbysurveillanceprogram.Availableonlinewww.colorado.govcsSatelliteCDPHE-DCEEDCBON125162143452123.NationalPublicRadioBabyBustWhytheUSBirthRateisDecliningDecember62012.Availableonlinewww.npr.org20121206166655696baby-bust-why-the-u-s-birth-rate-is-declining24.ColoradoDepartmentofPublicHealthandEnvironmentColoradoHealthInformationDatasetQueryBirthStatistics2009-2011.Availableonlinewww.chd.dphe.state.co.uscohidtopics.aspxqBirth_Data25.TheNationalCampaigntoPreventTeenPregnancyWhyitMattersTeenPregnancyandOtherHealthIssues.Availableonlinewww.thenationalcampaign.orgwhy-it-matterspdfhealth.pdf26.HealthyKidsColoradoSurveyEagleCountyRE-50SchoolDistrict2011-2012.PreparedbyOMNIDenverCOfortheEagleRiverYouthCoalition.Availableonlinewww.scribd.comdoc85966336Eagle-County-Report27.ColoradoDepartmentofPublicHealthandEnvironmentColoradoHealthInformationDatasetQueryBirthStatistics2009-2011.Availableonlinewww.chd.dphe.state.co.uscohidtopics.aspxqBirth_Data28.ColoradoDepartmentofPublicHealthandEnvironmentColoradoHealthInformationDatasetQueryPregnancyRiskandMonitoringAssessment2009-2011.Availableonlinewww.chd.dphe.state.co.uscohidtopics.aspxqPregnancy_Risk_Assessment_Data29.CentersforHealthEquityandJusticeWhatisHealthEquity.Availableonlinehttpwww.bphc.org30.CentersforDiseaseControlandPreventionChronicDiseasePreventionandHealthPromotionHealthEquity.Availibleonlinehttpwww.cdc.govchronicdiseasehealthequity31.RichardH.CarmonaM.D.M.P.H.F.A.C.S.SurgeonGeneralUSDepartmentofHealthandHumanServicesUSPublicHealthService 37TestimonyBeforetheSubcommitteeonCompetitionInfrastructureandForeignCommerceCommitteeonCommerceScienceandTransportationUnitedStatesSenate.TheGrowingEpidemicofChildhoodObesityMarch22004.Availableonlinewww.surgeonge-neral.govnewstestimonychildobesity03022004.html32.CDPHESurveyResearchUnitBehavioralRiskFactorSurveillanceSystem.SpecialdatarequestforEagleCounty2002-2005.33.HealthyKidsColoradoSurveyEagleCountyRE-50SchoolDistrict2011-2012.PreparedbyOMNIDenverCOfortheEagleRiverYouthCoalition.Availableonlinewww.scribd.comdoc85966336Eagle-County-Report34.HealthyKidsColoradoSurveyColoradoHighSchoolSurvey2011.PreparedbyOMNIDenverCO.Availableonlinehttpcollabora-tion.omni.orgsiteshkcData20Tables20and20ResultsFormsFront20Page.aspx35.CentersforDiseaseControlandPreventionYouthRiskBehaviorSurveillance2011.MorbidityandMortalityWeeklyJune82012Vol.61No.4.Availableonlinewww.cdc.govmmwrpdfssss6104.pdf36.EagleCountyWICProgramPediatricNutritionSurveillanceTables4Band6BEagleCountyColoradoandtheUS2011.37.USDepartmentofHealthandHumanServicesOficeofMinorityHealthObesityandHispanicAmericans2010Availableonlinehttpminorityhealth.hhs.govtemplatescontent.aspxID645938.ColoradoDepartmentofPublicHealthandEnvironmentColoradoHealthInformationDatasetBehavioralRiskFactorSurveillanceSystem2009-2010QueryRegion12.Availableonlinewww.chd.dphe.state.co.uscohidtopics.aspxqBehavioral_Risk_Factors39.ColoradoDepartmentofPublicHealthandEnvironmentOficeofHealthDisparitiesRacialandEthnicHealthDisparitiesinColorado200940.ColoradoDepartmentofPublicHealthandEnvironmentColoradoHealthInformationDatasetBehavioralRiskFactorSurveillanceSys-temQueryEagleCountyandColorado2009-2010.Availableonlinewww.chd.dphe.state.co.uscohidtopics.aspxqBehavioral_Risk_Factors41.CentersforDiseaseControlandPreventionBehavioralRiskFactorSurveillanceSystemPrevalenceandTrendsqueryNationwideStatesandDC.Availableonlinehttpapps.nccd.cdc.govbrfss42.HealthyKidsColoradoSurveyEagleCountyRE-50SchoolDistrict2011-2012.PreparedbyOMNIDenverCOfortheEagleRiverYouthCoalition.Availableonlinewww.scribd.comdoc85966336Eagle-County-Report43.HealthyKidsColoradoSurveyColoradoHighSchoolSurvey2011.PreparedbyOMNIDenverCO.Availableonlinehttpcollabora-tion.omni.orgsiteshkcData20Tables20and20ResultsFormsFront20Page.aspx44.CentersforDiseaseControlandPreventionYouthRiskBehaviorSurveillance2011.MorbidityandMortalityWeeklyJune82012Vol.61No.4.Availableonlinewww.cdc.govmmwrpdfssss6104.pdf45.ColoradoDepartmentofPublicHealthandEnvironmentColoradoHealthInformationDatasetBehavioralRiskFactorSurveillanceSystemQueryEagleCountyandColorado.Availableonlinewww.chd.dphe.state.co.uscohidtopics.aspxqBehavioral_Risk_Factors46.CentersforDiseaseControlandPreventionBehavioralRiskFactorSurveillanceSystemPrevalenceandTrendsQuery-NationwideStatesandDC.Availableonlinehttpapps.nccd.cdc.govbrfss47.HealthyKidsColoradoSurveyEagleCountyRE-50SchoolDistrict2011-2012.PreparedbyOMNIDenverCOfortheEagleRiverYouthCoalition.Availableonlinewww.scribd.comdoc85966336Eagle-County-Report48.HealthyKidsColoradoSurveyColoradoHighSchoolSurvey2011.PreparedbyOMNIDenverCO