2013 Augusta County
Community Health Needs Assessment
Igniting a Sense of Health
this document available at www.augustahealth.com
Adopted by the Board of Augusta Health 08-28-13
Table of Contents
Perspective--Creating a Sense of Health in the Community ................................................................. 3
Participants........................................................................................................................................ 3
Timeframe for Community Health Needs Assessment Process............................................................ 5
Definition of Community Assessed ....................................................................................................... 5
Characteristics of Defined Community .................................................................................................. 7
Population Projections ....................................................................................................................... 8
Morbidity and Mortality Snapshot ...................................................................................................... 8
Community Resources .......................................................................................................................... 9
Key Findings in the Community Health Needs Assessment ............................................................... 10
Data Collection Methodology .............................................................................................................. 11
Secondary Data Review ..................................................................................................................... 12
Overall Health.................................................................................................................................. 12
Health Outcomes ............................................................................................................................. 13
Physical Environment ...................................................................................................................... 13
Social and Environmental ................................................................................................................ 13
Clinical Care .................................................................................................................................... 14
Health Behaviors ............................................................................................................................. 14
Health Priorities................................................................................................................................... 15
Supporting Data Highlights .............................................................................................................. 16
Priority 1: Chronic disease management ..................................................................................... 16
Priority 2: Health Behaviors and Community Health Education ................................................... 19
Priority 3: Access and Affordability ............................................................................................... 21
Priority 4: Behavioral Health ........................................................................................................ 21
Priority 5: Socioeconomic Factors ............................................................................................... 22
Process and Criteria to Prioritize Health Needs .................................................................................. 24
Giving Credit Where Credit is Due ...................................................................................................... 25
2013 Augusta County Community Health Needs Assessment
2
Perspective--Creating a Sense of
Health in the Community
The federal government through the Internal Revenue Service
now requires that tax-exempt hospitals conduct a community
health needs assessment (CHNA). However, the Augusta
County area voluntarily has been at the forefront in collaborative
efforts to assess and improve community health. More than a
decade ago, Augusta Health (the hospital) and over 200
community agencies, organizations and governmental leaders
created a Community Health Forum where these organizations
meet bi-monthly to collaborate on health and community needs
issues. Augusta Health initiated a first community health needs
assessment in 2009, and worked with the Community Health
Forum to develop strategies and initiatives to address several
major community health needs.
In 2012 and 2013, Augusta Health and partner organizations
developed this more extensive Community Health Needs
Assessment planning process that included community surveys,
physician surveys, focus groups with key community leaders and
two community summits with over 60 health and community
leaders providing input.
Project Goals and Objectives
• To continue a formal and
comprehensive community health
assessment process that will provide
the identification of key health and
access issues, and a systematic
review of health status in the Augusta
County area
• To create an infrastructure that will
permit ongoing updating and easy
dissemination of available data, and
enable a continued partnership
between all stakeholders in the
community
• To create a health profile that will
establish prioritization of needs and
inform resource allocation, decision
making, and collective action to
improve health outcomes
The leadership of Augusta Health and the Community Health
Forum support joint planning and assessment and believe these
CHNAs help health care providers build stronger relationships
with their communities, identify needs and dedicate funding and
other resources toward programs that clearly benefit local
residents.
The 2013 Community Health Needs Assessment identifies
opportunities for health improvement for the Augusta County
area based on extensive primary and secondary research. The
assessment process creates a collaborative community
environment to engage multiple change agents, and establishes
an open and transparent process to listen and truly understand
the health needs of Augusta County. The results of this CHNA
report will be used to determine community health priorities and
to develop an updated implementation strategy that guides
collaboration and resource allocation.
Participants
Augusta Health is governed by a volunteer Board of Directors
made up of 15 individuals with a wide range of backgrounds,
expertise and experience. The Augusta Health Board of
Directors designated a standing board committee, the
Community Benefit Committee, to oversee the Community
Health Needs Assessment process.
2013 Augusta County Community Health Needs Assessment
3
A tremendous number and wide range of community and health
care organizations collaborated to implement a five stage
