LLCHC Service Area Needs Assessment
Final Report
Lower Lights Christian Health
Center
Service Area Community Health
Assessment
Exploring Health Issues, Policies, Services and Citizen Involvement impacting
residents of Franklinton, Ohio.
Created: October 21, 2013
Board Reviewed & Approved: November 05, 2013
by
Cornerstone Management
Wheelersburg, OH
LLCHC Service Area Needs Assessment
INTRODUCTION
Medicine and medical care come to mind when discussing health issues. However, there are
several factors which directly impact a person’s health which are not medical in nature. These
broad health status indicators deal with poverty, housing, education, environment and more. It is
these underlying causes of disease that is the focus of this project.
The health of the community concerns everyone. A healthy community is well equipped with
active, productive, participating citizens who are free to use their energies toward the good of
their employers, school systems, volunteer groups, and churches. The kind of community that
successfully joins together for the common good is made up of clean neighborhoods of healthy
families that support the mental and physical health of each individual. Few communities
completely obtain this goal. Most are plagued to some degree by polluted streets, emotional
health issues, excessive rates of preventable disease and death, increasing costs of medical care,
and an overall decline in the quality of life. When citizens’ health is poor, productivity declines,
employers are forced to deal with high rates of absenteeism, education suffers, and the pool of
available volunteers decline. Prevention and early intervention are the keys to creating a healthy
population living in healthy communities and so maximizing their ability to thrive. It is,
therefore, of vital importance to assess the underlying causes of poor health and the availability
of healthcare resources in the community in order to address the issues that are creating health
problems.
This report contains a baseline of measurable data upon which to build. It lays the groundwork
for developing a dynamic plan to continually assess and improve the health status of Franklinton
residents. This project will guide the development of strategies to implement community health
programs with an emphasis on prevention and provision of cost effective, high quality
comprehensive early intervention health care for all.
BACKGROUND
In the rapidly changing world of health care in our nation and in our state, we must strive to keep
current with changes that affect the health of the community. Health providers must become
more versatile in providing programs that meet the changing needs of the public. The Nationally
focused Healthy People 2020 Project and Ohio’s Public Health Plan have identified certain core
functions which are necessary to effectively change the way health providers organize resources
and programs. Community health needs assessment is identified as a strong tool by which a
community can identify important health problems by both of those projects, and begin to
aggressively address them. Health assessments include broad community representation that
provides necessary input to a data-driven assessment of the current state of the community’s
health.
LLCHC Service Area Needs Assessment
A review of the Lower Lights Christian Health Center programs precipitated the overall project.
This was followed by an assessment of the Franklinton community’s health delivery system in
order to determine, among other variables, the availability, accessibility, and quality of care being
offered. While these two facets of the project were taking place, a survey of Franklinton residents
was also implemented to obtain what “the people” considered their biggest health problems.
Concurrently, our researchers performed a background secondary data analysis and review of
historical data, conducted a series of interviews with health personnel and clientele, completed a
telephone survey of healthcare providers, conducted a random telephone sampling of community
members, and investigated similar sized systems for a comparative analysis. This sampling
provided a true research based assessment of the problems affecting the health status of
Franklinton residents.
SCOPE
This assessment is intended to provide insight into the community health status of Franklinton, a
suburb of Columbus, Ohio. It seeks to discover perceived problems from the community at large
and problems identified by those who work in the health professions. The core focus of the
project considers the primary health care needs and barriers to care for the approximately 12,000
of Franklinton residents with incomes below 200% of federal poverty guidelines. Therefore,
before further developing the descriptions of poverty and health concerns of Franklinton, it is
important to understand the basis-for estimates of the statistics used to describe the target
population.
Access Ohio notes that there is little health care data kept below the county level in Ohio. As
Access says, "health status indicators are not available for many cities, townships, rural counties
nor for specific population groups." Therefore, they conclude, most reliable information is
available at the county level. Nonetheless, there are a number. of census statistics kept at the
census tract level, (such as age, sex, race, poverty status, home ownership,) which impact health
status and do provide some specific numbers with respect to the Franklinton population. In many
cases, however, the best estimate of the degree of a problem in the target population is the same
as the figure for Franklin County as a whole, unless there is some circumstance that makes it
possible to conclude that the manifestations of the problem in the target population are greater or
less than the manifestations of the problem county-wide.
