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Health care survey shows various needs in Bismarck region, including affordable housing, child care

Bismarck Tribune - 6/10/2024

A recent survey of community health needs in the Bismarck region found concerns ranging from high housing prices to a relatively low number of mental health professionals.

CHI St. Alexius Health, Sanford Health, Bismarck-Burleigh Public Health and Western Plains Public Health work jointly on the assessment every three years, polling residents in Bismarck-Mandan and Burleigh and Morton counties about what areas of health care need to be improved in the community.

The latest survey was conducted from October to December last year and saw 1,118 responses, a 20% increase from the previous survey, according to Brian Ritter, head of market affairs for Sanford, who with Sister Nancy Miller from CHI St. Alexius presented the survey results to area leaders on Monday.

"This truly is a partnership. This is the culmination of a lot of months of effort," Ritter said.

The survey identified needs in a range of areas: availability of affordable housing, access to daily transportation, quality of child care, quality of long-term senior care, mental health care, healthy living, affordability and accessibility of care, environmental health, exercise opportunities and health care access. Surveyors ranked areas on a scale of one to five, with one being "poor" and five being "excellent." Each area was then given a score based off the average rank it received.

The survey indicated that the lowest-ranked area was affordable housing, receiving a score of 2.08. Ritter said comments on the survey suggested that wages have not kept up with housing prices. According to survey data, 10% of households in the community face "severe housing problems," which is below the national average (17%) and the state average (12%). Additionally, 9% of households surveyed are spending at least half their income on housing costs.

"It's not something we as health care providers can necessarily identify and address alone, but we hopefully can do it in a partnership with the service providers in this room," Ritter said.

Affordability came up as an area of concern for overall health care, being identified as a "top health care concern," according to Miller. She said that while most people in the community have a primary care provider and do yearly checkups, 26% of respondents who do not do regular checkups cited cost concerns.

Miller added that 7% of people in Bismarck-Mandan do not have health insurance, compared to 10% nationally and 9% in North Dakota. She said St. Alexus has worked to reduce that figure by assisting its patients in enrolling in health insurance programs and by collaborating with organizations to educate about insurance.

"One in five survey respondents indicated that they or a family member needed medical care in the past year but did not receive it ... and when asked why, the main reason was due to cost and long wait times," Miller told the audience.

Access to health care was identified as a concern in the survey, with long wait times, especially for specialty care, being an issue. Ritter said these concerns are due to health care facilities having hit capacity. He said Sanford has worked to address capacity issues by opening 16 clinics in Bismarck-Mandan. The hospital is also working to add 36 beds.

Ritter said both Sanford and CHI St. Alexius have also worked with Bismarck State College and the University of Mary to pay tuition for nurses who are willing to stay in the community.

"We need every single one. Our expectation is that over the next 12 to 18 months at Sanford, we're going to need to hire probably another 65 more nurses just to staff those beds that we're adding," he said. "And that's in addition to the needs that we already have."

Lack of access is a problem plaguing more individualized aspects of health care as well, according to the survey. An example is access to child care, receiving an average score of 2.94 in the survey.

Miller said respondents cited a lack of providers in the area to meet demand as a driver behind such a low score, along with high costs. The survey shows that an average household in the community spends 26% of its income on child care, which Miller said is "three to four time the proposed threshold for household affordability."

Miller believes the only way to address child care concerns is through partnerships. She said St. Alexius collaborates with the YMCA and the Youth Development Center to provide child care for hospital employees, and she wants to see that program expand to benefit others as well.

Some areas saw low rankings due to quality of care. Long-term senior care and housing received a low rating from survey respondents due to concerns about staffing shortages and inadequately trained staff. Ritter emphasized that long-term care facilities are going to need to prepare for a potential increase of patients in the next few years as North Dakota's population ages.

"You're going to have to prepare for that and do a better job to prepare for that as a community," he said.

Quality of care is also seen as an area of improvement for mental health, which was identified as one of the top three issues when respondents were asked about the most important health care issues facing their community. Respondents commented a need to offer or improve addiction services and behavioral and mental health services.

Miller said the Bismarck-Mandan area has an average of one mental health provider for every 437 people, compared to one for every 320 people nationally and one for every 450 in North Dakota.

"We continue to serve those with mental health needs through our adolescent and adult psych programs, and continue to recruit providers to serve in a way that is impactful and meaningful for our community," Miller said.


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