.Availableonlinehttpcollabora-tion.omni.orgsiteshkcData20Tables20and20ResultsFormsFront20Page.aspx49.CentersforDiseaseControlandPreventionYouthRiskBehaviorSurveillance2011.MorbidityandMortalityWeeklyJune82012Vol.61No.4.Availableonlinewww.cdc.govmmwrpdfssss6104.pdf50.HealthyKidsColoradoSurveyEagleCountyRE-50SchoolDistrict2011-2012.PreparedbyOMNIDenverCOfortheEagleRiverYouthCoalition.Availableonlinewww.scribd.comdoc85966336Eagle-County-Report51.NorthwestColoradoCouncilofGovernmentsRuralResortRegionGapsAnalysisofServicesforanAgingPopulationJanuary201152.ColoradoDepartmentofPublicHealthandtheEnvironmentColoradoActionPlanforOlderAdultWellnessAPublicHealthStrategy200753.IncomeEffectsofOlderadultHousingACountyLevelAnalysisofSummitandEagleCountiesColoradoGregTottenMastersStudentEconomicsCSU32201254.ColoradoDepartmentofPublicHealthandtheEnvironmentColoradoActionPlanforOlderAdultWellnessAPublicHealthStrategy200755.Ibid.56.ColoradoDepartmentofPublicHealthandEnvironmentColoradoHealthInformationDatasetQueryInjuryHospitalizations2009-2011.Availableonlinewww.chd.dphe.state.co.uscohidtopics.aspxqInjury_Hospitalizations57.ColoradoDepartmentofPublicHealthandtheEnvironmentColoradoActionPlanforOlderAdultWellnessAPublicHealthStrategy2007.58.AssessingtheNeedforAffordableCareinEagleCountyEagleCountyHealthandHumanServices201159.USCensusBureauSmallAreaHealthInsuranceEstimate2010-2011 3860.CenterforDiseaseControlandPrevention.November2011MMWR591-7.VitalSignsHealthInsuranceCoverageandHealthCareUtilization---UnitedStates2006--2009andJanuary--March2010.Availibleonlineathttpwww.cdc.govmmwrpreviewmmwrht-mlmm59e1109a1.htms_cidmm59e1109a1_w61.USCensusBureauSmallAreaHealthInsuranceEstimate2010-201162.DeckerS.L.2011August.HealthAffairs3181673-1679.doi10.1377hlthaff.2012.029463.ColoradoDepartmentofPublicHealthandEnvironmentColoradoHealthInformationDatasetBehavioralRiskFactorSurveillanceSystemQueryEagleCountyandColorado2009-2010.Availableonlinewww.chd.dphe.state.co.uscohidtopics.aspxqBehavioral_Risk_Factors64.RayandAssociatesSurveyEagleCounty201165.Ibid.66.DeckerS.L.2011August.HealthAffairs3181673-1679.doi10.1377hlthaff.2012.029467.ColoradoDepartmentofPublicHealthandEnvironmentColoradoHealthInformationDatasetBehavioralRiskFactorSurveillanceSys-tem.QueryEagleCountyandColorado.Availableonlinewww.chd.dphe.state.co.uscohidtopics.aspxqBehavioral_Risk_Factors68.ColoradoDepartmentofPublicHealthandEnvironmentColoradoHealthInformationDatasetQueriesDeathDataStatisticsandInjuryHospitalizations2009-2011.Availableonlinehttpwww.chd.dphe.state.co.uscohidtopics.aspxqDeath_Data69.HealthyKidsColoradoSurveyEagleCountyRE-50SchoolDistrict2011-2012.PreparedbyOMNIDenverCOfortheEagleRiverYouthCoalition.Availableonlinewww.scribd.comdoc85966336Eagle-County-Report70.NationalInstitutesonDrugAbuse71.HealthyKidsColoradoSurveyEagleCountyRE-50SchoolDistrict2011-2012Results.PreparedbyOMNIfortheEagleRiverYouthCoali-tion72.EagleCountyPublicHealthCommunityHealthImprovementPlanningProcessPartnerMeetingandCapacityDiscussiononMentalHealthandSubstanceAbuseNovember272012EagleCO.73.USEnvironmentalProtectionAgencyACitizensGuideToRadonTheGuideToProtectingYourselfAndYourFamilyFromRadonEPA402K-09001January2009.Availableonlinewww.colorado.govcsSatelliteCDPHE-HMCBON125161727421274.UnitedStateEnvironmentalProtectionAgencywebsiteRadonRiskforStates.Availableonlinewww.epa.govradonstates75.USEnvironmentalProtectionAgencyACitizensGuideToRadonTheGuideToProtectingYourselfAndYourFamilyFromRadonEPA402K-09001January2009.Availableonlinewww.colorado.govcsSatelliteCDPHE-HMCBON125161727421276.USEnvironmentalProtectionAgencywebsiteRadonRiskforStates.Availableonlinewww.epa.govradonstates77.USEnvironmentalProtectionAgencywebsiteRadonHealthRisks.Availableonlinewww.epa.govradonhealthrisks.html78.ColoradoDepartmentofPublicHealthandEnvironmentColoradoHealthInformationDatasetQueryAge-AdjustedCancerIncidenceEagleCountyandColorado2007-2009.Availableonlinewww.cohid.dphe.state.co.usscriptshtmsql.execancerPub.hsqltop79.EagleCountyPublicHealthCommunityHealthImprovementPlanningProcessPartnerMeetingandCapacityDiscussiononRadonAwarenessandMitigationDecember2012GlenwoodSpringsCO. 