Also, the under 200% of Poverty population is faced with significant health disparities as
evidenced by characteristics developed by the National Center for Health Statistics. In every
category, persons with low incomes fare significantly worse than persons with higher incomes:
having health insurance rates are lower; doctor visits are lower; dental visits are lower; dental
caries are higher; and routine cancer screening rates are lower. It is clear that health disparities
exist in the lower income ranges.
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LLCHC Service Area Needs Assessment
Table 1. Healthcare Disparities by Poverty Level
Income below 100% of
Incomes between
Incomes Over 200% of
the Federal Poverty 100% and 200% of the
the Federal Poverty
Level
Federal Poverty Level
Level
% of children without a
usual source of health care
13.5%
9.8%
3.8%
% of children without a
healthcare visit in the last
12 months
17.2%
14.7%
10.1%
% of adults without a usual
source of healthcare
27.5%
24.5%
12.6%
% of persons without a
dental visit in the past year
53.0%
48.1%
26.6%
% of persons with untreated
dental caries
33.8%
29.5%
12.7%
Income below 100% of Income above 100% of
the Federal Poverty
the Federal Poverty
Level
Level
% of women over 40
without a mammography in
the last two years
45.2%
27.9%
% of women over 18
without PAP in the last 3
years
27.9%
13.8%
Income below 100% of Income between 100% Income between 150%
the Federal Poverty
and 149% of the
and 199% of the
Level
Federal Poverty Level Federal Poverty Level
% of the population under
65 with no health care
insurance
31.4%
% of the population under
26.7%
65 with private health care
insurance
Source: National Center for Health Statistics
Income over 200% of
the Federal Poverty
Level
32.8%
25.6%
10.9%
39.2%
56.6%
83.9%
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LLCHC Service Area Needs Assessment
METHODOLOGY
Cornerstone Management, with significant input from the Lower Lights Christian Health Center
staff, collected, organized and analyzed the health assessment data from a number of major
sources. Sources include the US Census Bureau, Ohio Department of Health, Ohio Department
of Development, US Department of Health and Human Services, and the National Center for
Health Statistics. An external resource assessment was also completed in conjunction with the
Franklin County and Columbus City Health Departments. Questions centered on leadership,
community, public perceptions, professional staff, and additional resources their clinics offer.
This health assessment provides an understanding of not only the community’s health status but
also the internal strengths and limitations of the Franklinton health delivery system. Its design
also assists in determining residents’ perceptions of health issues and healthcare providers. To
increase the quality of responses, personal interview methodology was employed as often as
possible.
The statistical sampling included:

Fifty (50) randomly selected Franklinton households, contacted by telephone for a
general health and needs assessment. This provided an initial identification of
health issues, attitudes, and service and provider utilization by community
members. Approximately 30 of the 50 households contacted agreed to complete
the survey for a response rate of 60%. Of those declining to participate, about 60%
pleaded time constraints, 37% simply declined or seemed fearful of providing
information and 3% were unable to understand the purpose of the survey.

Primary care physicians were polled as to available services. There were 3.9
physicians providing services in 2 locations. Some respondents were unable or
unwilling to answer all the questions. None, other than Lower Lights, accepted
new Medicaid patients or provided income based sliding fee discounts.

Secondary data analysis on existing state and federal demographic, health, social
and economic reports (as well as information secured from local sources) was
compiled and examined for contextual placement.

Interviews with community leaders, social service providers, and governmental
entities serving the Franklinton area were employed as an additional method of
gathering information and community thought patterns in target areas of the
assessment. Community and health representatives provided input in this process.

In late 2012 LLCHC participated as a member of the Franklin County Community
Health Needs Assessment Steering Committee to provide the residents of central
Ohio with a comprehensive summary of the larger community’s health status and
needs. That report, Franklin County Healthmap 2013, was issued in January 2013
and is included as an attachment to this report
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LLCHC Service Area Needs Assessment
REPORT ORGANIZATION
This community health assessment covers five main areas:
I.
II.
III.
IV.
V.
Profile of Franklinton.
Assessment of community health status.
