Data Analysis for Community Health Needs Assessment

Transcription

1
Our Commitment to You
At IU Health Goshen Hospital, we integrate clinical excellence
with listening carefully. We seek to treat every patient and
community member as if they were a member of our family. To
reach that high expectation of care for our community, we
must be proactive in identifying the health needs of people in
our area so that we can better focus our resources in
addressing those needs. This is why we surveyed our
community this year to learn what you had to say about the
health needs of our residents.
In the pages that follow, you will find the 2015 Community
Health Needs Assessment Report that summarizes the survey
findings and how the needs identified will be addressed. We
welcome your reflections and comments as you review this
report. To share them with us, please visit the website
GoshenCommunityNeeds.com. We are committed to listening
to you as we improve the health of our communities by
providing innovative, outstanding care and services, through
exceptional people doing exceptional work.
– Randal Christophel,
President and Chief Executive Officer
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Table of Contents
Our Commitment to You .............................................................................................................................. 2
Executive Summary ...................................................................................................................................... 4
Introduction ................................................................................................................................................ 16
Purpose of Community Health Assessments ....................................................................................... 16
IU Health Goshen Hospital .................................................................................................................... 16
Mission Statement ................................................................................................................................. 16
Vision Statement.................................................................................................................................... 16
Core Values ............................................................................................................................................ 17
Awards and Recognition ........................................................................................................................ 17
Community Served: Elkhart County, Indiana ....................................................................................... 18
Data Collection and Analysis ..................................................................................................................... 19
Methodology ........................................................................................................................................... 19
Prioritized Community Health needs for 2012 and 2015 .................................................................. 20
Initiatives and Outcomes for Addressing 2012 Community Health Needs ....................................... 20
2015 Community Health Rankings within Indiana ............................................................................. 23
2015 Community Health Needs ........................................................................................................... 24
Health Needs Identified by the Community ......................................................................................... 24
Health Needs and Secondary Data ...................................................................................................... 24
Leading Causes of Death ...................................................................................................................... 25
2015 Community Health Needs ............................................................................................................... 26
Resources Available to Address Community Health Needs ................................................................ 26
Health Needs that IU Health Goshen will Address .............................................................................. 26
Implementation Plan .................................................................................................................................. 27
Appendix I: Data Analysis for Community Health Needs Assessment .....................................................28
Appendix II: Resources for Addressing Community Health Needs ........................................................158
Appendix III: Elkhart County Health Department Recommendations for CHNA Priorities ...................237
Appendix IV: Summary Statement of the 2015 Community Health Needs Assessment .....................238
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Executive Summary
4
5
6
7
8
9
10
11
12
13
14
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Introduction
Purpose of Community Health Assessments
The Patient Protection and Affordable Care Act of 2010 requires all charitable hospitals to conduct a
community health needs assessment every three years. Prior to that requirement, IU Health Goshen
began systematically engaging the community it serves in identifying its health needs. IU Health
Goshen did so in order to ensure that significant community health needs were understood and
aggressively addressed through services and programs offered by the hospital.
The last Community Health Needs Assessment (CHNA) Report was concluded in 2012, and an
Implementation Plan was created. In 2015, a new health needs assessment was initiated and
completed. The purpose of this effort was to identify and assess community health indicators,
concerns, and status, as well as perceived barriers to health care and lifestyle risk factors. IU Health
Goshen will develop an Implementation Plan to address community health needs.
This report outlines the process and outcomes related to determining and prioritizing the current
health needs of the community. Its purpose is to inform and guide efforts to enhance the wellness of
all patients and community residents.
IU Health Goshen Hospital
IU Health Goshen Hospital is located in the City of Goshen, Indiana, the county seat for Elkhart
County. The mission, vision and values of IU Health Goshen guide its day-to-day work, as well as long
range planning.
Mission Statement
The mission of IU Health Goshen is to improve the health of our communities by providing innovative,
outstanding care and services, through exceptional people doing exceptional work.
Vision Statement
Building upon our mission and values, Indiana University Health Goshen will deliver exceptional
healthcare to the communities we serve using an integrated model of care and achieving excellence
through a commitment to quality, leadership, and innovation. By 2020, we will achieve this vision by
focusing on the following strategic priorities:
1. Lead the region in clinical integration and the management of population health.
2. Deliver high value to our patients, providers, payers and colleagues.
3. Goshen’s Oncology and Heart & Vascular service lines become the destination of choice in
our broader region.
4. Cultivate a culture for Colleagues where personal and professional missions are aligned.
5. Inspire a spirit of partnership and generosity by engaging our community with opportunities
that meet regional health needs.
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Core Values
Compassion – and commitment to serve with empathy.
Accountability – with integrity and action.
Respect – through treating others as you wish to be treated.
Excellence – in all we do.
Awards and Recognition
IU Health Goshen has been recognized for its delivery of exceptional healthcare:
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•
Hospital care – 5th Best Regional Hospital in Indiana by US News and World Report
•
Nursing care -- Magnet Recognition for Nursing Excellence to IU Health Goshen Hospital for
a period of four years. This is Goshen’s third consecutive designation, an accomplishment
only 87 hospitals in the United States have achieved.
•
Cancer care -- Outstanding Achievement Award from The Commission on Cancer (CoC) of
the American College of Surgeons (ACOS)
•
Heart & Vascular care -- The Indiana University Health Goshen Heart & Vascular Center
was awarded the 2015 Platinum Performance Achievement Award by the American College
of Cardiology Foundation’s National Cardiovascular Data Registry (4th year running). Only
259 hospitals—out of approximately 6,000 nationwide—received this distinction.
•
Quality care – Top Performer on Key Quality Measures for 2014 by The Joint Commission
•
Critical care -- Beacon Award for Critical Care Excellence (ICU) from American Association
of Critical Care Nurses (IU Health Goshen is one of only two hospitals in the state to receive
the Beacon Award for Excellence from the American Association of Critical Care Nurses. This
is the second time IU Health Goshen has won the award; the first was in 2010. The
designation is for three years.)
•
W ound care -- The Center of Distinction award and The Robert A. Warriner III, M.D., Center
of Excellence award, were given to IU Health Goshen Wound Center by Healogics, Inc., the
nation’s largest provider of advanced wound care services.
Community Served: Elkhart County, Indiana
Elkhart County, located in northern Indiana approximately 100 miles east of Chicago and bordering
on the state of Michigan, is the primary service area for IU Health Goshen Hospital. For comparative
purposes, data from Kosciusko County, LaGrange County, Marshall County, Noble County and St.
Joseph County were also collected. As the sixth most populous county in Indiana, Elkhart County is
most similar to that of St. Joseph County (the fifth most populous county in Indiana) in
demographics.
Data from Health Resources and Services Administration (HRSA) indicate that Elkhart County is a
primary medical care health professional shortage area (HPSA), a dental provider shortage area
(DPSA), and a mental health provider shortage area (MPSA).
Figure 1: Elkhart County in northern Indiana
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Data Collection and Analysis
Methodology
More than 23,000 surveys, available in both English and Spanish, were sent to community
members, including the minority populations of Amish, Hispanic and African-American. Persons
receiving the community survey could respond via a web link, through the post, or by phone
(available 24/7) from the last week of May 2015 through the second week of June 2015. Over 600
surveys were returned, 559 (93.2%) of these from Elkhart County.
Besides providing residential and demographic information, recipients were also asked to rate their
own health, the community’s health, the top health needs in the community, whether or not there
were enough programs to meet these needs, and how IU Health Goshen could improve. Elkhart
County Health Department officials were also consulted. No comments were received from the public
regarding the last CHNA Report and Implementation Plan.
IU Health Goshen contracted with the Bowen Research Center, Department of Family Medicine,
Indiana University School of Medicine, to analyze primary data collected from the surveys. The
Bowen Center also analyzed various existing health, social, and economic secondary data sets. For
contextual comparisons, Elkhart County data were compared with Kosciusko, LaGrange, Marshall,
Noble and St. Joseph Counties, as well as the State of Indiana.
The report from the Bowen Research Center was finalized in August 2015 and includes primary and
secondary data that were considered (Appendix I). A list of the data sources is included, as well as
copies of the English and Spanish surveys.
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Prioritized Community Health needs for 2012 and 2015
The top seven community health needs identified by the community in 2015 are the same as those
identified in 2012, although the rank order has changed.
Prioritized Elkhart County Health
Needs
2015
Rank
2012
Rank
Obesity/Exercise/Healthy Eating
1
1
Access to Health Services
Treatment of Chronic Diseases
2
3
3
2
Mental Health/Addiction/Depression
4
4
Poverty
5
7
Health Literacy
Tobacco Use/Smoking
6
7
6
5
Table 1: Elkhart County Health Needs Identified and Prioritized in 2012 and 2015
Initiatives and Outcomes for Addressing 2012 Community Health Needs
Based on the health needs of the community identified in the 2012 CHNA Report, IU Health Goshen
identified five priorities and initiated 46 programs and services to address these needs.
2012 Com m unity Health Needs
Addressed by IU Health Goshen
Obesity Prevention
Tobacco Cessation
Diabetes
Access to Healthcare
Program s
Participants 20122014
21,767
19,636
2,573
11,989
Behavioral Health/Mental Health
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Total
55,992
Table 2: Priority Health Needs Addressed by IU Health Goshen 2012-2014
Many different programs and services were initiated to address each identified health need. For
example, the prevention of obesity included:
•
•
•
•
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Fitness classes
Obesity prevention programs
Nutrition and weight management support programs
Obesity screenings
In 2012, as well as in 2015, three Medically Underserved Areas were identified in Elkhart County.
Figure 2: M edically Underserved Areas in Elkhart County
Since 2012, IU Health Goshen has increased its efforts to ensure access to medical care. Examples
include:
•
•
•
•
•
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Recruitment of primary care physicians
Nurse On Call physician referral and telephone triage services
Construction begun in 2015 of an urgent care facility in a medically underserved area
(Dunlap in the figure above)
Expansion of clinical space and services available in Shipshewana and Syracuse with the
development of patient-centered medical homes.
Partnership with Maple City Health Care Center to expand access to health care in the
underserved area of north Goshen shown above.
A leading initiative in 2015 was the partnership of IU Health Goshen with the Maple City Health Care
Center (MCHCC) in order to increase access to primary care for 5,000 community members in the
underserved Goshen area shown in Figure 2. To make this possible, IU Health Goshen purchased the
Abshire Mansion, located at 803 North Main St. in Goshen. Through renovation of the existing
structure and new clinical construction in 2014, a second location for MCHCC has been developed.
Figure 3: Abshire M ansion artist rendering and floor plan
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2015 Community Health Rankings within Indiana
Although health factor ratings for Elkhart County have strengthened since 2012, the figure below
indicates that there is significant room for further improvement. The sub-factors for Health Behaviors
(25/92) include adult smoking, adult obesity, food environment index, physical inactivity, excess
drinking, and several other sub-areas. These behaviors directly impact community health, as
identified by the community, verified by other secondary data and further supported by the Elkhart
Community Health Department.
Figure 4: 2015 Com m unity Health Rankings*
*Source: http://www.countyhealthrankings.org/app/indiana/2015
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2015 Community Health Needs
Health Needs Identified by the Community
The health needs identified by the community are grouped in nine categories, as shown in the table
below. The rank order of health needs identified by two minority groups differed somewhat from that
of all Elkhart County residents, although obesity/exercise/healthy eating were ranked as the major
community health need by all groups. As can be seen from the table, some community health needs
selected by minority groups were given equal priority.
Rank Order
Comm unity Health Needs 2015
Obesity/exercise/healthy eating
Entire
Elkhart
County
1
Am ish
Hispanics
1
1
Access to health services
2
3
3
Treatment of chronic diseases
Mental health/addictions/depression
3
4
2
2
4
2
Poverty
5
N/A
4
Health literacy
Tobacco use/smoking
6
7
1
N/A
5
4
Injury/safety (2.1%)
8
N/A
5
Other (1.3%)
9
N/A
5
Table 3: 2015 Community Health Needs identified by Elkhart County Residents
A majority of survey respondents indicated that they do not believe that there are sufficient available
health programs.
Health Needs and Secondary Data
Health related factors identified in the secondary data for Elkhart County analyzed by the Bowen
Research Center, Department of Family Medicine, Indiana University School of Medicine, generally
support the health need perceptions of community residents. The number in parentheses indicates
the percentages of Elkhart residents for each health factor.
•
•
•
•
•
•
•
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Obesity (29.5%)
Physical inactivity (26.9%)
Inadequate social/emotional support (21.0%)
Smoking (adults, 20.1%)
Food insecurity (15.9%)
Excessive drinking (10.3%)
Diabetes (9.3%)
In addition, the secondary data also suggest that there are social economic health implications
within the county:
•
•
•
•
•
Uninsured children (11.2%)
Uninsured adults (25.9%)
Educational achievement (high school graduation, 85.4%; postsecondary education 44.9%)
Median household income ($45,806)
Could not see a doctor due to cost (15.6%)
Leading Causes of Death*
Addressing the health needs identified by the community could reduce the leading causes of death
in Elkhart County.
1
Leading Causes of Death (Rank Order)
Heart Disease
2
Cancer
3
Stroke
4
5
Lung Disease
Accidents
6
Alzheimer's
7
8
Diabetes
Influenza-Pneumonia
9
Nephritis/Kidney
10
Blood Poisoning
Table 4: Leading Causes of Death in Elkhart County (CDC 1999 – 2013 final data)
* Source: http://www.worldlifeexpectancy.com/usa/indiana-heart-disease
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2015 Community Health Needs
Resources Available to Address Community Health Needs
The health needs in the table below account for 96.6% of the health needs identified by community
residents and supported by secondary data from Elkhart County.
Elkhart Comm unity Prioritization of
Health Needs
2015
Rank
Obesity/Exercise/Healthy Eating
1
Access to Health Services
2
Treatment of Chronic Diseases
Mental Health/Addiction/Depression
3
4
Poverty
5
Health Literacy
6
Tobacco Use/Smoking
7
Table 5: Health Needs Identified and Ranked by Elkhart Com m unity Residents
Appendix II identifies an extensive list of resources beyond those of the IU Health Goshen Hospital,
which are available for addressing community health needs.
Health Needs that IU Health Goshen will Address
IU Health Goshen considered the following sources of information in prioritizing the health needs
that it would address:
•
•
•
Community perceptions – these were obtained through the community survey
Statistical health information – secondary data for Elkhart County was compared to its
benchmarks
Expertise of health leaders – the Elkhart County Health Department on the most significant
health needs
After careful consideration, IU Health Goshen has identified the following health needs in rank order
that it is best equipped to address:
•
•
•
•
•