process focused on identifying and defining local health issues,
concerns and needs. A complete list of all organizations and
individuals who were involved in developing the assessment is
listed in the back of this document.
The three-month process included gathering and analyzing
secondary data and input from the community. The interactive
and participatory process involved essentially every organization
in the community that impacts health.
Augusta Health, as the sponsor of the assessment, engaged
Stratasan, a healthcare analytics and facilitation company out of
Nashville, Tennessee to facilitate the process and provide
community health data and expertise.
Stratasan staff working with Augusta Health and the community
had a collective 80 years of experience in healthcare planning
and community health. J. Tod Fetherling, Founder and
Chairman of Stratasan, was the project leader assisted by Lee
Ann Lambdin, Vice President of Strategy for Stratasan. Tod and
Lee Ann each have 22 years healthcare analytics, planning and
facilitation experience. Heavily involved in the data review and
summit design was Stephanie Bailey, M.D. Dr. Bailey was the
head of the Metro Davidson County Nashville Health
Department. She then moved to the Center for Disease Control
and Prevention (CDC) in Atlanta, GA where she was the Chief of
Public Health Practice in the Office of the Director. She
presently serves as Interim Dean of the College of Public
Service and Urban Affairs at Tennessee State University as well
as the medical director for Stratasan. Stratasan provided the
analysis of community health data to assist the community with
determining focus areas and goals for improvement.
Augusta Health also engaged Catalyst Healthcare Research to
conduct the community telephone survey and develop the
employee and physician survey content. Catalyst is a health care
research specialist firm also located in Nashville, TN. Dan Prince,
President of Catalyst Research, has 30 years of healthcare
research experience and presented the research findings at the
Community Health Summit.
2013 Augusta County Community Health Needs Assessment
Sourced from the Robert Wood
Johnson Foundation’s County Health
Rankings website: http://www.countyhealthrankings.org/take-action
“We initiated the Community Health
Needs Assessment with the goal of
identifying public health needs, goals,
objectives and priorities,” said Kathleen
Heatwole, Ph.D., Vice President of
Planning and Development at Augusta
Health. “It is our goal to use our findings
as a foundation for improving and
promoting the health of each community
member.”
“The information we gathered provided
the insight we will need to set priorities
for local public health,” added G.
Douglas Larsen, MD, Health Director,
Central Shenandoah Health
Department. “The Community Solutions
Summit was the final, critical step in the
process. Now the real work—improving
the health of the community—begins.”
4
Timeframe for Community Health Needs Assessment Process
A Steering Committee was established in June 2012. A kick-off meeting was held June 29, 2012 where
interested individuals and organizations were invited to learn about the process and provide feedback on the
proposed process. A focus group with 20 individuals took place on June 28, 2012. A telephone survey of 302
households was conducted July 14-26, 2012, and a physician survey was conducted in July 2012. Additional
input was received from over 60 agencies, individuals and organizations represented to review the results of
the secondary data, focus group input, community survey and telephone survey in a final Summit on August
23, 2012. The results of the findings and the priorities were then reviewed with the Board of Directors and
standing Committee members of Augusta Health, medical staff leadership, and administrative staff at a
hospital retreat held in October 2012. The data were gathered in a final report and issued to the public in July
2013.
The question of how the organization can best use its limited charitable resources to address priority needs will
be the subject of Augusta Health’s separate implementation strategy. The Implementation Strategy will be
developed by the Community Benefit Committee, a standing Board Committee of Augusta Health, and will be
based on the results of the CHNA.
To be successful in creating a true sense of health in the Augusta County area, it will be necessary to have a
collaborative venture which brings together all of the care providers, citizens, government, and business and
industry around an effective plan of action. Several small groups will be responsible for implementation of the
priority health needs. Please contact the Community Wellness Department at Augusta Health for information
regarding ongoing efforts and how you may get involved.
Definition of Community Assessed
In order to define the boundaries of the community to be assessed in the Community Health Needs
Assessment process, an evaluation was conducted to determine the extent of the primary service area for
Augusta Health. Augusta Health is located in Augusta County, Virginia, a county that geographically
encompasses the independent cities of Staunton and Waynesboro. The Augusta County, Staunton and
Waynesboro area covers over 970 square miles and is the second largest county in Virginia. Augusta Health is
the only hospital in this large geographic area, and has received designations from CMS as a sole community
hospital and a rural referral hospital.
A ZIP code analysis was conducted based on calendar year 2012 to determine percentages of inpatient
admissions by ZIP code. As seen in the table on the following page, ZIP codes for Augusta County, Staunton,
and Waynesboro accounted for 81.1% of all admissions to Augusta Health. In addition, market share data for
the Augusta County, Staunton and Waynesboro area provided by Truven, one of the largest data analytic firms
in the country, show that approximately 70% of all patients in these ZIP codes use Augusta Health as their
primary health care provider.
The other 20% of admissions to Augusta Health come primarily from surrounding counties, including Rockbridge County, Bath and Highland Counties, and portions of Rockingham, Nelson and Albemarle Counties as
well as travelers and visitors from across the country in very small numbers. There are other hospitals in
Rockbridge County, Bath County, Rockingham County and Albemarle County, and all of these hospitals have
initiated Community Health Needs Assessments for those areas in which they have the dominant share of the
market for those counties.
For these reasons, it was determined that Augusta County, inclusive of the cities of Staunton and Waynesboro
(“Augusta County, Staunton, Waynesboro area” or “Augusta County”) most accurately defined the hospital’s
community for the Community Health Needs Assessment process.
2013 Augusta County Community Health Needs Assessment
5
Augusta Health is a not-for-profit, independent community hospital, and accepts all patients regardless of age,