Survey of available health services
Community perceptions
Conclusions and Recommendations
I - PROFILE OF FRANKLINTON
Franklinton, one of the first villages in the Northwest Territory and the oldest community in
Central Ohio, was founded at the confluence of the Scioto and the Olentangy rivers in 1797. The
community became known as “The Bottoms” since it was located in a flood plain. In fact, over
90 people died in the 1913 flood, thousands of people were left homeless, and many industries
were irreparably damaged and left the area. That event marked the beginning of Franklinton’s
decay as many residents relocated to the nearby Hilltop community. As a result, property values
dropped as much as 50% resulting in a large influx of low-income families to move to the area.
During the 1960s through 1980s period, construction of the Interstate Highway system delivered
another negative blow to Franklinton. The Columbus inner belt construction removed several
blocks of buildings along Sandusky Street, lowered property values and drove out of East
Franklinton most of the remaining stable families. This out-migration was once again followed
by an influx of low income families.
In addition to the land use and population changes that occurred, the inner belt formed a barrier
which sealed off the only side of East Franklinton that was not bordered by the Scioto River.
This isolation was further reinforced with the construction of West I-70. Franklinton is now
surrounded by highways, railroads and a river. This physical separation from the rest of the city
has created a unique and easily defined community.
The Franklinton area is generally bound by the Scioto River on the north, the first set of railroad
tracks west of Starling Street on the east, Greenlawn Avenue/City of Columbus corporate
limits/Mound Street on the south, and Central Avenue/I-70 on the west. It also includes an area
between the Scioto River and the first set of railroad tracks west of Starling Street. This area is
commonly referred to as the Scioto Peninsula.
Franklinton is roughly composed of census tracts 30, 32, 40, 42, 43, 50 and 51. These census
tracts contain an area that has been designated as a Medically Underserved Area (MUA) by the
Bureau of Primary Health Care (#02682), and that has been designated as a Health Professional
Shortage Area (HPSA).
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LLCHC Service Area Needs Assessment
Table 2. HPSA/MUA
Census Tract
30
32
40
42
43
50
51
MUA
x
x
x
x
x
x
x
Medical HPSA
x
x
x
x
x
x
x
Dental HPSA
x
x
x
x
x
x
x
Source HRSA
Unfortunately, Franklinton’s isolation and appellation as “The Bottoms” continues to connote the
poor economic conditions of its citizenry.
General economic issues demonstrate the pervasive poverty of the area:
 41% of families live at or below federal poverty guidelines, and this number jumps to
63% of families with children of less than five years of age. This is the highest poverty
rate within the City of Columbus.
 In 2011, at least 5000 of Franklinton’s 20,000 residents had no health insurance coverage.
 The median income is $23,102 as compared to Columbus at $55,039.
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LLCHC Service Area Needs Assessment
The estimated unemployment rate for Franklinton in September 2012 was 14% for males
and 10% for females, compared to 9.1% and 9.0% respectively for Columbus.
45.5% of the population does not have a high school diploma.
40.9% of the total population is under 100% of poverty, and another 18% are under 200%
of poverty. 22% of all housing in Franklinton is unoccupied, and only 33% is owner
occupied.
The racial composition of Franklinton population is 76% White, 15% Black, 2%
Hispanic, 2% Asian, and 5% unknown.
There have been no unusual changes in the demographic composition of the community
in several years.
Table 3. Economic Indicator Comparison, Service Area/Columbus
Indicator
Franklinton
Single Mother Households
14.3%
Less than a high school education
45.5%
College Graduates
15.3%
Household <$10K
25.9%
Household <$15K
36.4%
Household <$25K
54.7%
Family Median
$23,102
Poverty Families w/Children (n=1781)
45.5%
Source: US Census ACS 2011 (Franklinton): Tables
Columbus
7.5%
14.2%
29.1%
8.1%
13.5%
25.3%
$55,039
10.6%
Franklinton leaders believe that the physical and mental health of its residents directly affects the
economic health of the area. That a healthy, better educated, more reliable work force, which is
attractive to business and industry, will allow Franklinton residents to begin their escape from the
shrouds of poverty.
II – ASSESSMENT OF COMMUNITY HEALTH STATUS
The seven census tracts that generally conform to Franklinton community boundaries contain
both a designation as a Medically Underserved Area (MUA), and a Health Professional Shortage
Area (HPSA).