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Obesity
Access to health services
Mental health issues
Treatment of chronic diseases – focusing specific on diabetes and hypertension, potentially
cancer related health issues
Tobacco use/smoking
In addition, IU Health Goshen will indirectly address poverty. IU Health Goshen is also aware of and
sensitive to the health-related needs of all members of the community, and continually seeks
innovative ways for providing improved access to health services for those in poverty. Through
ongoing program development and monitoring, IU Health Goshen will be vigilant regarding infant
mortality. We will continue existing programs for addressing health literacy. However, the expertise of
IU Health Goshen is best suited to formally address the five priority needs noted.
Implementation Plan
Initiatives are being developed to address the needs identified through the 2015 Community Health
Needs Assessment. Plans include, though will not be limited to, the following strategies. Clearly,
successful programs launched in the wake of the 2012 CHNA, will also continue.
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•
Obesity. As the leading need of concern across the community, IU Health Goshen will
continue and enhance its focus on fitness, wellness and healthy lifestyle choices. Where
appropriate, clinical interventions to promote optimal health and quality of life for all
members of the community will be initiated.
•
Access to health services. Additional sites for providing convenient, excellent care are
planned, such as the urgent care clinic under way in the Dunlap area. We will add more
providers to serve the community. Efforts to educate all community members as to their
options for health insurance and financial aid will also continue.
•
M ental health services. Tele-health access to behavioral health professional services is
being arranged, to provide sorely needed services while offering convenience to the
community and efficiency for the limited providers available.
•
Treatm ent of chronic conditions, with a focus on diabetes, hypertension and cancer
risks. Early detection and vigilant management are keys to enjoying high quality of life in the
face of chronic conditions. IU Health Goshen will continue evaluating and implementing
highest-impact initiatives driving success, such as regular screenings, supportive groups and
coaching, and medical management where appropriate.
•
Tobacco use. Community classes, individual education, remote educational sessions and
outreach events and activities aimed at helping people quit, or never start smoking, are
ongoing. These services are expected to grow with staff dedicated to these services.
Appendix I
Data Analysis for Community Health
Needs Assessment
Produced by:
Bowen Research Center, Department of Family Medicine
Indiana University School of Medicine
Produced for:
IU Health Goshen
June 2015
(revised August 2015)
Author:
Laura Gano, MPH
INDIANA UNIVERSITY SCHOOL OF MEDICINE DEPARTMENT OF FAMILY MEDICINE BOWEN RESEARCH CENTER
Data Analysis for Community Health Needs Assessment
Prepared for IU Health Goshen
June 2015 (Revised August 2015) Laura Gano, MPH Acknowledgements This report was completed by the Indiana University School of Medicine, Department of Family Medicine, Bowen Research Center http://iufammed.iupui.edu/bowen‐research‐center and was funded by IU Health Goshen. June 2015 (Revised August 2015) 1.
Data Analysis for Community Health Needs Assessment Page 30
Table of Contents Acknowledgements .......................................................................................................................................30 Executive Summary .......................................................................................................................................34 Introduction ..................................................................................................................................................35 Methods ........................................................................................................................................................36 Data analysis .............................................................................................................................................37 Findings – Primary Data Quantitative Analysis .............................................................................................38 Demographics ...........................................................................................................................................38 Outcomes ..................................................................................................................................................38 Findings – Primary Data Qualitative Analysis ...............................................................................................51 Spanish‐language surveys ........................................................................................................................ 58 Findings – Secondary Data ........................................................................................................................... 54 Population characteristics ........................................................................................................................ 59 Population by county ........................................................................................................................... 59 Population by age group ...................................................................................................................... 60 Population by race ............................................................................................................................... 61 Population by ethnicity .........................................................................................................................62 Population by sex ..................................................................................................................................63 Population by rurality .......................................................................................................................... 64 Low birthweight births ......................................................................................................................... 65 Teen births ...........................................................................................................................................66 Uninsured children ............................................................................................................................... 67 Uninsured adults .................................................................................................................................. 68 High school graduation rate ................................................................................................................. 69 Some college (post‐secondary education) ........................................................................................... 70 English proficiency ............................................................................................................................... 71 Unemployment .................................................................................................................................... 72 Median household income .................................................................................................................. 73 Children living in poverty ..................................................................................................................... 74 Children eligible for free lunch ............................................................................................................ 75 Children in single parent households .................................................................................................. 76 1.
Data Analysis for Community Health Needs Assessment Page 31 Population morbidity .............................................................................................................................. 77 Diabetes prevalence ........................................................................................................................... 77 HIV prevalence .................................................................................................................................... 78 Poor or fair health ............................................................................................................................... 79 Poor physical health days ................................................................................................................... 80 Poor mental health days ..................................................................................................................... 81 Adult obesity ....................................................................................................................................... 82 Sexually transmitted infections (chlamydia) ....................................................................................... 83 Population mortality ............................................................................................................................... 84 Premature death ................................................................................................................................. 84 Infant mortality ................................................................................................................................... 85 Child mortality..................................................................................................................................... 86 Alcohol‐impaired driving deaths ......................................................................................................... 87 Motor vehicle crash deaths ................................................................................................................ 88 Drug poisoning deaths ........................................................................................................................ 89 Injury deaths ....................................................................................................................................... 90 Healthcare workforce and utilization ..................................................................................................... 91 Preventable hospital stays .................................................................................................................106 Diabetic screening ............................................................................................................................. 107 Breast cancer screening .................................................................................................................... 108 Healthcare costs ................................................................................................................................ 109 Could not see doctor due to cost ...................................................................................................... 110 Social/environmental factors affecting health ..................................................................................... 111 Adult smoking ................................................................................................................................... 111 Physical inactivity .............................................................................................................................. 112 Excessive drinking ............................................................................................................................. 113 Access to exercise opportunities ...................................................................................................... 114 Food insecurity .................................................................................................................................. 115 Limited access to healthy foods ........................................................................................................ 116 Inadequate social/emotional support .............................................................................................. 117 Severe housing problems .................................................................................................................. 118 1.
Data Analysis for Community Health Needs Assessment Page 32 Driving alone to work ......................................................................................................................... 119 Long commute (driving alone) ........................................................................................................... 120 Air pollution (particulate matter) ...................................................................................................... 121 Controlled substances dispensed ...................................................................................................... 122 Substance treatment admissions ....................................................................................................... 123 Arrests for driving under the influence (DUI), public intoxication (PI), liquor law violations (LLV) ... 127 Arrests for possession and sale/manufacture of marijuana .............................................................. 128 Arrests for possession and sale/manufacture of cocaine/opiates .................................................... 128 Arrests for possession and sale/manufacture of synthetic drugs ..................................................... 129 Arrests for possession and sale/manufacture of other drugs (including barbiturates/Benzedrine) . 129 Violent crime ...................................................................................................................................... 130 Homicide ............................................................................................................................................ 131 Summary .................................................................................................................................................... 132 Conclusion .................................................................................................................................................. 140 References ................................................................................................................................................. 141 Appendix A – Detailed Report Data Sources .............................................................................................. 143 Appendix B – Health Indicators Variance Report ....................................................................................... 147
Appendix C – IU Health Goshen Community Needs Survey ...................................................................... 153
(English & Spanish) ..................................................................................................................................... 153
1.
Data Analysis for Community Health Needs Assessment Page 33 Executive Summary IU Health Goshen leadership is proactively seeking an inclusive understanding of Elkhart County health needs and contracted with the Bowen Research Center to create a community health profile through analysis of primary data collected from surveys and secondary data collected from various existing health, social, and economic indicators datasets. To provide context, data are also provided for the surrounding counties of Kosciusko County, LaGrange County, Marshall County, Noble County and St. Joseph County as well as for the State of Indiana. As stakeholders in community health, Elkhart County Health Department (ECHD) leadership perspectives are included in this report as well. Elkhart County is the sixth most populous county in Indiana and its demographic profile more closely aligns with St. Joseph County’s (the fifth most populous county) and Indiana overall rather than its contiguous counties. Health Resources and Services Administration (HRSA) data show that Elkhart County is a designated primary medical care health professional shortage area (HPSA) and a mental health provider shortage area (MPSA)2 in its entirety as well as encompassing a designated medically underserved area (MUA) based upon income and geography1 and a dental provider shortage area (DPSA). Primary data analysis key findings are that respondents consider themselves and their communities to be healthy (85.1% rated their personal health status as very healthy or somewhat healthy; 61.8% rated their community as very healthy/somewhat healthy). The five greatest community‐
level health needs identified by respondents were: (1) obesity/exercise/healthy eating; (2) access to health services; (3) treatment of chronic diseases; (4) mental health/addictions/depression; and (5) poverty. Less than one‐half (n=221, 39.3%) of respondents agreed that there are enough community programs to address these needs. Although survey respondents who identified as Amish and those who identified as Hispanic/Latino ranked obesity/exercise/healthy eating as the foremost community health need, these groups differed from the population as a whole in how they ranked other health needs. Echoing community respondent health concerns, Elkhart County Health Department leadership identified the most pressing community health needs as access to health services, tobacco use, obesity and infant mortality. Secondary data analysis supports primary data analysis in that Elkhart County’s most challenging issues reside in the areas of access to healthcare, preventive health, poverty and education. Despite these challenges, Elkhart County generally performs better than Indiana overall in morbidity and mortality indicators. 1.
Data Analysis for Community Health Needs Assessment Page 34 Introduction When the Patient Protection and Affordable Care Act was enacted in 2010, new reporting requirements were set forth under Internal Revenue Service (IRS) Code 501(r) which obligated charitable hospitals to complete a Community Health Needs Assessment and corresponding implementation strategy every three years in order to retain 501(c)(3) charitable hospital exemption status. 3 To meet this need for required reporting for 2015, IU Health Goshen contracted with the Bowen Research Center to create a community health profile through analysis of primary data and secondary data collection and analysis from various existing health, social, and economic indicators datasets. The purpose of this community health profile is to assess health indicators, health concerns, health status, perceived barriers to health care, and lifestyle risk factors for IU Health Goshen’s catchment area residents to inform IU Health Goshen’s updated Community Health Needs Assessment as required under IRS Code 501(r) guidelines. 1.
Data Analysis for Community Health Needs Assessment Page 35 Methods IU Health Goshen provided Bowen Research Center with primary data that had been collected online and by mail. To assess health indicators, Bowen Research Center professional staff obtained data shown from existing secondary datasets. Datasets consulted include: 
US Census Population Estimates

