Napa County takes a deep look at local health needs

Two studies were submitted to the Napa County Board of Supervisors last week. Board chairman Joel Gallagher said they could be a “starting point” to ensure “a friendly community for all ages”.

The 96-page Community Health Needs Assessment was compiled by the county Health and Human Services Agency and Providence Queen of the Valley Medical Center. It combines data and interviews with 137 people in the county.

Christine Wu of the county's Department of Public Health said the results are “truly the voice of our community, often expressed in their own words.”

Below are sample quotes from local residents and service providers.

• “The middle class can't find services. They make too much money to apply for low-income housing or food stamps, yet they struggle to pay for rent and food.”
• “Health and happiness? It's all about love for each other.”
• “Some days I don't want to wake up. I just sit at home. That's not a good mental space. I need to connect with more people!”
• “My bus was late, so I missed my doctor's appointment, and they tried to take me to the hospital later, so I missed the bus home. This little errand took me the whole day.''
• “I live in St. Helena, but the only option for me is (childcare) in Napa, so I drive out four days a week. It's a really long drive and takes up a lot of time. .”
• “In Mali, the community raises the children. All the aunties come together. Here, no one had time for us.”
• “[Because]I'm poor, I'm elderly, I'm a lesbian, I have a chronic health condition, so I can't go to the doctor. I'm still 100% isolated because of COVID. It is invisible.”
• “People who work at certain wineries (farmers) have insurance, but for those who don’t have insurance, what we’re making isn’t enough.”
• “Nature is a good stress reliever. I try to surround myself with animals.”
• “Before, we were more actively involved. There were lotterias, prayer sessions, parties, birthday potlucks, etc… We need them again. The pandemic has ruined everything.”

Based on an August meeting that included community groups, the Community Health Needs Assessment prioritizes five needs: housing, behavioral health, access to health services, racial and LGBTQ inclusion, and economic stability. I attached it.

For example, this assessment accounted for behavioral health challenges.

“The scale of the mental health crisis appears to be overwhelming the care system,” the report said. “Mental health is often an underlying issue that remains unaddressed.”

When it comes to accessing health services, the assessment found that many people do not have stable relationships with their primary care providers. Wait times for appointments can be months long and you have to go to the emergency room.

Separate but related is the 52-page Napa County Senior Citizen Assessment.

Adults 60 and older make up 28% of Napa County's population and are the fastest growing area. The evaluation included 1,530 surveys, 21 interviews, and 76 focus group participants.

According to consultant BJ Bischoff, it's really a story of two communities.

“Wealth, majority-white communities are well-positioned to enjoy all the beauty and opportunity Napa has to offer,” the study states. “However, within those same counties, there are communities with large numbers of low-income Latinos who face disproportionate physical and economic hardships.”

The older adults surveyed rated their quality of life at an average of 8.1 on a scale of 1 to 10, with 10 being the highest. However, it dropped to 7.6 for Latinos and 7.1 for low-income residents.

Celine Regalia gave the example of older adults, revealing that while some have greater concerns than others, virtually all face challenges. Regalia is the executive director of Providence Adult Day Health.

An example is Ruby, who earns $50,000 a year. She is 80 years old, owns her own home and car, and has no worries about her food. However, she is widowed and lives alone, and she has had falls and uses a walker.

Ruby worries that one day she won't be able to drive. Regalia said driving connects her with family and friends and allows her to be independent.

“She worries that one day she will need more care because her family doesn't live locally and she doesn't want to be a burden,” Regalia said.

If she needs more care, she will become part of the “forgotten middle class.” Regalia said these people are middle-income people who don't have additional resources and are ineligible for programs such as home support services that provide care.

She talked about Juan and Mary, who each make less than $25,000 a year.

Both of them rent and live alone. Juan has his own car, which she struggles to maintain. Mary uses public transportation and Morley's Angels to go shopping and to medical appointments.

“They may have trouble meeting basic needs and expenses,” Regalia said. “They struggle to get the food they want that meets their cultural and medical dietary needs.”

But there is a thread that ties all three together. Everyone is concerned about affordable housing and the freedom to age in place. They worry about falls and the cost of dental care.

“And we know that transportation, transportation, transportation is key to access and quality of life in Napa County,” Regalia said.

Those surveyed were concerned about the cost of affordable care and the lack of affordable long-term care options, she said.

Napa County has data and priorities for two studies. These will help you find solutions and funding.

“I hope it's clear throughout this that there's no one strategy, there's no specific service or program that's needed,” said Jennifer Yasumoto, county health and human services director.

“We need everything. We need to address everything strategically and we will have better community health for everyone who lives in our communities. ”