39EagleCountyCommunityHealthImprovementPlanImplementationGuideEagleCountysCommunityHealthImprovementPlanisbasedonobjectivesandevidencebasedstrategies.Eachcommunitypriorityareahasdeinedabroadlongtermgoalorvisionforthecommunity.Priorityareaobjectivesarespeciicmeasurablestepsthatwillbeaccomplishedtoworktowardthehealthprioritygoal.Thepriorityareaobjectiveshaveestablishedbaselinemea-surestargetsorbenchmarksandmethodologiesformeasuringtheobjective.Eachcommunitypriorityareahasspecicactionstepsforthestrategies.Theseactionstepsprovidedetailonwhatwillbedonetoimplementeachstrategyandthecommunityorganizationsresponsiblefortak-ingtheleadforeachstep.Anticipatedoutcomeshavebeenidentiiedandwillbeusedtomeasureprogresstowardthestrategicplansgoalsandobjectives.ThisImplementationGuideprovidesannualtargetstoreporttheprogressofEagleCountysCommunityImprovementPlan.Thisinfor-mationwillbeupdatedregularlywithprogressreportsdevelopedannuallyforeachpriorityarea.Ainalreportwillbedevelopedandtheendoftheimprovementplanperiod.Itmustbenotedthattherearelimitationstothedataintheevaluationandmonitoringplan.Somedatausedtoevaluateobjectivesandoutcomesisfromnationalself-reportedsurveyssuchastheBehavioralRiskFactorSurveillanceSystem.Self-reportedsurveyscanbesubjecttorecallbiasnonresponsebiasvoluntaryresponsebiasandthatrespondentsmayleantowardsanswerswithhighersocialdesirability.Inadditionsurveysmaybesubjecttoselectionbiasinthatcertainpopulationsmaynothavebeensurveyedorareunder-representedinthesurveyresults.Otherlimitationsofthedatamayincludesmallersamplesizeslimitingtheabilitytogeneralizesurveyresultstotheentirepopulation.Howevercomparingbetweenpopulationswiththesameinstru-mentislesssubjecttoinaccuraciesasitissubjecttocomparablebiases. 40HealthyLivingGoalPreventchronicdiseasethroughthereductionofoverweightandobesityriskfactorsObjective1IncreasethecommunityscapacitytoidentifybarriersandaddressgapsinhealthyeatingandactivelivingthroughbuildinganeffectiveCoalition.BaselineCurrentlythereareindividualorganizationsfocusedonhealthyeatingandactivelivingbutthereisnotagroupoforganizationsworkingtogethertoaligneffortsforacommongoal.TargetTheHealthyCommunitiesCoalitionandcommunitypartnershipsareeffectiveinbuildingactionaroundhealthyeatingandactivelivingchangeandenablingmorecollaborationtotakeplaceamongcommunityorganizations.DataCollectionMethodsandSourcesMonitortheeffectivenessofthecollaborativeindevelopingastrategicplanbytrackingthememberparticipationnumberofmeetingsheldandattendedeffectivenessofcollaborativenetworksusingPARTNERevaluationtoolstrategicplanningprocessandresults.Strategy1Usethe5StepsofCoalitionBuildingtofostercollaborationandengagementamongcommu-nitypartnersforHEALActionStepsResponsibleAgencysExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsTimeLine20132014201520162017Developandcultivatecorecoalitiongroupbyengag-ingpartnersacrosssectors.EagleCountyPublicHealthOutcomeTheHealthyCom-munitiesCoalitioniseffectiveinaddressingbarrierstohealthyeatingandactivelivingthroughtheir5-yearstrategicplan.HealthyLivingCoalionmeetsregularlyWorkinggroupsareformedASteeringCommieeprovidesoversightAstrategicplanisdevelopedbasedontheresultsofthegapneedsandcapacityassessmentWorkfocusesonevidencebasedpraccesMonitortheeffectivenessofthecollabora-tiveindevelop-ingastrategicplanbytrackingthememberparticipationnumberofmeetingsheldandattendedeffectivenessofcollabora-tivenetworksusingPARTNERevaluationtoolstrategicplan-ningprocessandresults.XXXXXFormworkinggroupstoimplementevidence-basedstrategiessuchasfoodshedmapworksitewellnessrecognitionpro-gramUniversalBreakfastProgram.XXXXXDevelopaSteeringCom-mitteethatwillprovideoversightandstrategicguidancefortheCoalition.XCreatea5-yearstrategicplantoaddressbarrierstohealthyeatingandactiveliving.X 41Strategy2ImplementpolicyandenvironmentalsystemschangeforhealthyeatingandactivelivingActionStepsResponsibleAgencysExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsTimeLine20132014201520162017ConductareviewofCountyandTownpoliciesthatpromotehealthyeatingoractiveliving.EagleCountyPublicHealthHealthyCommunitiesCoalitionMountainHarvestFoundationOutcomes5townsadoptresolu-tionandjoinLiveWellHEALCit-iesandTownCampaignProcessmonitor-ingtodetermineprogressandcompletionofactivities.XRe-writeCountyLandUseRegulationstoincludeHEALpriorities.XFoodsystemschangeandpolicy.XXXXStrategy3Implementevidence-basedinitiativesActionStepsResponsibleAgencysExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsTimeLine20132014201520162017Determineevidence-basedstrategiestoimplementbasedonObesityPreven-tionPrioritizationProcess.EagleCountyPublicHealthCommunitypartnersOutcome30evidence-basedinitiativesareimplementedProcessmonitor-ingtodetermineprogressandcompletionofactivities.XXXXXFormworkinggroupstoimplementevidence-basedstrategiessuchasfoodshedmapworksitewellnessrecognitionpro-gramUniversalBreakfastProgram.XXXXXObjective2IncreaseeffortstoimprovehealthequitybyassessinghealthequityanddevelopingaroadmapforEagleCountyby2017.BaselineCurrentlyEagleCountydoesnothaveatooltoassessthecurrentlevelofhealthequityinEagleCounty.TargetPilottheHealthEquityIndexinEagleCountyanddevelopandimplementahealthequityroadmap.DataCollectionMethodsandSourcesTheHealthEquityIndexcommunitytooldevelopedbytheConnecticutAssociationofDirectorsofHealthwhichmeasuressocialdeterminantsthataffecthealthandtheircorrelationswithspeciichealthoutcomes. 