National Center for Chronic Disease Prevention and Health Promotion

National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention

Health Indicators Warehouse

CDC WONDER mortality data

National Center for Health Statistics

Behavioral Risk Factor Surveillance System

ESRI & US Census TIGER Files

Fatality Analysis Reporting System

Map the Meal Gap

USDA Food Environment Atlas

Health Research and Services Administration (HRSA) Area Resource File

Dartmouth Atlas of Health Care

Data.gov

Bureau of Labor Statistics

Small Area Income and Poverty Estimates

Federal Bureau of Investigation (FBI) – Uniform Crime Reporting

National Center for Education Statistics

Comprehensive Housing Affordability Strategy (CHAS) data

American Community Survey

Indiana Board of Pharmacy/Prescription Drug Mentoring Program (INspect)

Treatment Episode Dataset
Elkhart County Health Department leadership personnel were queried to provide a public health‐oriented view of priority health concerns. 1.
Data Analysis for Community Health Needs Assessment Page 36 Appendix A provides further details regarding data source years and how data are reported. Data analysis Primary and secondary data were compiled, merged and analyzed using Microsoft Excel® and SAS 9.4® software. Health indicators data were collected and summarized from secondary datasets in order to illustrate Elkhart County health in relation to Kosciusko, LaGrange, Marshall, Noble and St. Joseph Counties as well as Indiana overall. 1.
Data Analysis for Community Health Needs Assessment Page 37 Findings – Primary Data Quantitative Analysis Primary data were collected via online surveying and by surveys sent out through the postal service. Over three times as many (n=464) surveys were returned online compared to surveys which were mailed (n=150). Fourteen (14) records were excluded from the original dataset because the response to the question regarding residential county was left blank or was invalid. The dataset for analysis consisted of 600 records. Demographics The most common residential county for respondents was Elkhart County (n=559, 93.2%), while 42.1% (n=252) of respondents listed 46526 as their home zip code. The four Amish respondents who included their zip code noted residing in 46517, 46528 and 46550. Sixty percent (n=9, 60%) of the 15 Hispanic/Latino respondents recorded their zip code as 46526 while remainder resided in 46517, 46528, 46550 and 46567. The majority (n=401, 72.4%) of respondents were 50 years of age or older. More elderly respondents were seen among the Amish (n=17, 65.4%) while nearly three‐quarters (n=24, 72.7%) of Hispanic/Latino respondents were under age 50. Nearly two‐thirds (65.4%) of respondents identified as having European heritage (Western European, n=195, 53.1%; Eastern European, n=45, 12.3%). Less than ten percent of respondents identified as Hispanic/Latino (n=34, 9.3%) and 27 individuals (7.4%) identified as Amish. The greatest amount of diversity in heritage was seen in Elkhart County. Sixty‐two percent (n=318, 62.35%) of survey respondents reported household income of less than $50,000. More Amish respondents reported earning less than $50,000 (n=17, 65.3%) as did slightly more Hispanic/Latino respondents (n=21, 63.6%). Outcomes Slightly over 85% (n=506, 85.1%) of respondents ranked their personal health status as very healthy or somewhat healthy and more than sixty percent (n=336, 61.7%) ranked the health of their overall community as very healthy or somewhat healthy. Fewer Amish residents reported their personal health status as very healthy or somewhat healthy (n=21, 77.7%) while over 90% of Hispanic/Latino residents claimed very healthy or somewhat healthy personal health status. In contrast to personal health status, more Amish respondents (n=23, 88.4%) felt that the health of their community was very healthy or somewhat healthy while 58.8% (n=20) of Hispanic/Latino residents believed that their community health status was very healthy or somewhat healthy. 1.
The five greatest community‐level health needs identified by respondents were: (1) obesity/exercise/healthy eating; (2) access to health services; (3) treatment of chronic diseases; (4) mental health/addictions/depression; and (5) poverty. Less than one‐half (n=223, 39.3%) of respondents agreed that there are enough community programs to address these needs. Interestingly, the rankings for greatest community health needs differed among Amish and Hispanic/Latino residents. Amish residents ranked health needs thusly: (1) obesity/exercise/healthy eating; (2) treatment of chronic diseases; (3) access to health services; (4) injuries/safety and mental health/addictions/depression (tie); (5) health literacy. Hispanic/Latino residents prioritized health needs thusly: (1)
obesity/exercise/healthy eating; (2) mental health/addictions/depression; (3) access to health services;
(4) health literacy and poverty and tobacco use/smoking (tie); (5) treatment of chronic diseases and
injuries/safety and other (tie).
Sixty percent (n=344, 60.9%) of regional residents did not believe that there are enough programs within their communities to address the needs identified above. The proportions of individuals who felt there is sufficient programming were nearly opposite for Amish respondents and Hispanic/Latino respondents. One‐third (n=8, 33.3%) of Amish respondents did not feel that there is sufficient programming available to address health needs, while 71.9% (n=23) of Hispanic/Latinos believed that programming to address health needs is insufficient. (See Table 1 for descriptive statistics; please note that figures may not sum to 100.0 due to rounding and exclusion of Cass, Dubois and White County responses [n=3 for all of these counties] from this analysis. See also Figures 1‐13) 1.
Table 1. Primary data descriptive statistics Elkhart
(N, %) Kosciusko
(N, %) LaGrange
(N, %) Marshall
(N, %) Noble
N, %) St. Joseph
(N, %) Amish
(N, %) Hispanic
(N, %) All Other
(N, %) Respondent age (optional) 18 – 29 30 – 39 40 – 49 50 -- 59 60 – 69 70+ 31 54 60 140 132 97 6.0 10.5 11.7 27.2 25.7 18.9 1
0
3
4
6
3
5.9
0.0
17.6
23.5
35.3
17.6
1
1
0
1
4
6
7.7
7.7
0.0
7.7
30.8
46.2
0
0
1
0
0
0
0.0
0.0
100
0.0
0.0
0.0
0
1
0
0
1
2
0.0 25.0 0.0 0.0 25.0 50.0 0
0
0
2
0
0
0.0
0.0
0.0
100
0.0
0.0
0 12 4 43 33 3 2 2 33 190 14 0.0 3.6 1.2 12.8 9.8 0.9 0.6 0.6 9.8 56.5 4.2 0
5
0
0
1
0
0
1
0
2
0
0.0
55.6
0.0
0.0
11.1
0.0
0.0
11.1
0.0
22.2
0.0
0
9
0
1
0
0
0
0
2
1
0
0.0
69.2
0.0
7.7
0.0
0.0
0.0
0.0
15.4
7.7
0.0
0
0
0
0
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
1
0
1
0
0
0
0
0
2
0
0.0 25.0 0.0 25.0 0.0 0.0 0.0 0.0 0.0 50.0 0.0 0
0
0
0
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
23 14 39 63 74 123 54 83 4.9 3.0 8.2 13.3 15.6 26.0 11.4 17.5 2
0
2
0
3
2
6
0
13.3
0.0
13.3
0.0
20.0
13.3
40.0
0.0
6
1
1
1
1
2
1
0
46.2
7.7
7.7
7.7
7.7
15.4
7.7
0.0
0
0
0
0
0
1
0
0
0.0
0.0
0.0
0.0
0.0
100
0.0
0.0
0
1
0
0
0
0
0
1
0.0 50.0 0.0 0.0 0.0 0.0 0.0 50.0 0
0
1
0
0
1
0
0
0.0
0.0
50.0
0.0
0.0
50.0
0.0
0.0
2
2
2
3
8
9
7.7
7.7
7.7
11.5
30.8
34.6
7
8
9
3
3
3
21.2
24.2
27.3
9.1
9.1
9.1
17
24
24
81
84
70
5.7
8.0
8.0
27.0
28.0
23.3
5
2
4
1
5
5
1
3
19.2
7.7
15.4
3.8
19.2
19.2
3.8
11.5
4
0
4
7
6
10
1
1
12.1
0.0
12.1
21.2
18.2
30.3
3.0
3.0
12
9
20
35
39
75
43
48
4.3
3.2
7.1
12.5
13.9
26.7
15.3
17.1
Self-description (optional) African American Amish Asian American Eastern European Hispanic/Latino Jewish Mediterranean Middle Eastern Native American Western European Other Household income (optional) $0 - $15,000 $16,000 - $19,000
$20,000 - $29,000 $30,000 - $39,000 $40,000 - $49,000 $50,000 - $74,000 $75,000 - $99,000 $100,000 or more Data Analysis for Community Health Needs Assessment Page 40 Elkhart
(N, %) Personal health status Very healthy Somewhat healthy Somewhat unhealthy Very unhealthy Community health status Very healthy Somewhat healthy Somewhat unhealthy Very unhealthy Greatest community health