race, national origin or ability to pay. This assessment does not exclude from the community any category of
patient, or any limitation of any demographics within the defined community area. In order to assure that the
Community Health Needs Assessment process provided representation of medically under-insured, low
income and minority populations, a randomized telephone survey was conducted of area residents. In addition,
Steering Committee members included representatives from the Department of Health, Department of Social
Services, Office on Youth, the Augusta Regional Free Clinic and the Valley Community Services Board. Focus
group participation included representatives including WARM Program Shelter for homeless individuals, Casa
do Amistad representing the Hispanic community, Office on Youth, and the Boys and Girls Club representing
underprivileged youth, and the Shenandoah Adult Protective Services agency.
2012 Admissions by ZIP code
ZIP Codes- Augusta County
22843 – Mount Solon
22939 – Fishersville
22952 – Lyndhurst
24411 – Augusta Springs
24421 – Churchville
24430 – Craigsville
24431 – Crimora
24432 – Deerfield
24437 – Fort Defiance
24440 – Greenville
24459 – Middlebrook
24467 – Mount Sidney
24469 – Fort Defiance
24477 – Stuarts Draft
24479 – Swoope
24482 – Verona
24485 – West Augusta
24486 – Weyers Cave
24475 – Spottswood
24476 – Steeles Tavern
ZIP Codes - Staunton
24401 – Staunton
24402 – Staunton
24463 – Staunton
ZIP Codes - Waynesboro
22980 – Waynesboro
Total Augusta, Staunton, Waynesboro
Total Patients From All ZIP Codes
2013 Augusta County Community Health Needs Assessment
Inpatient Admissions
% of Total
48
0.4
660
5.5
199
1.7
21
0.2
227
1.9
217
1.8
192
1.6
23
0.2
39
0.3
218
1.8
52
0.4
78
0.7
11
0.1
859
7.2
108
0.9
369
3.1
36
0.3
53
0.4
2
0.0
20
0.2
3,440
70
9
28.8
0.6
0.1
2,732
9,683
11,941
22.9
81.1
100.0
6
Characteristics of Defined Community
Although a wide range of data sources were used to evaluate the demographic characteristics of the area, the
Virginia Atlas provides an excellent summary showing the characteristics of Augusta County and the two cities
of Staunton and Waynesboro, and provides a comparison with demographic characteristics for the
Commonwealth of Virginia.
Total 2012 Population
Square Miles
Population Density
Virginia
Total
8,154,81
5
40,32
7
202.2
Augusta
County
Staunton
Waynesboro
74,156
971
23,777
20
21,235
15
76.4
1,191.2
1,393.4
3,090,78
8
1,857,22
28,973
10,558
8,983
15,394
4,596
5,023
5
1,375,67
4
1,642,63
7
2,233,94
9,454
13,634
3,762
4,250
3,127
4,008
23,061
6,374
5,415
0
1,045,33
9
23%
12,613
4,795
3,662
21%
19%
24%
Adults Age 18-­­29 %
17%
13%
16%
15%
Adults Age 30-­­44 %
20%
18%
18%
19%
Adults Age 45-­­64 %
27%
31%
27%
26%
13%
4,148,68
0
4,006,13
5
51%
17%
20%
17%
36,587
12,992
11,062
37,569
10,785
10,173
49%
55%
52%
51%
45%
48%
374
2,966
188
2,914
159
2,262
9
5,573,48
0
542,01
69,176
19,850
17,407
1,640
825
1,407
6
655,98
6
6%
1,553
526
1,391
19%
1%
4%
1%
12%
1%
11%
68%
93%
83%
82%
7%
2%
4%
7%
8%
$34,30
7
$64,11
2%
2%
7%
$26,926
$27,029
$25,089
$57,673
$49,067
$45,703
5,367
2,819
2,587
Total Households
Children Age 0-­­17 #
Adults Age 18-­­29 #
Adults Age 30-­­44 #
Adults Age 45-­­64 #
Seniors Age 65+ #
Children 0-­­17 %
Seniors Age 65+ %
Females #
Males #
Females %
Males %
Asian #
Black/African American #
White #
Other or Multi-­­Race #
Hispanic Ethnicity #
Asian %
Black/African American %
White %
Other or Multi-­­Race %
Hispanic Ethnicity %
Per Capita Income
Median Household Income
Low Income (less than $25,000)Households #
Low Income (less than $25,000)Households %
2011 Estimated Total Population in Poverty #
2011 Estimated Total Population in Poverty %
Population Age 25+ #
Population Age 25+ Did Not Graduate High School #
Population Age 25+ Did Not Graduate High School %
49%
459,66
0
1,579,65
8
553,38
2
18%
912,77
6
11%
5,490,97
9
675,22
8
12%
19%
27%
29%
7,041
3,619
3,788
9%
15%
17%
53,164
16,947
14,577
7,083
2,278
2,303
13%
13%
16%
Source: Virginia Atlas
2013 Augusta County Community Health Needs Assessment
7
Population Projections
Population projections for the Augusta County, Staunton and Waynesboro area are provided by the Virginia
Employment Commission and are found in the following table.
Year Augusta Co % change Staunton % change Waynesboro % change
2010
73,750
23,746
21,006
2020
80,655
9.36
24,605
3.6
22,375
6.5
2030
87,580
8.59
25,574
3.9
23,575
5.4
2040
94,713
8.14
26,440
3.4
24,613
4.4
Source: Virginia Employment Commission
Morbidity and Mortality Snapshot
A number of sources were used to identify mortality and morbidity statistics for the defined community.
Interestingly, results varied depending on the method of collection and the year of measurement. Health
priorities were developed based on a comprehensive review and evaluation of all available data.
Health Profile, 2011 Virginia Department of Health
All Deaths
Total Deaths Rate
Malignant Neoplasms (Cancer)
Rate
Diseases of Heart Rate
Unintentional Injury Rate
Cerebrovascular Diseases Rate
Chronic Lower Respiratory
Diseases Rate
Alzheimer's Disease Rate
Influenza and Pneumonia Rate
Suicide Rate
Diabetes Mellitus Rate
Nephritis and Nephrosis Rate
Chronic Liver Disease Rate
Septicemia Rate
Primary Hypertension & Renal
Disease Rate
Augusta Co
703.3
Population 2011 Census
Staunton
Waynesboro
921
869.1
Virginia
735.8
168.4
213.8
208.2
169.5
160.3
39.1
36.0
186.7
39.4
62.9
210.7
16.9
33.4
161.3
33.4
41.4
27.9
59.7
52.9
38.4
27.7
19.7
17.7
16.6
10.3
8.6
7.3
40.9
28.7
17.4
10.1
14.4
11.9
13.8
41.8
35.5
18.4
12.6
10.0
13.0
14.0
>23.0
17.4
12.5
19.4
17.6
8.1
<16.8
6.9
22.1
6.3
6.9
73,549
23,769
21,311
8,096,604
Source: Virginia Department of Health
2013 Augusta County Community Health Needs Assessment
8
Mortality and Morbidity by age adjusted rates/100,000
Disease Profile
Virginia Total
Malignant Neoplasms Deaths/
Age adjusted rate/100,000
Heart Disease Deaths
Age adjusted rate/100,000
Chronic Obstructive Pulmonary
Disease (age adjusted/100,000
Congestive Heart Failure
Age adjusted rate/100,000
Diabetes discharges
Age adjusted rate/100,000
Bacterial Pneumonia discharges
Age adjusted rate/100,000
Augusta County
Staunton Waynesboro
169.5
168.4
213.8
208.2
161.3
160.3
186.7
210.7
134.2
42.9
85.8
116.2
233
154.2
386
335.3
133.2
66.1
229.7
163.7
197.4
102.9
189.2
237.2
Source: Virginia Atlas 2011
Community Resources
The Augusta Health community contains a variety of resources that are available to assist in addressing health
needs identified in this CHNA. See the section, “Giving Credit Where Credit Is Due” for a listing of community
organizations represented by individuals participating in interviews, focus groups, and the Community Summit.
Additionally, Augusta Health, the United Way, and the University of Virginia have compiled directories of
organizations and programs providing health and social service resources in Augusta County. The directories
may be accessed at the following links.