The pervasive poverty in Franklinton has contributed to significant health care disparities in the
service area and target population. Research of data from several sources identified many
healthcare disparities and these disparities have been organized by the five (5) Lifecycles for this
report and are as follows:
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LLCHC Service Area Needs Assessment
PERINATAL
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The percentage of pregnant women with no prenatal care in the first trimester is 35.0%
which far exceeds averages for both Franklin County (18.2%) and the State overall
(16.7%). [Source: Ohio Department of Health]
The perinatal mortality rate in Franklin County (2006-2008) is 8.8 per 1000 live births as
compared to the Ohio rate of 7.7 for the same period. [Source: Ohio Department of
Health]
The rate of low birth weight babies for the same three year period is 1.9% of all births
compared to the State of Ohio rate of 1.5%. Furthermore only 49.3% of the VLBW
infants were delivered at Level III facilities as compared to 71.2% in the State of Ohio. It
is estimated that this rate is even lower among the target population. [Source: Ohio
Department of Health 2008]
PEDIATRIC
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The infant mortality rates for Franklinton is 15.0 per 1000 live births as compared to
Franklin County (8.8 per 1000 live births), and Ohio (7.9 per 1000 live births). [Source:
Ohio Department of Health]
The neonatal mortality rate for Franklin County is 5.9 per 1000 live births (3 year
average) as compared to the State of Ohio at 5.2 per 1000 live births. Exact data is not
available for the target population. [Source: Ohio Department of Health]
The leading causes of death for Franklinton children between the ages of 1 and 14 include
accidents, homicides, and suicides with a crude (not age adjusted) death rate of 23.3 per
100,000 deaths as compared to a rate of 22.8 (2008) for the State of Ohio. [Source: Ohio
Department of Health]
Only 28% of Columbus children in 1st through 3rd grades have preventive dental sealants
on their permanent teeth compared to Healthy People 2020 goal of 50%; 29% of these
same children have untreated dental caries or decayed teeth; 5% of these children are in
need of immediate dental care; 25% of this group of children (1st through 3rd grade) have
not had a dental visit within the past year, and 3% have never had a visit (2002 Franklin
County Health Assessment updated 2008). This problem is worse among lower-income
children.
ADOLESCENT
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Drug use among Franklinton youth is pervasive but no solid data is available to document
the level of the problem.
The teen pregnancy rate in Franklinton is more than double the rate for Franklin County
as a whole: 7.6% vs. 3.5% (averages for the period 2006-2008 – Columbus Department
of Health).
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According to the Columbus Health Department, the number of new cases of HIV reported
in Franklinton has risen dramatically over the past ten years in this age group. No
comparative data is available.
The incidence of sexually transmitted diseases among this age cohort in Franklin County
per 100,000 population is much higher than the incidence in the United States according
to the 2002 Franklin County Health Assessment Updated 2008.
ADULT AND GERIATRIC
The health care problems among the target population and the Franklin County area are similar
for both life cycles.

8.1% of Franklin County residents have been diagnosed with diabetes/high blood sugar as
compared to 5.4% in the US according to the 2010 County Health Rankings Franklin
County. Furthermore, deaths per 100,000 persons attributable to diabetes are 34 as
compared to 25.2 in the US according to this same study. Not surprisingly this assessment
found that 61.7% of Franklin County residents are overweight compared to 56.5% of US
residents. The assessment also found that 25.8% of Franklin County residents were obese
as compared to only 19.1% in the US. In Franklinton 70.3% of residents have a BMI of
25 or higher compared to 56.3 for Franklin County.
According to the Ohio Hospital Association during 2008, fifty-nine (59) adults from
Franklinton were hospitalized for diabetic crises.
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Deaths from lung cancer per 100,000 (age adjusted) is 67 in Franklin County as compared
to 58 in the US. According to the 2002 Franklin County Health Assessment updated
2010, Health Department statistics estimate that 55.3% of Franklinton residents are
current smokers compared to 26.6% of Franklin County residents.
Deaths from stroke per 100,000 (age adjusted) in Franklin County is 48.1 in Franklin
County compared to the national benchmark of 41.4. Contributing factors include the fact
that 26.9% of Franklinton residents have been diagnosed with high blood pressure as
compared to 23.4% in the US.
Deaths from breast cancer per 100,000 (age adjusted) in Franklin County is 31.3
compared to 27 in the US according to the Ohio Department of Health 2008.
o Dental care is a problem for all lifecycles in the target population, especially for
low-income residents. Franklin County Health Department survey results
indicated that 33.7% of adults in Franklin County had not visited a dentist in the
past year, and 27.6% of adults had no dental insurance.