42Strategy1DevelopCommunityHealthWorkerProgramActionStepsResponsibleAgencysExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsTimeLine20132014201520162017Developscopeandbusinessplanofcom-munityhealthworkermodel.MentalHealthConsortiumEagleCountyHealthandHumanSer-vicesOutcomesCommunityHealthWorkersareactivelyworkinginthecommunitytobuildtrustandcapacityamongdisparatepopula-tionsBusinessandfundingplaniscom-pletedPlanissustainable2communityhealthworkersarerecruitedandtrainedProcessmoni-toringtodeter-mineprogressandcompletionofactivities.XXSecuresustainablefundingtoimplementmodel.XXImplementacom-munityhealthworkermodel.XXStrategy2GenerateaStrategicRoadMapHealthEquityActionStepsResponsibleAgencysExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsTimeLine20132014201520162017PartnerwithSparkInsti-tutetocreatearoadmapforHealthEquity.EagleCountyHealthandHumanSer-vicesOutcomesAcommunitywidehealthequityroadmapisimple-mented.HealthequityisassessedCommunitypartnersareengagedinthedevelopmentandimplementa-onofahealthequityroadmap.Processmonitoringtodeter-mineprog-ressandcompletionofactivities.XEngagecommunityinhealthequityroadmapimplementation.XXXStrategy3EngageLatinocommunitythroughEstoySanoActionStepsResponsibleAgencysExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsTimeLine20132014201520162017CommunityoutreachandengagementthroughparticipationateventsandinterfacewithLatinocommunity.EagleCountyPublicHealthCSUExten-sionOutcomesTheLatinocommunityhasincreasedawarenessofthehealthbeneitsofhealthyeatingandactiveliving.Processmonitoringtodeter-mineprog-ressandcompletionofactivities.EstoySanoevalua-tionandmonitoringplanXXXXXHealthpromotionprogrammingsuchasSpanishlanguagecookingshowhealthtipsonSpan-ishradiocookingandnutritionclassesEFNEP.XXXFosterLatinoHealthLeadershipGrouptobethevoiceoftheLatinocommunityviaoutreacheffortsandpartnerships.XXXXX 43IndependentlyAginginPlaceGoalCreateanenvironmentthatenablesolderadultstoindependentlyageinplaceObjective1ASeniorCommunityCollaborativedevelopsa5-yearplantosupportolderadultsag-inginplaceby2017.BaselineAcommunitycollaborativefocusingonthecoordinationofservicesforolderadultsandaddressingtargetpopulationspriorityneedsisnotinplace.Servicesforseniorsarefragmentedandnotcoordi-natedacrossmultiplecommunityagencies.TargetAcommunitywidestrategicplanfocusingonolderadultsaginginplaceisimplementedwitholderadultservicescoordinated.DataCollectionMethodsandSourcesMonitortheeffectivenessofthecollaborativeindevelopingastrategicplanbytrackingthememberparticipationnumberofmeetingsheldandattendedeffectivenessofcollaborativenetworksusingPARTNERevaluationtoolstrategicplanningprocessandresults.Strategy1FacilitateandfosteraseniorcollaborativegroupActionStepsResponsibleAgencyExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsTimeLine20132014201520162017Establishaseniorcollaborativeplanninggroup.EagleCountyPublicHealthOutcome5-yearplanhasbeeninitiatedandCollaborativegroupiseffectiveincoordinat-ingservicesforseniors.SeniorcollaborativegroupmeetsregularlyGapneedsandcapacityas-sessmentsarecompletedPriorityareasareidentifiedAstrategicplanisdevelopedbasedontheresultsofthegapneedsandcapacityas-sessmentThenumberofmeetingsheldbyseniorcollabora-tiveandlistofattendeesdocumentedinmeetingnotes.Analyzeassessmentofgapsneedsandcapacityassessmentsbydocu-mentationinmeetingnotesandgroupcommu-nications.Priorityareasareidenti-fiedandalignwithas-sessment.Astrategicplanisdevel-opedandfinalizedbythecollaborative.XXXXXAssesstargetpopulationneedsidentifygapsandcurrentservices.XXXDevelopastrategicplantocoordinateser-vicesandaddresspriorityareas.XXObjective2Increaseby100from2013thebaselinenumberofolderadultsparticipatingincommu-nityprogramsthatmanagechronicconditionsandreduceinjuriesduetofallsby2017.BaselineCurrentlytherearelimitedclassesofferedonchronicdiseaseself-managementandfallspreventionforolderadults.In2013therewere70participantsinclasses.Thereisalsonoformalizedrefer-ralmanagementsysteminplaceforhealthcareproviderstoreferpatientsandreceivefollowupontheirpatientsprogress.Target140participantsperyeararereferredbytheirhealthcareprovidertoHealthierLivingColoradoclassesby2017.DataCollectionMethodsandSourcesThechronicdiseaseself-managementandfallspreventionprogramisevaluatedusingoutputdatatomonitorandtracktheimplementationoftheprogramandcomparepreandpostself-reportedhealthoutcomesfromparticipants. 