Augusta Health directory: http://www.augustahealth.com/forum/community-organizations

United Way directory (last updated 2010):
http://www.unitedwayga.org/sites/unitedwayga.org/files/Quick_Guide.pdf

UVA directory (last updated 2010): http://faculty.virginia.edu/cffs/4.pdf
A federal designation from the Health Resources and Services Administration as a Health Professional
Shortage Area (HPSA), a medically underserved area (MUA), or a medically underserved population (MUP)
identifies geographic areas and populations in the community that may be facing barriers accessing care. A
geographic area or facility can receive a federal HPSA designation if a shortage of primary medical care,
dental care, or mental health care professionals is found to be present. An area or population group can be
designated as medically underserved based on the ratio of primary medical care physicians per 1,000 persons,
the infant mortality rate, the percentage of the population with incomes below the poverty level, and the
percentage of the population greater than age 64. Federally Qualified Health Centers (FQHCs) may be
established to serve MUAs and MUPs.
The low income population in Augusta County is designated as a primary medical care, dental care, and
mental health care HPSA. No HPSA facilities, MUA/P designations, or federally qualified health centers
(FQHCs) are present in the community.
2013 Augusta County Community Health Needs Assessment
9
Key Findings in the Community
Health Needs Assessment
In 2012, Augusta County is ranked 31st healthiest County
in Virginia out of 134 counties (1= the healthiest; 134 =
unhealthiest). The City of Staunton is ranked 53 and the
City of Waynesboro is ranked 64. Virginia is ranked the
20th healthiest state out of the 50 states.
Augusta County is living up to its motto “Let the ages
return to the first golden period”, referring to a period of
simplicity and happiness. In general, the Augusta County,
Staunton, Waynesboro area outperforms the state
averages for health status. Where local results fall at or
below those levels, we see an opportunity for combined
actions that result in improved community ratings. There
are several lifestyle gaps that need to be closed to move
Augusta County toward greater overall health.
Based on the telephone survey research of Augusta
County residents, 25% believe people taking more
responsibility for their own lifestyle/health is the issue most
impacting people’s health. While 11% believe affordable
health insurance and substance abuse services are the
second and third issues that have the most impact on
people’s health. Additionally, jobs and employment (6%)
is the next highest answer.
Physicians also believe that people taking more
responsibility for their own lifestyle/health is a top concern
as well as more primary care professionals and affordable health insurance.
2013 Augusta County Community Health Needs Assessment
Key Demographic Statistics:
The median age of the community (42.3) is
higher than Virginia (37.4) and the U.S. (37.2) The
median household income of the Augusta
County, Staunton, Waynesboro area ($46,329) is
significantly lower than Virginia ($58,234) and
lower than the U.S. ($50,227)
The per year growth rate from 2011 to 2016 of
the Augusta County, Staunton, Waynesboro area
(0.51%) is lower than Virginia (.86%) and the U.S.
(0.67%)
The medical care index of the community (94) is
significantly lower than Virginia (120) and lower
than the U.S. (100). This measures healthcare
spending of the population.
The community focus group mentioned mental
health and substance abuse, economic issues
and lifestyle and nutrition as the top issues that
impact people’s health.
After consideration of all data sources presented
in this study, the following issues were identified
as health priorities for Augusta County.