Health status indicators for mortality & chronic and infectious diseases prevalence and incidence
within the community and target population with comparisons are shown in the following tables:
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LLCHC Service Area Needs Assessment
Table 4. Health Status Indicators: Service Area/Columbus City/State/HP2020 Rates
Indicator
Service
Area
Columbus
City
State of
Ohio
HP
2010
Infant Mortality
per 1,000 live
births
Low Birth
Weight Births
Late Prenatal
Care
Births to
Women who
smoked
Teen Pregnancy
per 1,000
females age 1019
Coronary Heart
Disease
Cancer
Stroke
Diabetes
CLRD
11.0
8.4
7.8
4.5
8.6%
na
8.0%
5.0%
30.9%
18.5%
14.0%
12%
26.3%
na
18.9%
na
42.4
39.9
33.6
na
201.7
na
174.7
166
227.8
55.9 *
30.2 *
53.2 *
209.0
na
na
na
200.2
51.4
29.7
50.1
159.9
48
Source: Health Statistics, ODH 2008
* For some indicators data specific to the targeted population is not readily available but for those
indicators the overall Franklin County indicators were worse than State rates.
The first five (5) indicators can be categorized as Maternal and Child Health indicators. All 5
categories are consistently higher than the State of Ohio. Except for a few areas, the other Maternal
and Child Health indicators appear to be in line with the State of Ohio rates. The last five (5)
indicators on Table 5 are more disease related mortality rates. On these Health Status Indicators, the
target population does not fair as well. The service area had a higher average incidence rate per
100,000 populations than the State of Ohio in all of the five (5) categories.
Target population data for communicable disease rates compared to the State of Ohio is not
favorable and well above both State and HP 2020 rates. Residents of Franklinton tend to maintain
certain attitudes and values that drive unhealthy behaviors which impact access to and inappropriate
use of the health care system. Preventative health care or health maintenance is not valued by most of
the population. The lack of value is probably most pronounced in low income families where
substance abuse, violence, appointment no-show, unprotected sex, poor diet, etc., abound. The
general attitude is to classify health habits as personal issues, guarded by self-reliance, stoicism, and
personal privacy. Often, care for a health care problem is not sought unless it is perceived to be lifethreatening.
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Table 5. Communicable Diseases: Service Area/State Rates
Disease
HIV/AIDS
Chlamydia
Gonorrhea
Syphilis
Service
Area
235.8
447.4
335.4
4.7
State of
Ohio
124.8
315.1
184.2
2.0
HP 2020
na
na
19.0
0.02
Source: Health Statistics, ODH 2008
Table 6: Behavioral Risk Factor Indicators: County/State Rates
Indicator
Current
Smokers
Mammogram
40+, last
2 yrs.
Sigmoid 50+
last 5 yrs.
Overweight
BM>25
Pap Smear
18+ last 2 yrs.
Binge
Drinking
Service
Area
34.1%
State of
Ohio
26.6%
HP
2020
12%
67.2%
77%
70%
31.1%
46%
50%
61.7%
58.8%
15%
80.6%
86.6%
90%
28.9%
15.9%
20%
Source: Health Statistics, ODH 2008
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II – A REVIEW OF COMMUNITY RESOURCES
This section outlines views on the Franklinton community resources in context with their health
delivery system and service availability.
Leadership in Franklinton appears to be stronger in some areas than others. Everyone agreed that
the leaders of their community work well together, generally taking a long term view and giving
programs time to develop into assets. Most felt that while there is leadership from many areas of
the community, gaps exist in the areas of business and industry of which the notable exception is
Mt Carmel Medical Center which is providing outstanding support to the community.
Government responsiveness is thought to be good, but more involvement in community matters
would be desirable. Community needs are positively addressed, but there is room for
improvement in this area. Specifically, closer ties are needed between government, business, and
the non-profit sector. Community leaders do not regularly attend meetings that relate to the area’s
health services. For the most part, neither private industry nor the local media have joined with
the community to promote public health awareness. The community does have a strategic plan
but it is only directed at recruiting new industry. Problems within the community are often not
addressed until they become crises.
There is no local foundation specifically committed to the improvement of the community. There
are however, several local civic organizations devoted to the betterment of the community, most
notably, the Kiwanis, Rotary, and Lions Club.