needs Access to health services Treatment of chronic diseases Health literacy Injuries/safety Mental health/ addictions/
depression Obesity/exercise/healthy eating Poverty Tobacco use/smoking Other Sufficient available health
programs Yes No Kosciusko
(N, %) LaGrange
(N, %) Marshall
(N, %) Noble
(N, %) St. Joseph
(N, %) Amish
(N, %) Hispanic
(N, %) All Other
(N, %) 267 209 69 10 48.1 37.7 12.4 1.8 8
7
3
0
44.4
38.9
16.7
0.0
4
5
2
1
33.3
41.7
16.7
8.3
0
1
0
0
0.0
100
0.0
0.0
2
0
2
0
50.0 0.0 50.0 0.0 1
0
1
0
50.0
0.0
0.5
50.0
11
10
5
1
40.7
37.0
18.5
3.7
17
15
2
0
50.0
44.1
5.9
0.0
155
104
36
6
51.5
34.6
12.0
2.0
26 309 178 40 4.7 55.9 32.2 7.2 0
11
6
1
0.0
61.1
33.3
5.6
4
7
1
0
33.3
58.3
8.3
0.0
0
1
0
0
0.0
100
0.0
0.0
0
4
0
0
0.0 100 0.0 0.0 0
2
0
0
0.0
100
0.0
0.0
7
16
3
0
26.9
61.5
11.5
0.0
3
17
9
5
8.8
50.0
26.5
14.7
13
172
95
19
4.3
57.5
31.8
6.4
125 73 32 11 23.5 13.7 6.0 2.1 2
2
0
0
11.8
11.8
2
4
2
0
18.2
36.4
18.2
0
0
0
0
0.0
0.0
0.0
0.0
1
1
0
0
50.0 50.0 0.0 0.0 2
0
0
0
100
0.0
0.0
0.0
4
5
1
2
17.4
21.7
4.3
8.7
5
1
2
1
16.7
3.3
6.6
3.3
60
42
20
5
20.6
14.4
6.9
1.7
55 172 39 18 7 10.3 32.3 7.3 3.4 1.3 3
10
0
0
0
17.6
58.8
0.0
0.0
0.0
2
1
0
0
0
18.2
9.1
0.0
0.0
0.0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
1
0
0
0
0
0.0 0.0 0.0 0.0 0.0 0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
2
9
0
0
0
8.7
39.1
0.0
0.0
0.0
6
10
2
2
1
20.0
33.3
6.6
6.6
3.3
28
94
26
14
3
9.6
32.3
8.9
4.8
1.0
206 325 38.8 61.2 8
10
44.4
55.6
7
4
63.6
36.4
0
1
0.00
100
0
3
0.00 100 0
1
0.00
100
16
8
66.7
33.3
9
23
28.1
71.9
116
174
40.0
60.0
Data Analysis for Community Health Needs Assessment Page 41 Figure 1. Respondent age by county Respondent Age by County
100.0
90.0
80.0
Percentage
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0
Elkhart
Kosciusko
LaGrange
Marshall
Noble
St. Joseph
18 – 29
6.0
5.9
7.7
0.0
0.0
0.0
30 – 39
10.5
0.0
7.7
0.0
25.0
0.0
40 – 49
11.7
17.6
0.0
100.0
0.0
0.0
50 ‐‐ 59
27.2
23.5
7.7
0.0
0.0
100.0
60 – 69
25.7
35.3
30.8
0.0
25.0
0.0
70+
18.9
17.6
46.2
0.0
50.0
0.0
Figure 2. Respondent age by heritage Respondent Age by Heritage
100.0
Percentage
80.0
60.0
40.0
20.0
0.0
Amish
Hispanic
All Other
18 – 29
7.7
21.2
5.7
30 – 39
7.7
24.2
8.0
40 – 49
7.7
27.3
8.0
50 ‐‐ 59
11.5
9.1
27.0
60 – 69
30.8
9.1
28.0
70+
34.6
9.1
23.3
Data Analysis for Community Health Needs Assessment Page 43 Figure 3. Heritage by county Heritage by County
Percentage
80.0
60.0
40.0
20.0
0.0
African
Amer
Amish
Asian
Amer
E
Mediter
Native
Hispanic Jewish
MidEast
Europe
ranean
Amer
W
Europe
Other
Elkhart
0.0
3.6
1.2
12.8
9.8
0.9
0.6
0.6
9.8
56.5
4.2
Kosciusko
0.0
55.6
0.0
0.0
11.1
0.0
0.0
11.1
0.0
22.2
0.0
LaGrange
0.0
69.2
0.0
7.7
0.0
0.0
0.0
0.0
15.4
7.7
0.0
Marshall
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
Noble
0.0
25.0
0.0
25.0
0.0
0.0
0.0
0.0
0.0
50.0
0.0
St. Joseph
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
Data Analysis for Community Health Needs Assessment Page 44 Figure 4. Household income by county Household Income by County
100.0
90.0
80.0
Percentage
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0
Elkhart
Kosciusko
LaGrange
Marshall
Noble
St. Joseph
$0 ‐ $15,000
4.9
13.3
46.2
0.0
0.0
0.0
$16,000 ‐ $19,000
3.0
0.0
7.7
0.0
50.0
0.0
$20,000 ‐ $29,000
8.2
13.3
7.7
0.0
0.0
50.0
$30,000 ‐ $39,000
13.3
0.0
7.7
0.0
0.0
0.0
$40,000 ‐ $49,000
15.6
20.0
7.7
0.0
0.0
0.0
$50,000 ‐ $74,000
26.0
13.3
15.4
100.0
0.0
50.0
$75,000 ‐ $99,000
11.4
40.0
7.7
0.0
0.0
0.0
$100,000 or more
17.5
0.0
0.0
0.0
50.0
0.0
Figure 5. Household income by heritage Household Income by Heritage
100.0
80.0
Axis Title
60.0
40.0
20.0
0.0
Amish
Hispanic
All Other
$0 ‐ $15,000
19.2
12.1
4.3
$16,000 ‐ $19,000
7.7
0.0
3.2
$20,000 ‐ $29,000
15.4
12.1
7.1
$30,000 ‐ $39,000
3.8
21.2
12.5
$40,000 ‐ $49,000
19.2
18.2
13.9
$50,000 ‐ $74,000
19.2
30.3
26.7
$75,000 ‐ $99,000
3.8
3.0
15.3
$100,000 or more
11.5
3.0
17.1
Figure 6. Personal Health Status by county Personal Health Status by County
100.0
90.0
80.0
Percentage
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0
Elkhart
Kosciusko
LaGrange
Marshall
Noble
St. Joseph
Very healthy
48.1
44.4
33.3
0.0
50.0
50.0
Somewhat healthy
37.7
38.9
41.7
100.0
0.0
0.0
Somewhat unhealthy
12.4
16.7
16.7
0.0
50.0
50.0
Very unhealthy
1.8
0.0
8.3
0.0
0.0
0.0
Data Analysis for Community Health Needs Assessment Page 47 Figure 7. Personal health status by heritage Personal Health Status by Heritage
100.0
90.0
80.0
Percentage
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0
Amish
Hispanic
All Other
Very healthy
40.7
50.0
51.5
Somewhat healthy
37.0
44.1
34.6
Somewhat unhealthy
18.5
5.9
12.0
Very unhealthy
3.7
0.0
2.0
Figure 8. Community health status by county Community Health Status by County
100.0
90.0
80.0
Percentage
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0
Elkhart
Kosciusko
LaGrange
Marshall
Noble
St. Joseph
Very healthy
4.7
0.0
33.3
0.0
0.0
0.0
Somewhat healthy
55.9
61.1
58.3
100.0
100.0
100.0
Somewhat unhealthy
32.2
33.3
8.3
0.0
0.0
0.0
Very unhealthy
7.2
5.6
0.0
0.0
0.0
0.0
Data Analysis for Community Health Needs Assessment Page 49 Figure 9. Community health status by heritage Community Health Status by Heritage
100.0
80.0
Percentage
60.0
40.0
20.0
0.0
Amish
Hispanic
All Other
Very healthy
26.9
8.8
4.3
Somewhat healthy
61.5
50.0
57.5
Somewhat unhealthy
11.5
26.5
31.8
Very unhealthy
0.0
14.7
6.4
Data Analysis for Community Health Needs Assessment Page 50 Figure 10. Greatest community health needs by county Greatest Community Health Needs by County
100.0
90.0
80.0
Percentage
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0
Obesity/
MH/addi
Tobacco
Injuries/
exercise
ction/de
Poverty use/smo
safety
/healthy
pression
king
eating
Access
Treat
chronic
dis
Health
literacy
Elkhart
23.5
13.7
6.0
2.1
10.3
32.3
7.3
3.4
1.3
Kosciusko
11.8
11.8
0.0
0.0
17.6
58.8
0.0
0.0
0.0
LaGrange
18.2
36.4
18.2
0.0
18.2
9.1
0.0
0.0
0.0
Marshall
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
Noble
50.0
50.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
St. Joseph
100.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
Data Analysis for Community Health Needs Assessment Other
Page 51
Figure 11. Greatest community health needs by heritage Greatest Community Health Needs by Heritage
100.0
90.0
80.0
Percentage
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0
MH/addi Obesity/
Injuries/ ctions/d exercise/
Poverty
safety epressio healthy
n
eating
Access
Treat
chronic
dis
Health
literacy
Amish
17.4
21.7
4.3
8.7
8.7
39.1
Hispanic
16.7
3.3
6.6
3.3
20.0
All Other
20.6
14.4
6.9
1.7
9.6
Tobacco
use/smo
king
Other
0.0
0.0
0.0
33.3
6.6
6.6
3.3
32.3
8.9
4.8
1.0
Figure 12. Sufficient programming by county Sufficient Programming by County
100.0
Percentage
80.0
60.0
40.0
20.0
0.0
Elkhart
Kosciusko LaGrange
Marshall
Noble
St. Joseph
Yes
38.8
44.4
63.6
0.0
0.0
0.0
No
61.2
55.6
36.4
100.0
100.0
100.0
Figure 13. Sufficient programming by heritage Sufficient Programming by Heritage
100.0
Percentage
80.0
60.0
40.0
20.0
0.0
Amish
Hispanic
All Other
Yes
66.7
28.1
40.0
No
33.3
71.9
60.0
Data Analysis for Community Health Needs Assessment Page 53 Findings – Primary Data Qualitative Analysis The qualitative data collected from open‐ended responses to questions #6 and #7 on the survey reveal strong support of programming related to the five top‐ranked needs identified in question #6 (obesity/exercise/healthy eating; access to health services; treatment of chronic diseases; mental health/addictions/depression; and poverty) but also mention other areas of concern. The open‐ended portion of question #6 asked respondents to describe whether or not there are sufficient programs to address identified needs. Selected comments made by respondents related to these areas include the following: Obesity/exercise/healthy eating 
There is not enough help with obesity which is the underlying cause of many chronic conditions.