44Strategy1Aregionalpreventativesystemforchronicdiseaseself-managementandfallspreventionActionStepsResponsibleAgencyExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsTimeLine20132014201520162017ImplementHealthierLivingColorado-chronicdiseaseself-man-agementprogramandfallspreven-tionprograms.EagleCountyPublicHealthOutcome1ParticipantsreducehospitalvisitsduetofallsOutcome2ParticipantsreduceoutpatientandinpatienthospitalvisitsduetochronicdiseaseRecruitandtrain6instructorsSecure2-3communitysitesforclassesincludingCastlePeakSeniorCareCommunityServe70participantsin2014Serve140participantsin2015and2016ProgramevaluatedtomonitorNumberofclassesNumberofclassparticipantsNumberandloca-tionofcommunitysitesParticipantfeed-backonclassesandinstructorComparepreandpostparticipantsurveyregardinghealthoutcomesFall-relatedhospitalvisitsmonitoredbyagegroupbasedonhospitalreporteddataavailablefromCDPHEandlocalhospitals.ChronicdiseaserelatedhospitalvisitsmonitoredbyagegroupusinghospitalreporteddataatlocalhospitalsXXXXXCreatearefer-ralmanagementsystemforhealthcareproviderstoreferpatientstochronicdiseaseself-managementprogramsandreceivefollowuponpatientsattendanceandoutcomes.EagleCountyPublicHealthConsortiumforOlderAdultWell-nessOutcomeHealthcareprovidersareactivelyreferringpatientswithchronicdiseasetosched-uledHealthierLivingColoradoprograms.Form2-3relationshipswithhealthcareprovidersHealthcareprovidersareactivelyreferringpatientswithchronicdiseasetoscheduledHealthierLivingColoradoProgramsFollowuponpatientattendanceandgoalachievementprogressiscommunicatedtoproviderson100ofreferralsXXXXEstablishaMedi-careandMedicaidreimbursementvoucherprogramtosustainpro-gramfunding.EagleCountyPublicHealthandStateUnitonAgingOutcomeProgramissustainedthroughMedicareandMedicaidvouchersformedicalhomesandcommunitycenters.XXXX 45ConnectiontoPreventativeCareGoalConnectallresidentstopreventionfocusedprimarycareresourcesandservicesObjective1Increasetheuseofpreventativecareservicesbasedonrecommendedhealthindicatorscreeningsfrombaselinedata2007-2009toHealthyPeople2020benchmarks.BaselineAccesstopreventativecareindicatorsforRegion12includingEagleCountyfrom20082010Colo-radoBehavioralRiskFactorSurveillanceSystem67.1ofreportedhavinghadcholesterolscreeninginthepast5years62.8percentofadultsaged50yearswhohadacolonoscopywithin10yearsORsigmoidoscopywithin5yearsORfecaloccultbloodtestFOBTwithinthelast1year73.8offemalesaged40yearswhohadamammogramwithinlast2years90.2offemalesaged18yearswhohadaPapsmearwithinlast3years80.3ofadultsaged65yearswhoreporthavinghadalushotinthepast12monthsTargetHealthPeople2020benchmarksforthefollowingindicatorsCholesterolscreening82.1ColorectalCancerScreenings70.1Mammogramscreening81.1Papsmearwithinlast3years93.0Flushotadults6590.0DataCollectionMethodsandSourcesAnnuallymonitorthepreventativecareindicatorsforColoradosRegion12usingColoradoDepartmentofPublicHealthandEnvironmentHealthStatisticsSectionColoradoHealthIndicatorsAccessUtilizationandQualityCarePreventiveCareInEagleCounty.Dataindi-catorsarecollectedusingtheBehavioralRiskFactorSurveillanceSystem.Strategy1Identifyandsupportopportunitiestoenhanceorexpandprimarycaretounderservedpopula-tions.ActionStepsResponsibleAgencysExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsTimeLine20132014201520162017InvestigatethefeasibilityofestablishingacommunitycarecollaborativeinEagleCounty.WestMoun-tainRegionHealthCareCoalitionOutcomesHealthcareprovid-ersareengagedincreatingacollaborativetoprovidepatientcenteredcareandnavigationser-vicestoachieveasharedgoalofimprovedhealthforunderservedpopulations.Processmonitoringtodetermineprogressandcompletionofactivities.XXXXX 46Strategy2IncreasepublicawarenessoftheimportanceofregularpreventativecaretopositivehealthoutcomesActionStepsResponsibleAgencysExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsTimeLine20132014201520162017Incorporatepreventativecareandhealthmes-sagesinallagencyprogramsandout-reachmaterials.EagleCountyPublicHealthOutcomesPreventativehealthmessagesareincludedinalldepartmentoutreachmaterialsProcessmonitoringtodetermineprogressandcompletionofactivities.XXXXXObjective2IncreasedrateofinsuredindividualsinEagleCountyfrom77percentto85percent2010nationalaverageby2017.Baseline77ofEagleCountyresidentshavehealthinsurance.Target85ofEagleCountyresidentshavehealthinsurance.DataCollectionMethodsandSourcesUSCensusBureauSmallAreaHealthInsuranceEstimatesavailableannuallyStrategy1IncreasepublicawarenessofhealthinsuranceoptionsActionStepsResponsibleAgencysExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsTimeLine20132014201520162017HealthCareCover-ageGuidesarerecruitedandhiredtopromoteConnectforHealthColoradoandprovidein-personassistancetopersonsapplyingforinsurance.EagleCountyEconomicServicesOutcomes485personsonaverageareassistedpermonthwithinformationandenroll-mentservicesinMedicaidandtheConnectforHealthColoradomarketplace.Amonthlyaverageof30smallbusinesses2to50employeesreceiveassistanceinEagleCounty1490subsidypremiumtaxcrediteligibleuninsuredper-sonsreceivedinformationandenrollmentservicesduringthe1stEnrollmentPeriodOct12013-March312014595personsreceivedenroll-mentassistanceduetolifechangesduringnon-enroll-mentApril12014-Oct1220141490subsidypremiumtaxcrediteligibleuninsuredper-sonsreceivedinformationandenrollmentservicesduringthe2ndEnrollmentPeriodOct132014-Dec7201450ofpersonsreceivingsubsidypremiumtaxcreditsin1stEnrollmentPeriodreturnduring2ndEnrollmentPeriodforrenewalQuarterlyreportsareprovidedtotheBoardofDirectorsofConnectforHealthColoradoOrganizationoncharacteristicsofpopulationservednumberservicesaswellasoutreachandenrollmentstrategiesandoutcomes.ParticipateintheCon-nectofHealthColo-radoOrganizationsstatewideevaluationprogramthroughsitevisitsinterviewsanddatacollectionandreporting.XHealthCoverageGuidesprovidein-personassistancetopersonsapplyingforinsurance.XHealthCoverageGuidesprovidelocalsmallbusinessesassistanceintheConnectforHealthColoradomarket-place.XX 47MentalHealthandSubstanceAbuseGoalToincreaseawarenessofmentalillnessasanimportantpublichealthproblemandtheimportanceofmentalhealthpromotionandmentalillnessprevention.Objective1Increaseby25frombaselinethenumberofEagleCountyresidentsaccessingself-guidedmentalhealthandsubstanceabuseresourcesby2017.BaselineMantherapy.org301visitsbyEagleCountyresidentsfromJuly12012-June302013.MyStrength.comCollaboratewithMindSpringsHealthtoestablishbaselinein2013.ColoradoQuitLine49visitsbyEagleCountyresidentsfromJuly12012June302013.TargetMantherapy.org500sitevisitsbyEagleCountyresidentsperyear.MyStrength.comIncreaseby25ofbaseline.ColoradoQuitlineIncreaseby10thenumberofvisitstotheQuiteLinebyEagleCountyresidentsperyear.DataCollectionMethodsandSourcesCompareannualvisitdataforMantherapy.orgMyStrength.comandColo-radoQuitLinecollectedasdescribedbelowtobaselineforeachresource.Strategy1Promoteofself-guidedmentalhealthandsubstanceabuseresourcesActionStepsResponsibleAgencysExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsTimeLine20132014201520162017Integrateandpro-moteself-guidedresourcessuchasMyStrength.comMantherapy.orgColoradoQuitLineMindSpringsHealthSpeakUpReachOutEagleCountyPublicHealthOutcomeEagleCountycommunityorgani-zationspartnertopromotetheuseself-guidedmentalhealthandsubstanceabuseresources.Mantherapy.orgRequestsitevisitreportfromCDPHEJarrodHindmanatOficeofSuicidePreventionevery6months.CDPHEusesGoogleanalyticstotrackvisitstositebycityortownofresidentsaswellasaveragetimespentonsitepervisit.MyStrength.comRequestdatafromMindSpringsHealthonsitevisitsevery6months.ColoradoQuitLineRequestareportevery6monthsfromtheQuitLinewithnumberofvisitsbyCountybymonth.XXXXX 48Objective2Increasethecommunityscapacitytoidentifymentalhealthneedsandlinktomentalhealthservicesandresourcesby2017.Baseline56ofcommunityhealthassessmentsurveyrespondentsreportedthatmentalhealthwasapriorityhealthissueinEagleCounty.Surveyresultsandkeyinformantinterviewsindicatedthatthecom-munitywasunawareofmentalhealthservicesandresourcesandthesystemthatwasfragmentedduetonocollaborativeorworkinggrouptoalignmentalhealthresources.SourceCommunityHealthAssessmentSurveyandkeyinformantinterviewsconductedbyEagleCountyPublicHealthTargetSecureresourcestoimplementactivitiesofthestrategicplandevelopedbytheEagleCountyMentalHealthConsortium.DataCollectionMethodsandSourcesMonitortheeffectivenessofthecollaborativeindevelopingastrategicplanbytrackingthememberparticipationnumberofmeetingsheldandattendedeffectivenessofcollaborativenetworksusingPARTNERevaluationtoolstrategicplanningprocessandresultsStrategy1DevelopaworkinggroupofmentalhealthprovidersandreferralagenciesActionStepsResponsibleAgencysExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsTimeLine20132014201520162017Developaworkinggroupofmentalhealthprovidersandreferralagen-cies.EagleCountyPublicHealthEagleCountyMentalHealthConsortiumOutcomeMentalHealthpro-vidersandreferralagenciescollaboratetoalignprogramsandincreasecapacityofthecommunitysmentalhealthsystem.Groupisestablishedandmeetsregularly.Agapassessmentiscom-pleted.Priorityareasareidentifiedbasedongapassessment.Acommunitywidementalwellbeingstrategicplanisdeveloped.Fundingissecuredtoimple-menttheplan.Thenumberofmeet-ingsheldbymentalhealthworkinggroupandlistofattendeesdocumentedinmeetingnotes.Analyzeassessmentofgapsneedsandcapac-ityassessmentsbydocumentationinmeet-ingnotesandgroupcommunications.Priorityareasareiden-tifiedandalignwithassessment.Astrategicplanisdevelopedandimple-mentedbytheworkinggroup.XIdentifyandassessthementalhealthandsubstanceabusegapsneedsandinitiatives.XXMentalhealthandsubstanceabusecommunitypriorityareasareidentified.XDevelopamentalhealthstrategicplan.XXSecureresourcestoimplementtheactivitiesofthestrategicplan.XX 