The community agreed there are no ethnic or racial divisions posing problems. Generally groups
work well together and the community is not dominated by any special interests. There is a
shared sense of pride and vision for the community within the consortium.
Responses identified Mt Carmel Medical Center as a strong leader in health services. As an
example, its cooperation with LLCHC in providing care to the underserved, Mt Carmel sets a
fine example of partnering between quasi-government and the private sector. Respondents were
disappointed that the same cooperation isn’t seen in other areas.
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III - SURVEY OF AVAILABLE SERVICES
All 3.5 primary care providers serving the Franklinton area were contacted.
The survey of primary care providers showed:

The total number of primary care physicians in Franklinton providing services to the
medically indigent is inadequate.

None of the respondents other than LLCHC accepts new Medicaid patients or provides
discounted fees for low income patients
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100 % of respondents had office hours Monday through Friday.
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In two of the offices, a physician was available only 4-5 hours per day.
Other health care providers that provide some level of care to the target population (most of
which cooperate with LLCHC) include:
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Mt. Carmel West Hospital provides both diagnostic laboratory and radiologic services to
LLCHC patients based on a sliding fee scale. Mt. Carmel also accepts LLCHC in its
specialty clinics to include Obstetrics, Gynecology, Orthopedics, General Surgery and
Cardiology, Gastroenterology, and Urology. Uninsured patients are accepted based on
family size and income in accordance with the Hospital Care Assurance Program
(HCAP). Mt. Carmel also assists with in-patient care for LLCHC patients. Mt. Carmel’s
assistance greatly enhances LLCHC’s ability to provide comprehensive services.
A number of private practice medical specialists will accept uninsured and Medicaid
eligible new patients referred by LLCHC. They will not accept any new patients not
referred by LLCHC.
Lower Lights Ministries provides many varied services. These services include substance
abuse programs, employment/educational counseling, food pantry, clothing pantry,
housing assistance, transportation, and community outreach.
WIC services and nutritional counseling are available and a Franklin County WIC office
located across the street from LLCHC.
The PRIDE Center, an arm of the Columbus Health Department, is also located across the
street from LLCHC. Services provided include case management, eligibility assistance,
discharge planning or home evaluation.
The Alpha Group, a private mental health/substance abuse agency will accept LLCHC
referrals regardless of ability to pay but will not accept new patients not referred by
LLCHC.
Netcare, a community mental health safety net agency accepts patients regardless of
ability to pay.
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The Columbus Health Department Dental Clinic accepts patients regardless of ability to
pay. Services provided include fillings, exams, cleanings, extractions, and some root
canals.
The East Central Health Center Dental Clinic also provides low cost dental care, and
provides the same services as the Columbus Health Department. (Not in service area.)
The Ohio State University Family Practice on High Street – Dental Clinic provides
limited dental services for adults and children based on a sliding fee scale. (Not in
service area.)
The Vineyard Free Medical Clinic provides limited dental services on Fridays to include
exams, fillings, and extractions. (Not in service area.)
IV- CLIENT AND COMMUNITY PERCEPTIONS
Client survey results of the Lower Lights Christian Health Center
To obtain a sampling of attitudes toward current service delivery at the LLCHC clinic, random
personal interviews with ten clinic clients provided the opportunity to ask open-ended questions
that provided insight and answers inherently unobtainable in formal closed-ended surveys, and,
that might not have been expressed among peers in a focus group setting. In this case, the
interview guide was constructed to more fully gain an understanding of the deeper feelings and
attitudes of the residents in Franklinton toward the clinic, its programs, and other community
issues. The semi-structured interviews yielded a fairly tight set of results regarding opinions
toward the clinic. It also provided very candid responses concerning sensitive and sometimes
conflicting issues within the community. For example, most of respondents listed drug-abuse,
drinking, and smoking at their top health concern while two respondents specified the need for
universal health care.
The sampling provided a balanced group by family income status. Sixty percent of respondents’
household income fell between $10,000 and $15,000; thirty percent were below $10,000; and
only one was over $25,000. Only twenty percent (20%) of respondents owned the homes they
occupied. This compares to an owner occupied rate of sixty-three percent (63%) for Ohio and
seventy-three percent (73%) nationally. Family members, co-workers, and friends provided an
introduction to the clinic for most respondents. Sixty percent of the respondents visit a “family
doctor” only one or two times per year; two persons indicated they “never” see a doctor. All
respondents said the clinic provided the services they needed. None had trouble scheduling an
appointment.