We have one gym in town but no programs that I know of.

I would like to see more exercise‐type programs for people in their 50s‐60s tailored to their age.
Access to health services 
We do not have an endocrinologist, rheumatologist, or dermatologist.

The rising cost of healthcare can be a deterrent to patients keeping them from getting health
care or making them postpone treatment.

Not enough family doctors.
Mental health/addictions/depression 
Addictions and mental health/depression is not addressed at all in our community in my
opinion. Where is Oaklawn? Why aren’t they tag‐teaming with IU Health to improve this?

No easy access to mental health care, follow‐up for these patients is lacking on all levels.

We need a program to address addictions and eating disorders. Oaklawn Hospital is not
designed well to help people who struggle with addictions or eating disorders.
Poverty 
For those who are struggling financially, unemployed or underemployed, or many with chronic
mental or physical illnesses, the resources are not adequate at all.

This is not a situation that only a program can solve. Better wages and quality housing should
be addressed.
Data Analysis for Community Health Needs Assessment Page 54 
Poverty – immediate needs are addressed but we lack long‐term rehabilitation (teaching basic
financial principles, life skills, job skills) to allow individuals to help themselves out of poverty.
Respondents also raised other concerns that were not among the choices given for question #6.
These concerns centered on awareness, utilization and provision of urgent care. Selected comments made by respondents related to these areas include the following: Awareness 
Community education and awareness of services offered are just as important as the programs
themselves.

There could always be more programs, but it’s more important to connect people with existing
programs.

There are enough programs in our community. The issue is promotion and communication.
People who need these programs many times either don’t know about them or how to access
them.
Utilization 
We have lots of programs for people to use but people don’t do it for whatever reason.

There are plenty of resources. People just don’t take control of their own lives and health.

Having enough programs is only part of the answer. The other part is having community
members want to access or see a need for the program.
Urgent care 
We need urgent care facilities, some place for people to go evenings and weekends when it’s
important but not an emergency.

Urgent care to replace use of emergency care.