49Strategy2IntegratementalhealthscreeningincommunitybasedsettingsActionStepsResponsibleAgencysExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsTimeLine20132014201520162017Traindiverseworkforcesandcommunitymemberstoidentifypersoninneedofadditionalmentalhealthscreeningandreferral.Train-ingmodelsincludeSBIRTScreeningBriefInterventionReferraltoTreatmentalcoholdrugsandtobaccoMentalHealthFirstAidQPRQuestionPer-suadeRefersuicidepreventiontrainingVailVal-leyMedicalCenterMindSpringsHealthSpeakUpReachOutOutcomeCommunityorganizationsaretrainedinmentalhealthscreen-ingandreferraltoolsandactivelyusethetoolswiththeirclients.Baselineofnumberofcommunityorganiza-tionsindividualstrainedisestablishedIncreasenumberofpro-fessionalandcommunitymemberstrainedby20frombaseline.Evaluatethetrainingsandorganizationsuseofscreeningandreferraltomentalhealthservicesre-sourcesXXXXXStrategy3Createmoreeffectivelinkagesbetweendisparatepopulationsandthementalhealthsystem.ActionStepsResponsibleAgencysExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsTimeLine20132014201520162017Developscopeandbusinessplanofcom-munityhealthworkermodel.MentalHealthConsortiumEagleCountyHealthandHumanSer-vicesOutcomesCommunityHealthWorkersareactivelyworkinginthecommunitytobuildtrustandcapacityamongdisparatepopula-tionsBusinessandfundingplaniscompleted.Planissustainable.2communityhealthworkersarerecruitedandtrained.Processmonitoringtodetermineprogressandcompletionofactivities.XXSecuresustainablefundingtoimplementmodel.XXImplementacom-munityhealthworkermodel.XXObjective3Implementpoliciesfocusedondecreasingandpreventingyouthaccesstoalcoholandmari-juanaBaseline43ofEagleCounty9th-12thgradersreportedusingalcoholinpast30days63ofEagleCounty9th-12thstudentsreportedthatalcoholwaseithereasyorveryeasytoget58ofEagleCounty9th-12thstudentswhodrinkreportedthatthecommonplacethisoccursisatsomeoneelseshouse39ofEagleCounty9th-12thgradersreportedeverusingmarijuana43ofEagleCounty9th-12thstudentsthatusemarijuanasaidthatsomeonegaveittothem28ofEagleCounty9th-12thgradestudentswhoreportedbingedrinkinginthepreviousmonthSourceHealthyKidsColoradoSurveyEagleCountyRE-50SchoolDistrict2011-2012Results.Pre-paredbyOMNIfortheEagleRiverYouthCoalition.TargetPoliciesrelatedtopublicmarijuanauseandsocialhostordinancesareadoptedandenforcedinEagleCounty. 50MaintainordecreasethenumberofEagleCounty9th-12thgradestudentsthatusemarijuanathatreportsomeonegaveittothem.Decreasethepercentof9th-12thgradestudentsthatreportedalcoholwaseithereasyorveryeasytoget63to50.DataCollectionMethodsandSourcesCompare2015-2016resultstothebaselineindicatorsfrom2011-2012fromtheHealthyKidsColoradoSurveyEagleCountyRE-50SchoolDistrict.ThesurveyisconductedbytheEagleRiverYouthCoalition.Strategy1PolicyplanningmobilizationandimplementationActionStepsResponsibleAgencysExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsTimeLine20132014201520162017Supportthedevelopmentofasocialhostordi-nance.EagleRiverYouthCoali-tionOutcomesEagleCountyhighschoolstudentsreportthatitismoredificulttoaccessalcoholandmarijuana.Processmonitoringtodetermineprogressandcompletionofactivities.HealthyKidsColoradoSurveyEagleCountyRE-50SchoolDistrictXXXExploretheimpactandpotentialstrategiesrelatedtomarijuanausepreventionandreduc-tionofprevalence.XXXX 