All (100%) of the respondents indicated they would still use the services of the clinic if given a
choice among health care providers. Ninety percent rated the prenatal care a top ranking “5" and
indicated they felt comfortable recommending it to a family member. All respondents said the
health clinic workers informed them of “important health issues” and 90% said they “always” get
clear directions concerning specific needs.
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Community Survey Results
This section contains a summary of the primary data collected from telephone interviews
conducted within the project area. Major findings are presented for comparison with secondary
data. Not surprisingly, perceptions of respondents conflicted with actual services offered in a
number of cases. This was especially evident in several “public awareness” or communicative
issues regarding some health indicators.
Thirty-three of 46 respondents were familiar with the LLCHC clinic. Four were not sure if they
knew specifically of the clinic, but thought they “might have heard of it.” The annual average
number of physician encounters for respondents was three, with a standard deviation of +/- 4;
however there were several responders indicating 20 to 24 visits per year. Such extreme numbers
usually result from some type of special problem/need. Approximately seventy-five percent
(75%) of respondents stated they were moderately to very conscious of their family’s health.
Fifty-two percent use private insurance or cash to pay for medical care, while twenty-seven
percent (27%) utilize Medicare and eight (18%) are enrolled in Medicaid. The average household
size of respondents in the telephone survey was three. The minimum household size was one and
the maximum was six. Incomes for households responding to the survey varied somewhat.
Twenty-four percent were under $10,000, while three percent totaled over $45,000. The
remaining respondents were evenly spaced between these two limits. Twenty-four percent (24%)
of respondents in the telephone survey said they felt cancer was the number one health concern
facing the community. Sixteen percent (16%) said pollution, which directly relates to increased
cancer risks, was paramount. Fifteen percent (15%) of respondents stated that “all” of the
problems listed were pressing issues and needed immediate attention. Fourteen percent (14%)
listed drug abuse, ten percent said “colds and flu”, and nine percent (9%) said there were
essentially “no problems” facing the community. Other problems cited by participants included
alcohol, allergies, child abuse, lime disease, measles and transportation.
V - CONCLUSIONS
Community Perceptions
Almost one third of survey respondents under age 60 were unfamiliar with the clinic. An outreach
and education effort, especially in middle and high schools, could increase early clinic usage and
could positively impact maternal health as well as the risk of low birth weight and infant
mortality.
Franklinton citizens are concerned about a wide range of health issues according to survey results.
Publicity and education could address many of these concerns, with a focus on cancer detection
and prevention. Clean up campaigns targeting specific areas in one or two week blocks could
involve civic groups, schools, businesses and citizens in an effort to eradicate rodent, tick, and
mosquito breading areas, clean trash from roadways and streams, and beautify formerly unsightly
areas. Drug abuse education and treatment options should be publicized, with law enforcement
stepping up efforts at eradication.
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LLCHC Service Area Needs Assessment
Education
“Education and community based health promotion and disease prevention interventions are
important in reducing illness, injury, disability, and premature death in Ohio.” (Healthy People
Ohio 1997) Citizens must be educated about the need for prevention and early interventions.
Community respondents were often unaware of services offered by LLCHC. Some were aware
that services were available, but not sure if they would qualify or if specific services such as a
dental clinic were offered. A focused media campaign involving radio, TV, and print media is
recommended to inform people about Health Department clinics, education programs, and income
guidelines.
Access
Access to care within the area is a serious problem. If suitable space could be found, consideration
should be given to relocating the clinic, thereby improving accessibility to clients.
The health of the community concerns everyone. If the Franklinton community is to move
forward economically and educationally, its citizens must be mentally and physically up to the
challenge. With the identification of problem areas, both real and perceived, steps may be taken to
upgrade the health of individuals, families, and neighborhoods.
Franklinton’s economic woes are in some ways the cause of and caused by health problems.
Pollution of air and water by industry in the past may have contributed to lung problems and
cancer. Unemployment and underemployment worries contribute to or worsen emotional and
physical diseases caused by stress, along with the social problems of alcoholism, drug abuse, and
domestic violence. An unhealthy workforce brings problems with absenteeism, low productivity,
and worker dissatisfaction. Improving the health of the community as a whole through clean-up
projects, stress control education, and affordable, available health care would improve the health
of industry already present in the community, and make Franklinton more attractive to new
businesses.