Options other than the emergency room for folks with no insurance.
One unique response to question #6 addressed the regional Amish population: 
“The Amish trust problem: I think the “Quacks” out there have picked up on key words and key
phrases that cause the Amish to believe in them. Anything that is “natural”, etc. They are so
Data Analysis for Community Health Needs Assessment Page 55 taken advantage of due to their general mistrust of educated health professionals (“who are just out to get their money…”). Responses to question #7 (which asked respondents how IU Health Goshen or other community organizations could better meet the needs identified in question #6) paralleled the open‐ended responses to question #6 and also included additional areas of concern. The most frequent comments centered on promotion of exercise/physical activity, improving access to health services, provision of mental health services, and lowering costs and offering services free of charge. Like areas of concern discussed in response to question #6, there was also support for creating greater awareness of program offerings and for provision of urgent care facilities. Lastly, respondents also advocated for increasing population health literacy and for increasing communication efforts. Selected comments made by respondents related to these areas include the following: Obesity/exercise/healthy eating 
The evidence‐based dose‐response relationship between physical activity and health outcomes
is undeniable. All‐cause mortality, cardiorespiratory health, metabolic health, weight
management, obesity, musculoskeletal health, functional health, colon and breast cancers,
mental health and general well‐being all are definitely improved with regular physical activity
and exercise. IUGH needs to get behind this movement to promote life‐long activity for both
primary and secondary prevention for healthy and at‐risk populations, respectively.

There should be more of a partnership between the medical community and the surrounding
gyms.
Access to health services 
Mobile health care? Talk to people in poverty neighborhoods and ask them what they need.

Offer quarterly community health screenings.

Partner with factory owners to provide health programs at work.
Mental health/addictions/depression 
Participate in or host some trials that allow the uninsured, underinsured, or those who want
anonymity from their employers to seek medical treatment for addictions.

Increase ease of referral process for mental health access to local facilities or bring in your own.
Data Analysis for Community Health Needs Assessment Page 56 Cost 
More free health care options for low income families and individuals.

Make things affordable! I’m on a fixed income.

Provide medications at a lower cost or supplies such as diabetes testing strips at a low cost.
Awareness 
Not sure if people are aware of programs out there.

The women’s retreat program is great, but many people do not seem to know about it.

There should be a central place where people can access information.
Urgent care 
Walk‐in clinics

Walk‐in treatment centers for stiches, bee stings, poison ivy, etc.
Health literacy 
Maybe IU Health could engage the local schools with health promotion and health literacy
programs as part of the school experience.

Put RNs back in doctors’ offices to do patient education.

Provide “health literacy” free for everyone.
Communication 
Get out there and talk to people. Find out what the community is saying. The general
population, not the affluent and business people. The majority of the community.

Stay focused on needs and make sure other community organizations are kept informed.

