It took six months, but Napa County now has a comprehensive view of its population’s overall health, its most pressing needs and possible solutions.

The assessment lists four key areas of need. They are:

1. Prevention and “healthy living” and wellness programs to produce a long-term impact on health improvement, including comprehensive efforts that address nutrition, exercise and tobacco cessation;

2. Community-based mental health services, as described in the county’s Mental Health Services Plan;

3. Affordable, community-based dental services that focus on low-income seniors and children;

4. Efforts that address alcohol abuse and underage drinking using evidence-based community intervention strategies.

Although the state mandates that all counties complete a needs assessment every three years, Dr. Karen Smith, Napa County public health officer, said this year’s assessment is different than those done in other years.

“This is the first time the agencies pooled their efforts, which made it a stronger document,” she said. Those agencies included all the usual suspects — Queen of the Valley Medical Center, St. Helena Hospital, Kaiser Foundation Health Plan and Napa County Public Health — but also included representatives from the Napa Valley Vintners and its Auction Napa Valley, which funds many organizations that provide health services.

The group of agencies, called the Napa County Collaborative of Health Organizations and Community Funders, said its report “provides the foundation for policymakers, community organizations and advocates to more strategically plan services and make needed improvements in Napa County. It also informs funders about directing investments toward areas and populations of highest need.”

Survey facts

The survey reveals a variety of facts about Napa County, including demographics, socioeconomic factors, key health factors and unmet health needs. The Collaborative also agreed that all health partners should focus on four key areas.

• Demographics — Napa County’s 2006 population was listed at 134,326. Of those, one-quarter is Hispanic or Latino, although among children, ages 0-5, the proportion is closer to half. One-quarter of the county’s K-12 students are English-learners. At the other end of the scale, the county’s senior population is projected to double by the year 2030. American Canyon is the county’s fastest-growing city. Its population grew 34.5 percent between 2000 and 2004.

• Socioeconomic factors — The survey shows that close to 11,000 people, 11 percent of children and 6 percent of seniors, live below the poverty level. Additionally, while most of the county’s labor force is employed, one in five work in jobs that do not offer health insurance, typically low-paying jobs in the service industry, retail and agriculture. Some 88 percent of Napa County residents have some type of health insurance, but having coverage does not guarantee access to care. Finally, Napa County residents have a higher level of education than the state average.

• Key health factors — There is good news and bad news when comparing Napa County residents to statewide and national averages. The good news includes, a good percentage of seniors, those age 65 and older, report their health is either excellent, good or fair; there are fewer AIDS incidents, less prevalence of diabetes and obesity and coronary heart disease; and more screenings for breast cancer and colorectal.

On the other hand, Napa County residents are more likely than other Californians to have asthma; die from lung cancer or chronic liver disease and cirrhosis; not have adequate prenatal care; or be an adult who smokes, or is arrested for alcohol violations. The report also talks about Napa County youth’s use of alcohol.

The report states, “Napa County, like many other counties, has a significant issue with alcohol abuse. It is not at all clear that this is related to the wine industry. Rather, it is likely related to the interrelatedness of poverty, family dynamics, mental health and other complex issues.”

Additionally, the abuse of alcohol and drugs by Napa County’s youth, which is higher than statewide averages, and the resulting arrests and alcohol-involved motor vehicle accidents, suggests areas for community intervention, according to the report.

• Unmet health needs — These include lifestyle related and preventive health, including obesity, nutrition, exercise and wellness; gaps in mental health service, depression and social/cultural isolation; chronic disease, including diabetes, cancer and allergies; dental services for children, adults and seniors; lack of insurance or the provider not accepting Medi-Cal or Medicare; drug and alcohol-related problems; lack of bicultural and bilingual health care workers; lack of awareness of the services available and transportation issues.

Consultant hired

Dr. Karen Smith said the Collaborative hired a consultant, Barbara Aved Associates, who sifted through a large amount of existing data that is incorporated into the study. Additionally, the consultants interviewed 50 “key informants,” those who work in the health care field and asked their perspectives and opinions about the state of health care issues in Napa County.

The consultants also conducted focus groups with seniors, those who speak Spanish, and those who are economically disadvantaged; and passed out questionnaires at public places, including local libraries, in an effort to gather as much information as possible.

By examining existing data, conducting interviews and gathering information, the final draft of the needs assessment, which came out in November, presents a unified voice, Smith said.

Besides Smith, those who served on the working committee for the needs assessment were: P.J. LoDuca, executive director, and Dr. Donald Hitchcock, medical director, Community Outreach, Queen of the Valley Medical Center; Gayle Hunt, Napa Solano Community Benefit manager, Kaiser Foundation Health Plan; Linda Schulz, director, The Women’s Center of St. Helena Hospital; Suzanne Shiff, grants outreach consultant for Auction Napa Valley/Napa Valley Vintners; Beatrice Bostick, executive director and Stacey McCall, assistant executive director of Community Health Clinic Ole; Catherine Hoffman, associate director, Kaiser Commission on Medicaid and the Uninsured; and Dr. Jennifer Henn, Epidemiologist for Napa County Public Health.

The complete 135-page report is available at www.co.napa.ca.us.

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