Chronic disease management is
needed in the community, especially for
obesity, diabetes, cancer, heart disease,
poor nutrition, and physical inactivity.

Health behaviors and community
health education, particularly related to
obesity and physical activity, was
supported by the data.

Access and affordability of care is
needed in the community, especially
primary care for Medicaid and Medicare
beneficiaries, low income residents, and
the uninsured.

Behavioral health issues surfaced
relative to depression, teen suicide and
substance abuse as well as the need to
integrate mental health and primary care.

Socioeconomic factors including low
income and low educational attainment
are problematic, especially in the cities of
Staunton and Waynesboro.
10
Data Collection Methodology
The health of the community was studied extensively
through primary and secondary research methods.
Data was gathered using several methods:
Augusta Health Patients
• The Community Health Assessment Steering
Committee provided support and oversight to the
process.
• Stratasan collected and analyzed three years of
hospital data (including inpatient, outpatient, and
emergency room visits). The data was summarized
by service line and mapped by location. This
information was used to more thoroughly understand
the health service demand and disease profile of the
community. Community health data such as
socioeconomic, clinical, physical environment, and
behavioral were also analyzed.
• 302 area residents were surveyed via telephone to
gather information about their personal health and
well-being, health-related behaviors and risks for
diseases.
Data was gathered by ZIP code and by Augusta
County. The map shows the use of healthcare
services by residents both in and outside of Augusta
County.
• 61 physicians responded to a survey, providing their
opinion on community health status and unique
perspectives on the health needs in the community.
• 21 community members, employers, and
government representatives were interviewed via a
focus group for their perspectives on community
health needs and issues.
• A community health kick-off event presented the
process and encouraged participation in the process.
• A community summit was conducted with 62 community leaders and citizens. The audience consisted
of healthcare workers, business leaders, school
systems, government representatives, and other
community members.
Lessons learned from this process:
The Augusta County, Staunton, Waynesboro area needs to ignite a “Sense of Health” that permeates
the culture of the counties, cities, employers, school systems, churches, and community organizations.
•
There is a direct relationship between health outcomes and affluence (income and education). Those
with the lowest income and education generally have the poorest health outcomes.
•
While any given measure may show an overall good picture of community health, there are significantly
challenged subgroups.
•
It will take a partnership with a wide range of organizations and citizens pooling resources to
meaningfully impact the health of the community.
•
2013 Augusta County Community Health Needs Assessment
11
Secondary Data Review
Overall Health
Strengths
• Augusta County ranks well in Health Factors at #24
out of 134 counties. Staunton ranks 56 and
Waynesboro ranks 67. These rankings are all in the
top half of the counties in Virginia. Health Factors are
comprised of health behavior (30%), clinical care
(20%), social & economic factors (40%) and physical
environment (10%). The percentages in parentheses
represent the amount each of the factors comprises of
the total ranking, totaling 100%.1
• The lower violent crime rate in the city of Staunton
and Augusta County compared to Virginia is positive.2
• The Physical Environment ranks high for all three:
Augusta County at 26, Waynesboro at 27 and
Staunton at 7 of 134 counties. These are factors such
as: air pollution-particulate matter days, air pollutionozone days,3 access to recreation facilities4, limited
access to healthy foods,5 and access to fast food
restaurants.6
children in single-parent households,14 and violent
crime rate.15
• The northeast side of Waynesboro (makes a reverse
C around Waynesboro) has more poverty and chronic
disease (smoking, asthma, diabetes, depression,
obesity).16
• The southwest side of Staunton has more poverty
and chronic disease (obesity, diabetes, asthma).17
• Access to health care can be difficult for those with
public health insurances (Medicaid and Medicare),
particularly when it comes to finding a provider that
accepts new Medicaid and Medicare patients.
Access to affordable dental care and mental health
care for those with mild to moderate conditions is
also a struggle.18
• Clinical care pertaining to diabetic and
mammography screenings is very positive for all three
areas.7
Opportunities
• Mortality measured by premature death (years of
potential life lost before age 75 per 100,000 population,
age-adjusted) ranking was 60 in Staunton, 80 in
Waynesboro, the second highest rank of all the
indicators, and Augusta County was35 out of 134
counties.8 Social and economic factors are lower for the
cities of Staunton and Waynesboro: high school
graduation,9 some college,10 unemployment,11 children
in poverty,12 inadequate social support, 13
1
County Health Rankings, 2012.
National Archive of Criminal Justice Data, National Incident-Based
Reporting System, 2007-2009
3
CDC, Environmental Public Health Tracking Network, 2007
4
US Census Bureau, County Business Patterns, 2009
5
US Department of Agriculture, Food Environment Atlas Data File, 2010
6
US Census Bureau, County Business Patterns, 2009
7
Dartmouth Atlas of Health Care, 2009
8
National Center for Health Statistics, National Vital Statistics System,
2006-2008)
9
Virginia Department of Education, 2010-2011
10
US Census Bureau, American Community Survey, 5-Year Estimates,
2006-2010
11
Bureau of Labor Statistics, 2010
12
US Census Bureau, Small Area Income and Poverty Estimates, 2010
13
CDC, Behavioral Risk Factor Surveillance System, 2005-2010
2
2013 Augusta County Community Health Needs Assessment
14
US Census Bureau, American Community Survey, 5-Year Estimates,
2006-2010
15
National Archive of Criminal Justice Data, National Incident-Based
Reporting System, 2007-2009
16
Esri computes Market Potential by combining 2011 Tapestry™
Segmentation data with Doublebase® 2009 data from GfK MRI.
Doublebase 2009 is an integration of information from four consumer
surveys.
17
Income, US Census Bureau ESRI forecasts
18
Community Interviews and Survey, 2012
12
• Those without adequate income or health
insurance (16% uninsured) are less likely to receive
the appropriate care at the appropriate site within the
continuum of care.19
Physical Environment
• Thirty-five percent of respondents in the community
survey indicated they had a chronic disease, with
diabetes, heart disease, and cancer being most
prevalent.20
• Access to recreational facilities per population is
higher in Staunton (17 per 100,000 pop.) than
Virginia (11), and slightly above the U.S. benchmark
of 16 days.29
• Sixty percent of the respondents in the community
survey indicated that prescription drug abuse is a
problem in the community.21
• The percent of low income population with no
grocery store nearby is very low and below the
Virginia average.30
Health Outcomes
Strengths
• Relatively low morbidity rankings are reported
(Staunton at 56, Waynesboro at 67 and Augusta
County at 24), including poor or fair health, poor
physical and mental health days,22 and low birth
weight.23
• Augusta County’s poor or fair health percentage is
11%, which is lower than Virginia at 13% and only
slightly higher than the U.S. benchmark of 10%24
• Augusta County’s poor physical health days are
lower at 2.7 than Virginia at 3.2 (avg. number in the
past 30 days) but slightly higher than the U.S.
benchmark of 2.6%25
• Low birth weight babies are less common than the
state for all three areas (Staunton 7.2%, Waynesboro
7.2%, Augusta County 7.4% compared to Virginia at
8.4%) but above the U.S. benchmark of 6.0%26
Strengths
• Air pollution is minor and there have been a limited
number of chemical releases.
• The fast food restaurants as a percent of total
restaurants are lower than Virginia, but higher than
the U.S. benchmark.31
Opportunities
• Access to recreational facilities in Waynesboro and
Augusta County are lower than Virginia.32
Social and Environmental
Strengths
• A lower prevalence of violent crime is reported in
Staunton (234 per 100,000 pop.) and Augusta County
(117) than Virginia (252), but higher than the U.S.
benchmark(73).33
• A lower percentage of children living in poverty is
reported in Augusta County (13%) than Virginia
(15%) and matches the U.S. Benchmark of 13%34
Opportunities
• The percent of adults reporting poor mental health
days in the last 30 days in Augusta County (3.2) is
consistent with the Virginia level and much higher
than the U.S. benchmark of 2.327
• Age-adjusted rates for cancer, heart disease,
congestive heart failure and diabetes are high.28
19
US Census Bureau, Small Area Health Insurance Estimates, 2009
Community Survey, 2012
21
Community Survey, 2012
22
29
CDC, Behavioral Risk Factor Surveillance System, 2004- 2010
CDC, Environmental Public Health Tracking Network, 2007
23
National Center for Health Statistics, National Vital Statistics System, 30
US Department of Agriculture, Food Environment Atlas Data
2002-2008
File, 2010
24
CDC, Behavioral Risk Factor Surveillance System, 2004-2010
31
25
US Census Bureau, County Business Patterns, 2009
CDC, Behavioral Risk Factor Surveillance System, 2004-2010
32
26
US Census Bureau, County Business Patterns, 2009
National Center for Health Statistics, National Vital Statistics System,
33
National Archive of Criminal Justice Data, National Incident-Based
2002-2008
27
Reporting System, 2007-2009
CDC, Behavioral Risk Factor Surveillance System, 2004-2010
28
Virginia Atlas
• 34 US Census Bureau, Small Area Income and Poverty Estimates, 2010
20
•
2013 Augusta County Community Health Needs Assessment
13
• Unemployment is lower in Augusta County (6.7%)
than Virginia (6.9%), but higher than the U.S.
Benchmark of 5.4%.35
Opportunities
• More children are in poverty (Staunton 24%,
Waynesboro 27%) compared to Virginia (15%) and
the U.S. (13%).36
• Unemployment is higher in Staunton (7.6%) and
Waynesboro (8.7%) than in Augusta County (6.7%) or
Virginia (6.9%) and all are higher than the U.S.
benchmark of 5.4%.37
• High school graduate rates are lower in Staunton
(81%) and Waynesboro (80%) compared to Virginia
(87%) and Augusta County (88%).38
• Post-secondary education rates are lower in
Staunton (55%), Waynesboro (47%) and Augusta
County (41%) compared to Virginia (65%), and all are
lower than the U.S. benchmark of 68%.39