Share information between different IU Health facilities so that we don’t have to take insurance
information to each one individually.
Data Analysis for Community Health Needs Assessment Page 57 Spanish‐language surveys Two incomplete Spanish‐language surveys were received after analysis of the primary data had been completed. The contents of those surveys are summarized below. Both respondents were from Elkhart County, zip code 46256. One respondent identified as Hispanic/Latino and documented household income of $20,000 ‐ $29,000. The other respondent identified as having Eastern European heritage and documented household income of $75,000 ‐ $99,000. The Hispanic/Latino individual categorized his personal health and his community health as somewhat unhealthy. The Eastern European categorized his health as ‘very healthy’ and his community health as somewhat unhealthy. Neither individual identified top community health needs. However, the Hispanic/Latino respondent did not feel that there are sufficient programs to address health needs and his open‐ended comments centered on access to health services (“We need public help centers for people who don’t have a job or health insurance” and “Giving more information about how to find places that can help you with your problems”). Conversely, the Eastern European individual answered that programming is sufficient to meet needs and offered “Educating students at the schools” as his response to question #7. Data Analysis for Community Health Needs Assessment Page 58 Findings – Secondary Data In spite of challenges related to poverty, healthcare access, preventive health and education, Elkhart County generally performs better than Indiana overall in morbidity and mortality indicators but has high rates of teen births, sexually transmitted infections, and infant mortality. Population characteristics Population by county In relation to population size, the five county region is characterized by extremes in population size. Elkhart County has the second‐highest population (199,619) while St. Joseph County’s population (266,344) is over five times greater than the three less populous counties (LaGrange County, 37,521; Marshall County, 47,024; Noble County, 47,582) and more than three times greater than Kosciusko County (77,069). Table 1. Total county population Population Elkhart 199,619 Kosciusko 77,609 LaGrange 37,521 Marshall 47,024 Noble 47,582 St. Joseph 266,344 Figure 1. Total county population Population by County
300000
250000
Number
200000
150000
100000
50000
0
Elkhart
Kosciusko LaGrange Marshall
Noble
St. Joseph
Population by age group When compared to Indiana, LaGrange County represents extremes in relation to having high proportions of geriatric residents as well as individuals less than age 18. With the exception of St. Joseph County (24.2%), each county has a higher proportion of individuals less than 18 years of age than in Indiana overall (24.3%); in LaGrange County, 34.0% of the population is less than 18 years of age. LaGrange County has a reduced proportion of geriatric people (12.2%) when compared to Indiana (13.6%) while Marshall County has a higher proportion (15.5%). Table 2. Population by age group % < 18 % > 65 Indiana 24.3 13.6 Elkhart 28.1 12.7 Kosciusko 25.0 14.4 LaGrange 34.0 12.2 Marshall 26.0 15.5 Noble 26.3 13.6 St. Joseph 24.2 13.8 Figure 2. Population by age group Population by Age Group
40
35
Percentage
30
25
20
15
10
5
0
Indiana
Elkhart
Kosciusko LaGrange
< 18
Marshall
Noble
St. Joseph
65 and over
Data Analysis for Community Health Needs Assessment Page 60 Population by race With the exception of St. Joseph County’s African American and Asian populations (12.6% and 2.1%, respectively), the racial composition of the six county region is less diverse than Indiana overall. Correspondingly, St. Joseph County has the lowest proportion of non‐Hispanic White residents (75.3%); LaGrange County has the highest non‐Hispanic White population (95.0%). Table 3. Population by race % African % American American Indian/ Alaskan Native Indiana 9.1 0.4 Elkhart 5.6 0.6 Kosciusko 0.7 0.4 LaGrange 0.3 0.2 Marshall 0.4 0.3 Noble 0.4 0.3 St. Joseph 12.6 0.5 % Asian 1.7 1.1 1.0 0.3 0.5 0.4 2.1 % Native Hawaiian/ Other Pacific Islander 0.1 0.1 0.0 0.0 0.1 0.0 0.1 % Non‐Hispanic white 81.3 77.0 89.6 95.0 89.1 88.3 75.3 Figure 3. Population by race Population by Race
Percentage
100.0
80.0
African American
60.0
American Indian/ Alaskan Native
40.0
Asian
20.0
Native Hawaiian/ Other Pacific
Islander
0.0
Non‐Hispanic white
Data Analysis for Community Health Needs Assessment Page 61 Population by ethnicity Of the Counties in this analysis, Elkhart County has the highest proportion (14.%) of residents identifying as Hispanic; this proportion is more than double the overall Indiana percentage (6.2%), while the proportion of LaGrange County’s Hispanic population (3.6%) is nearly one‐half of Indiana’s Hispanic population overall. Table 4. Population by ethnicity % Hispanic Indiana 6.2 Elkhart 14.4 Kosciusko 7.5 LaGrange 3.6 Marshall 8.8 Noble 9.7 St. Joseph 7.5 Figure 4. Population by ethnicity Hispanic Population
16
14
Percentage
12
10
8
6
4
2
0
Indiana
Elkhart Kosciusko LaGrange Marshall
Noble
St. Joseph
Data Analysis for Community Health Needs Assessment Page 62 Population by sex Elkhart, Kosciusko, Marshall and Noble Counties’ populations mirror Indiana’s proportions of female/male residents (50.8% and 49.2% respectively). LaGrange County has fewer females (49.7%) and more males (50.3%) while St. Joseph County has more females (51.5%) and fewer males (48.5%). Table 5. Population by sex County % Female % Male Indiana 50.8 49.2 Elkhart 50.7 49.3 Kosciusko 50.3 49.7 LaGrange 49.7 50.3 Marshall 50.6 49.4 Noble 50.0 50.0 St. Joseph 51.5 48.5 Figure 5. Population by sex Population by Sex
100.0
Percentage
80.0
60.0
40.0
20.0
Female
Male
0.0
Population by rurality Except for Elkhart County and St. Joseph County, populations of the counties contiguous to Elkhart County are more rural than Indiana overall (27.6%). Kosciusko County has over 1.5 times as many rural residents (46.6%); Marshall County and Noble County have more than twice as many rural residents; LaGrange County has over three times as many rural residents as the remainder of Indiana. Table 6. Population by rurality % Rural Indiana
27.6 Elkhart
20.6 Kosciusko
46.6 LaGrange
91.6 Marshall
63.3 Noble
68.0 St. Joseph
9.0 Figure 6. Population by rurality Rural Population
100.0
Percentage
80.0
60.0
40.0
20.0
0.0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 64 Low birthweight births Low birthweight births are a priority public health issue. With the exception of St. Joseph County (8.4%), each county in the region has better outcomes for low birthweight births than Indiana overall (8.3%). Only 5.4% of LaGrange County births are low birthweight births. Table 7. Low birthweight births % Low birthweight births Indiana 8.3 Elkhart 7.3 Kosciusko 7.0 LaGrange 5.4 Marshall 6.5 Noble 7.7 St. Joseph 8.4 Figure 7. Low birthweight births Low Birthweight Births
9.0
8.0
Percentage
7.0
6.0
5.0
4.0
3.0
2.0
1.0
0.0
Indiana
Noble
St. Joseph
Teen births When comparing teen births to Indiana’s rate (40.2 per 1,000), Elkhart County (55.2 per 1,000) and Noble County (47.0 per 1,000) experience substantially more teen births; Kosciusko County’s rate (41.1 per 1,000) and St. Joseph County’s (40.4%) are also higher. However, Marshall County’s rate (36.6 per 1,000) is lower and LaGrange County’s rate (26.4 per 1,000) is substantially lower. Table 8. Teen births Teen birth rate Indiana 40.2 Elkhart 55.2 Kosciusko 41.1 LaGrange 26.4 Marshall 36.6 Noble 47.0 St. Joseph 40.4 Figure 8. Teen births Teen Births
60.0
Rate per 1,000
50.0
40.0
30.0
20.0
10.0
0.0
Indiana
Noble St. Joseph
Uninsured children Each county within the area has a higher proportion of uninsured children than in Indiana (8.3%) overall; the proportion of uninsured children in LaGrange County (15.3%) is nearly double the proportion of Hoosier uninsured children. Elkhart County Health Department leadership identified lack of health insurance as one of the key factors related to community‐wide deficiency in access to health care. Table 9. Uninsured children % Uninsured children Indiana 8.3 Elkhart 11.2 Kosciusko 12.2 LaGrange 15.3 Marshall 10.4 Noble 11.2 St. Joseph 9.2 Figure 9. Uninsured children
Uninsured Children
20.0
Percentage
15.0
10.0
5.0
0.0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 67 Uninsured adults As with uninsured children in Indiana, the proportions of uninsured adults in the six contiguous counties are higher than the proportion of uninsured adults throughout Indiana ((20.0%). Nearly one‐
third (31.4%) of adults in LaGrange County are uninsured. Elkhart County Health Department leadership identified lack of health insurance as one of the key factors related to community‐wide deficiency in access to health care. Table 10. Uninsured adults % Uninsured adults Indiana 20.0 Elkhart 25.9 Kosciusko 23.0 LaGrange 31.4 Marshall 23.1 Noble 23.6 St. Joseph 21.7 Figure10. Uninsured adults Uninsured Adults
35.0
30.0
Percentage
25.0
20.0
15.0
10.0
5.0
0.0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 68 High school graduation rate With the exception of Kosciusko County (87.8%), the high school graduation rate for each of the remaining contiguous counties is lower than Indiana’s rate (86.5%). In St. Joseph County, only 82.8% graduate high school. Table 11. High school graduation rate % Graduated Indiana 86.5 Elkhart 85.4 Kosciusko 87.8 LaGrange 83.2 Marshall 85.3 Noble 85.2 St. Joseph 82.8 Figure 11. High school graduation rate HIgh School Graduation Rate
100.0
Percentage
80.0
60.0
40.0
20.0
0.0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 69 Some college (post‐secondary education) St. Joseph County is the only county that has a higher proportion (63.7%) of residents who have had at least some college or post‐secondary education compared to Indiana (59.7%) residents overall. Lower proportions of residents of the other contiguous counties have achieved some level of post‐
secondary education compared to other Indiana residents; the rate for LaGrange County residents is significantly lower (28.2%). Table 11. Some college (post‐secondary education) % Some college Indiana 59.7 Elkhart 44.9 Kosciusko 52.6 LaGrange 28.7 Marshall 48.2 Noble 46.1 St. Joseph 63.7 Figure 11. Some college (post‐secondary education) Some Level of Post‐secondary Education
70.0
60.0
Percentage
50.0
40.0
30.0
20.0
10.0
0.0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 70 English proficiency Elkhart County has the highest proportion of population not proficient in English (3.9%) compared to Indiana (1.6%) overall; LaGrange (3.3%), Marshall (2.5%) and Noble (2.6%) also have fewer residents who are proficient in English. Only Kosciusko County (1.3%) and St. Joseph County (1.4%) have more residents who are proficient in English. Table 13. English proficiency County % Not Proficient in English Indiana 1.6 Elkhart 3.9 Kosciusko 1.3 LaGrange 3.3 Marshall 2.5 Noble 2.6 St. Joseph 1.4 Figure 13. English proficiency Population Not Proficient in English
5.0
Percentage
4.0
3.0
2.0
1.0
0.0
Indiana
Noble
St. Joseph
Data Analysis for Community Health Needs Assessment Page 71 Unemployment Kosciusko County (7.4%) and LaGrange County (7.9%) experience lower rates of unemployment than Indiana (8.4%). Elkhart County’s unemployment rate is 9.6%; both Noble County (9.2%) and St. Joseph County (9.7%) also have unemployment rates over 9.0%. Table 14. Unemployment % Unemployed Indiana 8.4 Elkhart 9.6 Kosciusko 7.4 LaGrange 7.9 Marshall 8.9 Noble 9.2 St. Joseph 9.7 Table 14. Unemployment Unemployment
12.0
Percentage
10.0
8.0
6.0
4.0
2.0
0.0
Indiana
Noble St. Joseph
Median household income Except for Kosciusko County ($50,153) and LaGrange County ($47,870) median household income is lower in the six county region than in Indiana ($46,954). Noble County has the lowest median household income ($44,192). Elkhart County median household income is $45,806. Table 15. Median household income Median household income Indiana $46,954 Elkhart $45,806 Kosciusko $50,153 LaGrange $47,870 Marshall $46,129 Noble $44,192 St. Joseph $45,248 Figure 15. Median household income Median Household Income
$52,000
$50,000
Dollars
$48,000
$46,000
$44,000
$42,000
$40,000