Goals for continued improvement should focus on information, education, and access. If the
community is informed about the availability of care, provided access to care through better
affordability, and educated about the importance of good health practices and preventative care,
Franklinton can realize the vision of a vibrant community, where every individual is fully
equipped to live up to his potential to the benefit of everyone.
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LLCHC Service Area Needs Assessment
Gaps in Service
Health services (except those offered by the LLCHC) available to uninsured and under-insured
citizens of Franklinton is virtually non existent. An effort should be made to attract more primary
care physicians to the area, which would assure availability of care and increase the base of care
available to Medicaid recipients. Physicians should be educated about the need for evening and
Saturday hours, and encouraged to offer expanded hours at least one or two days a week (perhaps
one evening and every other Saturday). Working parents were often unable to schedule
appointments during non-working hours, a result borne out by the lack of evening and Saturday
office hours found in the survey of primary care physicians
Physicians also need to be encouraged to allow uninsured or under-insured patients to pay on a
sliding fee scale.” Working poor” who are unable to qualify for a medical card, and who have
little or no discretionary income available to pay for office visits, often put off obtaining care.
Also this barrier includes those with incomes in the $20,000 to $30,000 range who have private
insurance which doesn’t pay for office visits, or whose deductibles are prohibitively high.
Oral health is also a serious problem for Franklinton residents. Dental services are not available to
the vast majority of residents.
According to Ohio’s Public Health Plan:
“Access to primary and preventive dental care, continues to be a problem for people
without financial means.”
Franklinton’s 12,000 people living below the 200% federal poverty level easily fall in the category
of “people without financial means”.
Lower Lights Community Health Center
The following outlines findings from an internal and external assessment of the Lower Lights
Christian Health Center and its clinical program. This assessment was conducted via interviews
with key personnel from LLCHC. Questions in the interviews were adapted from the Ohio Health
Plan’s Guide for Community Assessment.
While the LLCHC has a strategic plan, it is not widely known to the employees. The mission
statement does appear common to all those within the organization. The staff of the LLCHC feels
that they are the ones primarily responsible to be good health advocates. LLCHC is the most vocal
agency within the community on promoting the public health.
Communication within LLCHC is very good. All lines of communication are open within the
chain of command. Staff meetings are held weekly with supervisors. Employees expressed an
atmosphere conducive to sharing ideas and differing perspectives. This is strength of the
organization. A leadership role is taken by the CEO, who makes the final decision when a general
consensus cannot be reached. Teamwork within the agency is an excellent indicator of quality care
and service. The clinic is utilizing available technology via Internet access and Electronic Health
Records systems.
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LLCHC Service Area Needs Assessment
Board representation is good, with low income, clinic users and professional communities being
well represented. Age, race, and gender are adequately diverse.
The Lower Lights Community Health Center internal and external assessment reveals an
organization with the necessary resources to continually assess and provide for the health of the
community. It has the capacity to fill important roles in the assessment and care delivery process.
Those being: Leader, collaborating partner, and a source of technical assistance and data. The staff
of the LLCHC works well together, and communication within the clinic is generally very good.
Continually updating the strategic plan and communicating it to the staff should be a priority.
Yearly updates will ultimately save time and allow the clinic to be continually responsive to the
community.
In summary, LLCHC and Mt Carmel are clearly leading the provision of health care services in
Franklinton and providing the springboard from which to launch non healthcare redevelopment.
An aggressive program of networking involving leadership in all segments of the community
would benefit the area as a whole and create a cooperative atmosphere that is attractive to
prospective industry. Many larger companies now understand that healthier, happier employees
are more loyal and more productive. They are actively forming partnerships with local
governments, schools, and non-profit organizations that encourage their employees to volunteer
their time and talents. They also provide funding for many projects.
As stated earlier, LLCHC was a participant in developing the Franklin County Healthmap 2013.
This report focuses on the LLCHC Franklinton service area, while the Healthmap 2013 provides
an excellent overview of the entire Columbus MSA. Both reports should be used together to
facilitate the development of LLCHC strategies to provide comprehensive, affordable, healthcare
to the impoverished residents of its Franklinton service area.
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