Siouxland District Health Department (SDHD) serves as the public health department for Woodbury County, Iowa (pop: 105,941). Woodbury County is comprised of Sioux City (pop: 85,797) and 15 other rural towns making up the remaining 20,000 residents. Sioux City is comprised of 68.3% white non-Hispanic, 19.6% Hispanic, 4.4% black and 3.4% Asian individuals. Sioux City and Woodbury County sits on the tri-state border of Nebraska, South Dakota and Iowa, with large portions of South Dakota and Nebraska residents working, shopping, socializing and seeking medical care in Sioux City.
According to the annual County Health Rankings, Woodbury County continues to rank in the bottom quarter of the state for overall health outcomes and health factors. Adult obesity is at 35% in Woodbury County and 27% of residents report limited to no physical activity.
Iowans with disabilities (IWD) are more likely to be inactive, have high blood pressure, and be obese. According to the CDC Disability and Health Data System, 35.7% of IWD are inactive compared to 23% of adults without disabilities. Thirty-eight percent of IWD have high blood pressure compared to 25.2% Iowans without disabilities and 44.8% of adults with disabilities are obese compared to 33.3% of adults without disabilities. According to the US Census, just over 10% (12,602) of Woodbury County residents have a disability, which again does not include individuals from neighboring counties or states that frequent our community.
The overall goal for SDHD was to strengthen disability inclusion efforts within our local health department and community partners by improving access to care and physical activity options to improve the health of residents living with a disability by utilizing the Community Health Inclusion Index (CHII) Assessment tool.
Three objectives were set for this particular project:
Objective #1: Increase Siouxland District Health Departments capacity to serve individuals with disabilities within Siouxland District Health Departments programs and services by implementing a minimum of four policy, system, or environmental (PSE) changes by July 15, 2022.
Objective #2: Increase Siouxland District Health Department's All Abilities Coalition's capacity to provide inclusive recreational opportunities for residents with disabilities by completing a minimum of two policy, system or environmental changes at a minimum of one recreational facility by July 30, 2022.
Objective #3: Increase Siouxland District Health Departments community partners capacity to reduce barriers and/or increase accessibility for individuals with disabilities by completing a minimum of two policy, system or environmental changes at a minimum of one location targeting the underserved by July 30, 2022.
Several activities and outcomes were implemented and accomplished for this project:
Activities and outcomes for Objective #1.
SDHD completed an on-site Community Health Inclusion Index (CHII) onsite assessment and implemented a minimum of four PSE changes.
· SDHD provided training to health department staff on disability and health and added training to new employee orientation. (system level change)
· SDHD modified clinic exam rooms to become sensory friendly with the inclusion of: dimmer light switches, fluorescent light covers, weighted lap mats, liquid floor tiles and other sensory products, along with a wheelchair-accessible scale. (environmental change)
· SDHD modified appointment requests both online and over the phone to require asking if special accommodations are required for the requested appointment (system level change)
· SDHD reviewed and revised the health department's branding and style guide to ensure content in promotional materials (print and electronic) were accessible. (policy/system level change)
Activities and outcomes for objective #2
SDHD completed an onsite CHII assessment at the local bowling alley, Plaza Bowl and provided recommendations for PSE changes along with providing technical assistance to complete a minimum of two PSE changes.
· Plaza Bowl secured a variety of adaptive bowling equipment including, a push button ramp, bowling ball pusher and retractable handle bowling ball (environmental change)
· Plaza Bowl remodeled their women's bathroom to become fully accessible. (environmental change).
Activities and Outcomes for objective #3
SDHD completed an onsite CHII assessment at the Warming Shelter, a local nonprofit that houses homeless individuals during the day and overnight to prevent death from cold temperatures. SDHD provided recommendations for PSE changes and provided technical assistance to complete a minimum of two PSE changes.
· The Warming Shelter installed a wheelchair charging station (environmental change)
· The Warming Shelter replaced top loading wash machines with front loading machines (environmental change)
· The Warming Shelter built a ramp at their emergency exit door (environmental change).
This projected was successful due to support from SDHD's administration, having strong community partnerships in place through our All-Abilities Health and Wellness Coalition and funding from NACCHO.
The public health impact was to enhance local capacity to meet the needs of people with disabilities within health department programs by increasing accessibility and accommodation policies and procedures and expanding collaboration between local public health and organizations that serve the individuals with disabilities.
Community partnerships included in this project consisted of SIMPCO - the Siouxland Interstate Metropolitan Planning Council that assisted with the CHII assessments, Plaza Bowl a local recreation bowling alley and the Warming Shelter, a day and night shelter for homeless individuals.
Our website is www.siouxlanddistricthealth.org
This practice is to highlight how the implementation of the Community Health Inclusion Index (CHII) onsite assessment tool can be utilized by local public health departments and community partners to advance health equity for those with a disability.