51RadonAwarenessandMitigationGoalReducetheriskoflungcancercausedbyradongasexposureObjective1Increaseusagerateofdistributedtestkitsby65by2017.Objective220oftestsindingradonlevelsover4.0pCiLwillresultinappropriatemitigationmeasuresby2017.BaselineBaselinewillbemeasuredin2014withtheimplementationoftheradontestkitdatatrackingsys-tem.Targets65increaseinusageofdistributedradontestkitsfrombaseline.20oftestsindingradonlevelsover40pCiLresultinradonmitigation.DataCollectionMethodsandSourcesTheregionalradontestingdatacollectionsystemwillbeusedtotrackradontestkitdistributionusageandmitigation.Thedataisenteredintothesystemregularlywithdataanalyzedandreportedannually.Strategy1Increaseknowledgeofthehealthrisksofexposuretohighradonlevelsandprovidecitizenswiththenecessarytoolsandinformationtomakeinformeddecisionsaboutradonmitigation.ActionStepsResponsibleAgencyExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsActivityTimeLine20132014201520162017Developadatamanage-mentsystemtotrackkitdistributionusageandremediation.EagleCountyEnvironmentalHealthEnergySmartOutcomeDatatrackingsystemisusedtotrackkitdistributionus-ageandremediatedhomesDatasystemiscreatedandimple-mentedDataaretrackedandanalyzedbykitdistribu-tionusageandremedi-atedhomesXXXXXConductacommunitywideeducationaloutreachcampaignduringNationalRadonActionMontheachJanuary.OutcomeIncreasecommunityawarenessofhealthrisksduetoexposuretoradonOutreachplanimplementedan-nuallyMeasuredbaseonthemethodsofcommunica-tionusednumberoftestkitsdistributedasaresultoftheeducationalcampaign.XXXXSecureresourcesforkitdistribution.OutcomeIncreasedcommunitymemberuseofradontestkits200testkitsaredistributedan-nually130testkitsusedannuallytomeasureradonlevelsKitsaretrackedtoidentifyfollowup.100oftestkitrecipientsthathavenotusedkitin1montharecontacted.ThedatatrackingsystemisusedtomonitorthefollowingnumberofradonkitsdistributednumberofradontestkitsusedversusamountdistributedkitrecipientfollowupcallsnumberoffollowupcallsresultedinkituseXDistributeradontestkitstocitizenswithinformationonuseandradonrisk.XXXXUsedatatrackingsystemtotrackkitdistributionuseandfollowup.XXXXContactrecipientsofkitsthathavenotbeenusedafter1monthwithas-sistanceandinformationprovidedasneeded.XXXXConductone1Do-It-Yourselfradonmitigationclassannuallyforhome-ownersandinterestedcontractorstoeducateoncosteffectivestepsthatcanbetakentomitigatetheirhomes.OutcomeIncreaseinnumberofresidentswithtestresultsgreaterthan4.0pCiLtakingactiontomiti-gatetheirhome.Conduct2radonmitigationclasses25participantsattendeachdo-it-yourselfradonmitigationclass100ofCitizenswithgreaterthan4.0pCiLresultsarecontactedTheradondatatrack-ingsystemisusedtomeasurenumberoftestresultsover4.0pCiLcom-paredtototalnumberoftestkitsusednumberofmitigationsystemscompletedduetodiscoveryofelevatedlevelsXXXXXProvidecitizenswithtestresultsgreaterthan4.0pCiLinformationonlocalmitigationcompaniesanddemonstrationproj-ectsinthearea.XXXX 52Objective3Policyisadoptedthatsupportsincreasingawarenessandpromotingradonresistantconstructioninallnewbuildingsby2017.BaselineCurrentbuildingcodedoesnotsupportradonresistantconstruction.TargetsAllnewconstructionincludesradonresistantconstructionbyexpandingAppendixFtomulti-familybuildings.DataCollectionMethodsandSourcesMonitorpolicymobilizationprocess.Strategy1PolicymobilizationandimplementationActionStepsResponsibleAgencyExpectedResultsOutcomesandOutputsOutcomeDataCollectionMethodsActivityTimeLine20132014201520162017WorkwithplanningcommitteeandcommissionerstoexpandAppendixFtomulti-familybuild-ings.AppendixFispartoftheInternationalResidentialCodethatsetsstandardsforpassiveradonresistantconstructioninoneandtwofamilydwellings.EagleCountyEnvironmentalHealthEnergySmartOutcomeNewconstruc-tionofmulti-familybuild-ingsinEagleCountyisradonresistant.Processmonitoringonprogressofactivi-tiesandimplementa-tionofpolicy.XXXX 53AcknowledgementsEagleCountyPublicHealthwouldliketothankthefollowingpartnersandthecommunityatlargeforassistinginthedevelopmentofthisplan.Throughnominalgroupprocessesstakeholdersgavenumeroushoursoftheirtimesharingideasconcernsandprioritiesforourcommunity.EagleCountyPublicHealthappreciatespartnerorganizationsforcollectingandsharingdatathatcontributedtothecommunityhealthassessmentandprioritizationprocess.BrightFutureFoundationBrushCreekRanchCastlePeakSeniorCareCommunityCatholicCharities-VailValleyColoradoDepartmentofPublicHealthandEnvironmentColoradoRiverRanchColoradoSchoolofPublicHealthColoradoStateUniversityExtensionOficeCommunityHealthServicesInc.DoctorsPlusofColoradoInc.EagleCareClinicEagleCountyBoardofCommissionersEagleCountyGovernmentEagleCountyParamedicServicesEagleCountyRE50SchoolDistrictEagleCountysHealthyCommunitiesCoalitionEagleRiverYouthCoalitionEarlyChildhoodPartnersGarieldCountyPublicHealthHealthConsortiumofEagleCountyJamiePfahlMindSpringsHealthPitkinCountyEnvironmentalHealthRobinSmartSamaritanCounselingCenteroftheRockiesSeniorCareEagleColorado-VisitingAngelsSpeakUpReachOutTownofAvonPoliceDepartmentTownofEaglePoliceDepartmentTownofVailPoliceDepartmentVailValleyFoundation-YouthFoundationVailValleyMedicalCenterVailValleySalvationArmyVladkaKovarova EagleCountyHealthHumanServicesPublicHealthDepartmentAdoptedDecember2013www.eaglecounty.uspublichealth