• Diabetic screenings are all higher (Staunton at
85%, Waynesboro at 92%, Augusta County at
86%) than Virginia (84%) and very close to the
U.S. benchmark (89%).44
• Mammography screenings are higher (Staunton
at 71%, Waynesboro at 80%, Augusta County at
75%) than Virginia (67%) and very close to the
U.S. benchmark (74%).45
Opportunities
• The percent uninsured (Staunton at 16%,
Waynesboro at 17%, Augusta County at 15%) is
higher than Virginia at 14%, and higher than the U.S.
benchmark of 11%.46
• The ratio of population to physicians is quite high.
The physician needs analysis indicates a shortage.
The community needs to work together
collaboratively with the hospital, existing medical
staff, and government to attract more primary care
and specialists to the community.47
Waynesboro has a higher violent crime rate (358 per
100,000 pop.) compared to Virginia (252).40
Health Behaviors
 People are more likely to report they have
Strengths
inadequate social support in Augusta County (19%)
• Excessive Drinking is lower in Augusta County
compared to Virginia at (18%) and much higher than
(10%) than Virginia (16%) and only slightly higher
the U.S. benchmark of 14%.41
than U.S. benchmark of 8%.48
Clinical Care
Strengths
• Preventable hospitalizations are lower (Staunton
at 57, Waynesboro at 53 and Augusta County at 47)
than Virginia (60) and higher than U.S. benchmark
of 49. However, Augusta County is lower than the
U.S. benchmark.42
• Input from the community is very positive
regarding care at Augusta Health. The level of trust
is high and the percent of people who would
recommend Augusta Health is also very high.43
• Sexually transmitted infections are lower in
Augusta County (170 chlamydia infections per
100,000 pop.) than Virginia (398), but higher than
the U.S. benchmark of 84.49
• Smoking in Augusta County is less (17%) than
Virginia (19%). The community survey indicates only
15% of the respondents smoke, which is slightly
above the U.S. benchmark of 14%.50
Opportunities
• Teen Birth Rate is higher (Staunton at 38 per
1,000 females age 15-18, Waynesboro at 64, and
Augusta County at 39) than Virginia (35), and
higher than U.S. benchmark of 22.51
35
44
36
45
Bureau of Labor Statistics, 2010
US Census Bureau, Small Area Income and Poverty Estimates, 2010
37
Bureau of Labor Statistics, 2010
38
Virginia Department of Education, 2010-2011
39
US Census Bureau, American Community Survey, 5-Year Estimates,
2006- 2010
40
National Archive of Criminal Justice Data, National Incident-Based
Reporting System, 2007-2009
41
CDC, Behavioral Risk Factor Surveillance System, 2005-2010
42
Dartmouth Atlas of Health Care, CMS 2009
43
Community Survey, 2012
2013 Augusta County Community Health Needs Assessment
Dartmouth Atlas of Health Care, CMS 2009
Dartmouth Atlas of Health Care, CMS 2009
46
US Census Bureau, Small Area Health Insurance Estimates, 2009
47
Health Resources and Services Administration Area Resource File,
2010-2011; Stratasan physician need analysis, 2011
48
CDC, Behavioral Risk Factor Surveillance System, 2004-2010
49
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB
Prevention, 2009
50
CDC, Behavioral Risk Factor Surveillance System, 2004-2010
51
National Center for Health Statistics, National Vital Statistics System,
2002-2008
14
• Motor vehicle crash death rates are higher in Augusta County (21 per 100,000 pop.) than Virginia (13 per
100,000 pop.) and higher than the U.S. benchmark of 12.52
• Adult obesity in both Staunton and Waynesboro is equal to Virginia at 28%, and higher than U.S.
benchmark 25%. Obesity puts people at increased risk of chronic diseases such as diabetes, kidney disease,
joint problems, hypertension and heart disease.53
• Leisure time physical inactivity is higher (Staunton at 26%, Waynesboro at 27%, Augusta County at 26%)
than Virginia (24%) and higher than U.S. benchmark (21%).54
Health Priorities
Based on input from the community survey, community interviews, data collection and the community summit,
the following priorities were identified and form the foundation of Augusta County’s health initiatives. The work
in the next months will determine the ideas to be implemented.
Health Priorities:
1. Chronic disease management
a. Obesity
b. Diabetes
c. Cancer
d. Heart disease
e. Nutrition
f. Physical inactivity
2. Health behaviors and community health education
a. Take personal responsibility in regard to obesity and physical activity
b. Increased health education and programming for diabetes, obesity, and wellness
3. Access and affordability
a. Access to primary care providers, particularly for care for Medicaid and Medicare
beneficiaries, low income residents, and the uninsured
b. Affordable health insurance
c. Overuse of emergency department
4. Behavioral health
a. Integration of mental health and primary care
b. Depression
c. Teen suicide
d. Substance abuse
e. Access to mental health care and substance abuse treatment services
5. Socioeconomic factors
a. Low income/poverty in Staunton and Waynesboro
b. Low educational attainment
52
National Center for Health Statistics, National Vital Statistics System, 2002-2008
National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation, CDC BRFSS and US Census Population
estimates, 2009
54
National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation, CDC BRFSS and US Census Population
estimates, 2009
53
2013 Augusta County Community Health Needs Assessment
15
Supporting Data Highlights
There are specific data that led to the priority health
issues.
Priority 1: Chronic disease management
Chronic disease management is supported in the
priorities based on:
• Demographic data with higher % of elderly in our
service area, and confirmation of high presence of
chronic diseases.
• Secondary data supports priority.
• Community survey respondents identified chronic
disease as major issue and the physician survey also
identified chronic disease as a major factor.
Chronic Diseases:
Obesity
Diabetes
Cancer
Heart disease
The Augusta County, Staunton, Waynesboro area’s median age was 42.3, compared to VA at 37.4 and the
U.S. at 37.2. Older residents are more likely to have one or more chronic diseases than younger cohorts. Due
to the higher proportion of residents aged 45 and older, the community may have a greater chronic disease
burden than the state or national average.
2013 Augusta County Community Health Needs Assessment
16
From the community survey:
Esri demographic and survey data are based upon national propensities to use various products and services,
applied to local demographic composition. The map below illustrates the propensity of each area to use insulin
to control diabetes.
Source: GfK MRI collected usage data in a nationally representative survey of U.S. households. Esri forecasts for 2012.
2013 Augusta County Community Health Needs Assessment
17
This table indicates the % more or less likely to do something than the average U.S. household. Households
using prescription drug for arthritis is 63% higher in the community than the U.S. Using a prescription drug for
diabetes (46%), and high cholesterol (46%) and high blood pressure (47%) are higher than the U.S. average.
From the Community Health Summit, the participants ranked the following as the top health issues:
2013 Augusta County Community Health Needs Assessment
18
Priority 2: Health Behaviors and Community Health Education
Secondary data highlighted behavior and lifestyle health issues as major problems in our service area.
Personal responsibility topped the list of needs from phone survey respondents and from physicians and
ranked 3rd from Summit attendees.
The physicians listed personal responsibility for one’s own health as the top health issue that needs to be addressed in their survey responses.
Lifestyle: People taking more responsibility for their own health
Access: More primary care professionals
Access: Affordable health insurance
Access: Mental health and behavioral health services
Community Issue: Jobs/Employment
Access: Affordable services and programs
Lifestyle: Information on managing chronic health conditions
Access: Dental health services
Lifestyle: Affordable healthy lifestyle or fitness programs
Community Issue: Education
Lifestyle: Walking or biking paths or trails
Lifestyle: Information on nutrition and healthy cooking
Access: Substance abuse services
Community Issue: Poverty
Community Issue: Transportation
Lifestyle: Safe and affordable places to exercise
Access: More specialists
Access: Health care services for seniors
Lifestyle: More sidewalks
Lifestyle: Affordable, fresh foods
Community Issue: Affordable housing
Access: Vision health services
2013 Augusta County Community Health Needs Assessment
19
The community telephone survey respondents listed people taking more
responsibility for their own lifestyle and health as the top issue.
The community telephone survey respondents also feel that people in the community may benefit from health
programs and information for health/wellness/diabetes and obesity.
2013 Augusta County Community Health Needs Assessment
20
Priority 3: Access and Affordability
Access and affordability are supported as a
priority by:
• Area demographics and income
levels
• 2nd on Community Survey
• 3rd on Physician Survey
• 4th and 6th from Summit
Priority 4: Behavioral Health
Behavioral health is on the priority list due to:
• Secondary data shows higher incidence
of depression, use of prescription drugs for
depression
• Ranked 2nd on the Summit list
• Substance Abuse ranked #3 on Telephone poll
• Ranked #4 on Physician Survey
Major Issues:
• Lack of Insurance
• Lack of access to physicians (High population to
physician ratios)
• Large geographic area with diverse pockets of
needs
• Overutilization of emergency department
The community telephone respondents believe that
prescription drug abuse is a major problem in the
community.
The service area demand indicates
overutilization of the emergency department in
Staunton and Waynesboro. The use rates are
higher than VA and the U.S.
The Youth Risk Behavioral Survey indicates there are
some behavioral health issues in the schools in
Waynesboro and Staunton.
From the Community Health Summit, the
participants ranked the following as the top health
issues. Access and affordability were 4 and 6
Source: YRBSS conducted Jan/Feb 2012.
2013 Augusta County Community Health Needs Assessment
21
Priority 5: Socioeconomic Factors
The following issues prompted socioeconomic factors onto the priority list.
Income:
• Less income = poorer health
• Less income = higher obesity
• Impacts basic needs, such as food security
Education:
• Less education = poorer compliance = poorer health Safety/crime
Household income in Staunton and Waynesboro is much lower than VA and the U.S.
2013 Augusta County Community Health Needs Assessment
22
There are pockets of population in the area where incomes are extremely low.
Population with Household Income Less than $15,000 per year
There are pockets of population in the area where the crime index is higher than the U.S. average, which is the
area in red surrounding Waynesboro on three sides
2013 Augusta County Community Health Needs Assessment
23
Process and Criteria to Prioritize Health Needs
The Community Health Needs Assessment process considered and evaluated a wide range of sources
including extensive secondary data collection, the results of the community telephone survey, results of the
focused group interviews, results of the physician survey and input and recommendations from two broad
community summits.
Priorities and Criteria to Prioritize Health Needs
In order to prioritize the needs found through the CHN process, a ranking methodology was applied using
recognized prioritization methodologies from Healthy People 2020, CDC, the IRS and other national
organizations. The following criteria were applied to prioritize needs:

The frequency and intensity with which common themes emerged – importance of the need based on
community input from the full range of sources

Disparities in the community compared to state and national benchmarks

Availability of evidence based initiatives that have proven to be effective in impacting the issue

Estimated feasibility and effectiveness of possible interventions

Probable negative consequences if the health issue is not addressed

Availability of measurable outcomes data
2013 Augusta County Community Health Needs Assessment
24
Giving Credit Where Credit is Due
Acknowledgments
We would like to acknowledge the efforts of this collaborative group. It is energizing when a diverse group of
citizens comes together to work toward a common cause. Funding of this project has been provided by
Augusta Health.
Community Health Assessment Project Steering Committee
Name
Dr. Doug Larsen
Department of Health
Margaret Hersh
Augusta Regional Free Clinic
Population Being Represented
Total community population, including minority populations
and residents who are low income or medically underserved
Low income, medically underserved, and uninsured
residents
Elizabeth Middleton
Department of Social Services
Low income, medically underserved, and uninsured
residents
Carol Blair
Office on Youth
Underprivileged youth
John Maher
CATS
Cynthia Pritchard
United Way
Total community population
Low income residents, underprivileged youth, and the
medically underserved
Linda Hershey
Chamber of Commerce
Augusta County businesses and workforce
Neysa Simmers
Valley Program for Aging
Services
Valley Community Services
Board
Senior residents
Residents of total community with mental health, intellectual
disability, and substance abuse issues.
Mike Hamp
City Manager, Waynesboro
Waynesboro residents
Steve Owen
City Manager, Staunton
Staunton residents
Pat Coffield
County Administrator
Total community population
Michael Wilhelm
Police Chief, Waynesboro
Waynesboro residents, particularly victims of crime and
violence, and those suffering from substance abuse,
behavioral health issues, and homelessness
Ophie Kier
Staunton residents
Chuck Bishop
Council Member, Staunton
School Superintendent, Augusta
County Schools
Arona Richard
Augusta Health
Employees of Augusta Health and Augusta County residents
Jeanne Russell
Kathleen Heatwole
Augusta Health
Augusta Health
Employees of Augusta Health and Augusta County residents
Employees of Augusta Health and Augusta County residents
Linda Gail Johnson
Augusta Health
Employees of Augusta Health and Augusta County residents
Courtenay Beebe, MD
Augusta Health
Employees of Augusta Health and Augusta County residents
Paul Lavigne
Group or Organization
2013 Augusta County Community Health Needs Assessment
Augusta County youth
25
Twenty-one individuals representing the following groups or constituencies participated in a focus group to
assist in deter- mining community health needs:
Group or Organization
Population Being Represented
Waynesboro Mennonite Church
Waynesboro residents
WARM Program Shelter
Homeless residents
Staunton City residents
Staunton City residents
Augusta County residents
Total community population
Waynesboro residents
Waynesboro residents
College student
Augusta County young adults
McKee
Total community population
Disabled community
Residents with disabilities
Western State Hospital
Residents with mental or behavioral health issues
Casa de Amistad
Hispanic residents
Mediation services
Families going through the process of divorce
Office on Youth
Staunton Police Department
Underprivileged youth
Staunton City residents, particularly victims of crime and violence, and those
suffering from substance abuse, behavioral health issues, and homelessness
Augusta Regional Free Clinic
Low income, medically underserved, and uninsured residents
Boys and Girls Club
Underprivileged youth
County Supervisor
Total community population
WWRC
Residents with disabilities
Sheriff ’s Office
Augusta County residents, particularly victims of crime and violence, and those
suffering from substance abuse, behavioral health issues, and homelessness
Community Wellness
Shenandoah Adult Protective Services
Augusta County residents, particularly those with chronic disease needs
Augusta County residents, particularly victims and perpetrators of crime and
violence
Disabled adults over age 18 and residents over 60 suffering from abuse and
neglect
United Way
Low income residents, underprivileged youth, and the medically underserved
District Court Judge
The following sixty-one people representing a wide range of organizations attended the community health
summit.
Name
Group or Organization
Population Being Represented
Bill Pfost
Augusta Health Board & Community
Services Committee
Bud Levin
Jenn Chestnut
Paul Lavigne
Waynesboro Police Dept.
Valley Program for Aging Services
Valley Program for Aging Services
Augusta County residents, particularly the medically underserved
and others in need of health and wellness services
Waynesboro residents, particularly victims of crime and violence,
and those suffering from substance abuse, behavioral health
issues, and homelessness
Senior residents
Senior residents
Cynthia Pritchard
Howard Miller
Donna Gum
United Way of Greater Augusta
Waynesboro Mennonite Church
Mental Health America –Augusta
Low income residents, underprivileged youth, and the medically
underserved
Waynesboro residents
Residents with mental health needs
JoAnne Hammer
Augusta Health, Community Wellness
Augusta County residents, particularly those with chronic
disease needs
Dana Breeding
Anna Leavitt
Augusta Health, Community Wellness
CAPSAW
Augusta County residents, particularly those with chronic
disease needs
Low income residents
2013 Augusta County Community Health Needs Assessment
26
Name
Judy Williams
Group or Organization
Fishersville United Methodist Church
Population Being Represented
Fishersville residents
Dr. Douglas
Larsen
Central Shenandoah Health District
Total community population, including minority populations and
residents who are low income or medically underserved
Karen Hicks
Valley Community Services Board
Residents of Staunton, Waynesboro, and Augusta County with
mental health, intellectual disability, and substance abuse
issues.
B. J. Glendye
Augusta Health, Employee Health
Services
Employees of Augusta Health and Augusta County residents
Jeanne Russell
Augusta Health, Employee Health
Services
Augusta Health Community Services
Committee
Employees of Augusta Health and Augusta County residents
Augusta County residents, particularly the medically underserved
and others in need of health and wellness services
Mary Askew
Charles Downs
Sylvia Woodworth
Central Shenandoah – Medical
Reserve Corps
State Rehab. Council
Learn English and Reading Now
Residents in the Central Shenandoah Health District who receive
public health services
Commonwealth residents with disabilities
Adult residents with literacy challenges
Bonnie Riedesel
Central Shenandoah Planning District
Commission
Gail Johnson
Daily Living Center
Total community population
Residents in need of adult day healthcare and independent living
support
Invista
CASA for Children
Waynesboro workforce
Children who have been abused or neglected
Penny Cooper
Susan Butler
Augusta Health, Integration Service
Mgr., Information Technology
Hershey Chocolate Co.
Employees of Augusta Health and Augusta County residents
Augusta County workforce
Wanda Crosby
Jim Mahoney
Steve Owen
Genia Towler
Pat Coffield
Comfort Care Women’s Health
Financial Management, Inc.
City of Staunton
Avante of Waynesboro
County of Augusta
Staunton and Waynesboro residents who have experienced an
unplanned pregnancy
Waynesboro residents
Staunton residents
Senior residents of Waynesboro
Total community population
Arona Richard
Community Foundation of the Central
Blue Ridge
Augusta Health Board, Community
Services Cmte.
Total community population
Augusta County residents, particularly the medically underserved
and others in need of health and wellness services
Beth Negron
Augusta Health, Human Resources
Employees of Augusta Health and Augusta County residents
Neysa Simmers
Valley Community Services Board
Residents with mental health, intellectual disability, and
substance abuse issues
Lisa Schwenk
Deborah BundyCarpenter
Augusta Health, Public Relations
Terry Team
Wanda
Rittenhouse
Michael Nay
Christiana Shields
Central Shenandoah Health District
Employees of Augusta Health and Augusta County residents
Total community population, including minority populations and
residents who are low income or medically underserved
David Cohron
Augusta Health Community Services
Cmte.
Melissa Donahue
Bill Roberts
Judith Schrauder
Bob Stuart
Laura McCall
John Maher
Central Shenandoah Health District
Love, Inc.
Office on Youth
News Virginian
Shenandoah Valley Headstart
Virginia Regional Transit/CATS
Augusta County residents, particularly the medically underserved
and others in need of health and wellness services
Total community population, including minority populations and
residents who are low income or medically underserved
Total community population
Underprivileged youth
Total community population
Families with children under the age of 5
Total community population
Michelle Pyle
Karen Bourne
Shenandoah Nursing & Rehab.
Legacy Hospice
Residents in need of skilled nursing or assisted living facilities.
Terminally ill residents of Augusta County
2013 Augusta County Community Health Needs Assessment
27
Name
Group or Organization
Population Being Represented
Anna Stell
Intrepid Home Health Care
Staunton residents in need of home health services
Dr. Fred Castello
Jeff Fife
Augusta Health, Senior Vice President
Medical Affairs/Chief Medical Officer
Waynesboro YMCA
Employees of Augusta Health and Augusta County residents
Waynesboro residents
Tanya Farrell
Augusta Regional Free Clinic
Low income, medically underserved, and uninsured residents
Margaret Hersh
Augusta Regional Free Clinic
Low income, medically underserved, and uninsured residents
Dee Childs
Healthy Families of the Blue Ridge
First-time parents from pre-births through three months of age
Pamela Tetro
Amber Ham
Augusta Health, Advanced Practice
Nurse
Office on Youth
Employees of Augusta Health and Augusta County residents
Underprivileged youth
Pat Caulkins
Augusta Health, Community Wellness
(WOW and Project GROWS)
Youth, the working population, and seniors with chronic diseases
related to nutrition and lifestyle
Linda Gail
Johnson
Augusta Health, Community Wellness
Director
Augusta County residents, particularly those with chronic
disease needs
Hannah ClymerShowalter
Tyrell McElroy
Augusta County residents, particularly those with chronic
disease needs
Underprivileged youth
Linda Hershey
Augusta Health, Community Wellness
Boys & Girls Club, Project GROWS
Greater Augusta Chamber of
Commerce
Kathleen
Heatwole
Augusta Health, V.P. Planning/
Development/Marketing
Employees of Augusta Health and Augusta County residents
Rhonda Clifton
Maria Longley
Augusta Health, Community Wellness
The News Leader
Augusta County residents, particularly those with chronic
disease needs
Total community population
Augusta County businesses and workforce
Others who participated in creating the Augusta County Community Health Improvement Plan:
Augusta Health, leader and sponsor of the Community Health Needs Assessment process, Stratasan,
healthcare analytics and CHNA process facilitators, Catalyst Healthcare Research, market telephone
research.
2013 Augusta County Community Health Needs Assessment
28
2013 Augusta County
Community Health Needs Assessment