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 73 Children living in poverty Children residing in the region are less likely to live in poverty than other Hoosier children (22.1%), except for those who live in St. Joseph County; in this county, nearly one‐quarter (24.0%) of children live in poverty. Elkhart County Health Department leadership identified poverty as one of the key factors related to community‐wide deficiency in access to health care. Table 16. Children living in poverty % Children in poverty Indiana 22.1 Elkhart 21.2 Kosciusko 16.4 LaGrange 20.8 Marshall 18.6 Noble 21.2 St. Joseph 24.0 Figure 16. Children living in poverty Children in Poverty
30.0
Percentage
25.0
20.0
15.0
10.0
5.0
0.0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 74 Children eligible for free lunch One‐half of the region’s Counties have fewer children eligible for free lunch than other children in Indiana (38.9%). However, in St. Joseph County (45.2%) and Elkhart County (46.2%) over 45.0% of children are eligible for free lunch. Children eligible for free lunch serves as a proxy for poverty level; Elkhart County Health Department leadership identified poverty as a key factor impacting community‐
wide deficiency in access to health care. Table 17. Children eligible for free lunch % Free lunch Indiana 38.9 Elkhart 46.2 Kosciusko 37.6 LaGrange 35.3 Marshall 38.9 Noble 41.8 St. Joseph 45.2 Figure 17. Children eligible for free lunch Children Eligible for Free Lunch
50.0
Percentage
40.0
30.0
20.0
10.0
0.0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 75 Children in single parent households Compared to other children residing in Indiana (38.9%), fewer children live in single parent households in four of the region’s six counties (Elkhart County, Kosciusko County, LaGrange County, and Marshall County). In Noble County (34.5%) and St. Joseph County (35.6%), more than one‐third of children reside in single parent households. Table 18. Children in single parent households % Single parent households Indiana 32.8 Elkhart 32.6 Kosciusko 22.6 LaGrange 13.1 Marshall 22.0 Noble 34.5 St. Joseph 35.6 Figure 18. Children in single parent households Single Parent Households
40.0
35.0
Percentage
30.0
25.0
20.0
15.0
10.0
5.0
0.0
Indiana
Noble St. Joseph
Population morbidity Diabetes prevalence At least 9.3% of the populations for the six contiguous Counties have diabetes. For Indiana overall, diabetic prevalence is 10.5% of the population; Kosciusko County and LaGrange County experience higher prevalence (10.7% and 10.9%, respectively). Table 1. Diabetes prevalence % Diabetic Indiana 10.5 Elkhart 9.3 Kosciusko 10.7 LaGrange 10.9 Marshall 10.3 Noble 10.2 St. Joseph 9.5 Figure 1. Diabetes prevalence Diabetic Population
Percentage
15.0
10.0
5.0
0.0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 77 HIV prevalence All of the contiguous Counties have HIV prevalence rates lower than Indiana’s prevalence rate of 159 per 100,000 except for St. Joseph County (197 per 100,000). Table 2. HIV prevalence Rate per 100,000 Indiana 159 Elkhart 95 Kosciusko 55 LaGrange 22 Marshall 44 Noble 33 St. Joseph 197 FIgure 2. HIV prevalence HIV Prevalence
250
Rate per 100,000
200
150
100
50
0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 78 Poor or fair health At 17.8%, Kosciusko County residents had the highest proportion of residents reporting poor or fair health on a continuum of excellent, very good, good, fair, or poor; this percentage was higher than the Indiana overall response rate of 16.1% residents who reported poor or fair health. The five other counties of the region reported poor or fair health ranging from 11.2% (Marshall County) to 15.0% (Elkhart County). Table 3. Poor or fair health % Poor/fair health Indiana 16.1 Elkhart 15.0 Kosciusko 17.8 LaGrange 13.9 Marshall 11.2 Noble 14.8 St. Joseph 14.3 Figure 4. Poor or fair health Poor or Fair Health
20.0
Percentage
15.0
10.0
5.0
0.0
Indiana
Noble St. Joseph
Poor physical health days Elkhart, Kosciusko, LaGrange, Marshall and St. Joseph Counties reported a fewer average of poor physical health days compared with the Indiana average (3.6 average poor physical health days); Noble County reported the same average number (3.6) of poor physical health days as Indiana overall. Table 4. Poor physical health days Average physically unhealthy days Indiana 3.6 Elkhart 3.1 Kosciusko 3.2 LaGrange 3.0 Marshall 3.0 Noble 3.6 St. Joseph 3.5 Figure 4. Poor physical health days Poor Physical Health Days
4.0
3.5
Average
3.0
2.5
2.0
1.5
1.0
0.5
0.0
Indiana
Noble
St. Joseph
Poor mental health days Noble County averaged more poor mental health days (3.9) than Indiana residents overall (3.7). The five other contiguous Counties averaged from 3.1 (Marshall County) to 3.7 (LaGrange County) poor mental health days. Table 5. Poor mental health days Average mentally unhealthy days Indiana 3.7 Elkhart 3.6 Kosciusko 3.2 LaGrange 3.7 Marshall 3.1 Noble 3.9 St. Joseph 3.4 Figure 5. Poor mental health days Poor Mental Health Days
4.5
4.0
3.5
Average
3.0
2.5
2.0
1.5
1.0
0.5
0.0
Indiana
Noble
St. Joseph
Adult obesity Obesity is a key public health issue. Elkhart County (29.5%), Kosciusko County (30.8%), and St. Joseph County (28.7%) have lower proportions of obese adults than elsewhere in Indiana (31.4%). Marshall County has the same proportion (31.4%) of obese adults while LaGrange County (32.7%) and Noble County (33.9%) have greater proportions of obese adults than other Indiana citizens overall. Elkhart County Health Department officials cited obesity as a significant, community –wide area of concern. Table 6. Obesity % Obese Indiana 31.4 Elkhart 29.5 Kosciusko 30.8 LaGrange 32.7 Marshall 31.4 Noble 33.9 St. Joseph 28.7 Figure 6. Obesity Obese Adults
35.0
34.0
Percentage
33.0
32.0
31.0
30.0
29.0
28.0
27.0
26.0
Indiana
Noble St. Joseph
Sexually transmitted infections (chlamydia) With the exception of Elkhart County, all of the six contiguous counties have lower rates of sexually transmitted infections (chlamydia) than Indiana’s rate (427 per 100,000). Rates ranged from 96 per 100,000 (Marshall County) to 430 per 100,000 in Elkhart County, which is higher than the overall Indiana rate of 427 per 100,000. Table 7. Sexually transmitted infections (chlamydia) Chlamydia rate Indiana 427 Elkhart 430 Kosciusko 211 LaGrange 86 Marshall 96 Noble 196 St. Joseph 415 Figure 7. Sexually transmitted infections (chlamydia) Sexually Transmitted Infection Rate (Chlamydia)
Rate per 100,000
500
400
300
200
100
0
Indiana
Noble St. Joseph
Population mortality Premature death Premature death is a measure defined by the Centers for Disease Control (CDC) as”the number of….deaths occurring before a predetermined end point, set at age 65 years”.27 Indiana’s overall age‐
adjusted premature mortality (residents under the age of 65) rate is 382 per 100,000. All of the six contiguous counties had lower premature mortality, ranging from 292 per 100,000 (LaGrange County) to 373 per 100,000 (Noble County). Elkhart County experienced 326 premature deaths per 100,000. Table 1. Premature deaths Premature deaths per 100,000 Indiana 382 Elkhart 326 Kosciusko 359 LaGrange 292 Marshall 349 Noble 373 St. Joseph 369 Figure 1. Premature deaths Premature Deaths
450
400
Rate per 100,000
350
300
250
200
150
100
50
0
Indiana
Noble St. Joseph
Infant mortality Infant mortality is a priority public health issue. In these data, infant is defined as less than one year of age. The six contiguous counties are evenly split – three (Kosciusko County, LaGrange County, Marshall County) have lower rates than Indiana overall (7.7 per 1,000 live births) and three have higher rates (Elkhart County, Noble County, St. Joseph County). Elkhart County Health Department leadership have also recognized that infant mortality is an important community health problem. Table 2. Infant mortality Infant mortality rate Indiana 7.7 Elkhart 7.9 Kosciusko 6.3 LaGrange 6.5 Marshall 4.4 Noble 8.7 St. Joseph 8.5 Figure 2. Infant mortality Infant Mortality
Rate per 1,000 live births
10.0
8.0
6.0
4.0
2.0
0.0
Indiana
Noble St. Joseph
Child mortality In this data analysis, a child is defined as an individual between 1 and 18 years of age. LaGrange County (68.4 per 100,000) and St. Joseph County (70.9 per 100,000) have higher rates of child mortality than Indiana overall (63.6 per 100,000). Elkhart County and Marshall County have lower rates, while Kosciusko County has the lowest rate among the contiguous Counties at 51.1 per 1000,000. Table 3. Child mortality64
Child mortality per 100,000 Indiana 63.6 Elkhart 56.6 Kosciusko 51.1 LaGrange 68.4 Marshall 58.7 Noble 54.0 St. Joseph 70.9 Figure 4. Child mortality Child Mortality
80.0
Per 100,000
60.0
40.0
20.0
0.0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 86 Alcohol‐impaired driving deaths The proportion of driving deaths in which alcohol was a factor is more than ten percent higher in LaGrange County (38.9%) than in Indiana overall (26.2%); Kosciusko County (34.0%) and St. Joseph County (32.3%) also have higher proportions of alcohol‐impaired driving deaths. In Elkhart County (24.5%) and Noble County (23.3%) the rates are lower, while the rate in Marshall County (13.9%) is much lower than the Indiana rate. Table 4. Alcohol‐impaired driving deaths % Alcohol‐impaired driving deaths Indiana 26.2 Elkhart 25.4 Kosciusko 34.0 LaGrange 38.9 Marshall 13.9 Noble 23.3 St. Joseph 32.3 Figure 4. Alcohol‐impaired driving deaths Alcohol‐impaired Driving Deaths
45.0
40.0
Percentage
35.0
30.0
25.0
20.0
15.0
10.0
5.0
0.0
Indiana
Noble St. Joseph
Motor vehicle crash deaths LaGrange County (20 per 100,00) and Marshall County (21 per 100,000) have motor vehicle crash death rates over 1.5 times as high as Indiana’s rate (13 per 100,000) and Noble County’s rate is well over 1.25 times as high as the Indiana rate. Elkhart County (14 per 100,000) and Kosciusko County (15 per 100,000) also have rates higher than the Indiana rate of 13 per 100,000. St. Joseph County’s rate is far lower (9 per 100,000). Table 5. Motor vehicle crash death rate Motor vehicle crash mortality per 100,000 Indiana 13 Elkhart 14 Kosciusko 15 LaGrange 20 Marshall 21 Noble 19 St. Joseph 9 FIgure 5. Motor vehicle crash death rate Motor Vehicle Crash Deaths
25
Rate per 100,000
20
15
10
5
0
Indiana
Noble
St. Joseph
Drug poisoning deaths At 12 per 100,000 Indiana drug poisoning mortality is higher than all of the reported rates for the contiguous counties (Kosciusko County and Noble County, 10 per 100,000 each; Elkhart County, Marshall County, St. Joseph County, 8 per 100,000 each). No drug poisoning deaths were reported for LaGrange County. Table 5. Drug poisoning deaths Drug poisoning mortality per 100,000 Indiana 12 Elkhart 8 Kosciusko 10 LaGrange 0 Marshall 8 Noble 10 St. Joseph 8 Figure 5. Drug poisoning deaths Drug Poisoning Deaths
14
Rate per 100,000
12
10
8
6
4
2
0
Indiana
Noble
St. Joseph
Injury deaths The injury mortality rate is higher for Indiana (61 per 100,000) than for any of the six contiguous counties. Injury mortality rates ranged from 49 per 100,000 in LaGrange County to 60 per 100,000 in Marshall County. In Elkhart County, injury mortality was 51 per 100,000. Table 7. Injury deaths Injury mortality per 100,000 Indiana 61 Elkhart 51 Kosciusko 57 LaGrange 49 Marshall 60 Noble 55 St. Joseph 53 Figure 7. Injury deaths Injury Deaths
70
Rate per 100,000
60
50
40
30
20
10
0
Indiana
Noble
St. Joseph
Healthcare workforce and utilization Indiana’s ratio of population to primary care providers is 1539:1; with the exception of St. Joseph County (1170:1), the contiguous counties have fewer primary care workforce providers than Indiana overall. Alarmingly, the ratio of population per primary care provider is over twice as high in LaGrange County (3398:1). In the category of Other Primary Care Providers, inequity exists in each of the contiguous counties in relation to Indiana. (Other Primary Care Providers refer to nurse practitioners who have identified as working in primary care and physician assistants who are supervised by a primary care physician (e.g., physicians who specialize in family medicine, general practice, general pediatrics, general internal medicine, or pediatric internal medicine). The low number of available primary care providers was specified by Elkhart County Health Department leadership as a key factor negatively impacting community‐wide access to health care. For Indiana overall, the ratio of population per other primary care provider is 2045:1 but in LaGrange County, other primary care providers must provide care for over twice as many residents (4690:1) and in Noble County other primary care providers are obligated to provide care for more than five times as many residents (11896:1). Fewer disparities exist in regard to mental health providers; in Indiana overall the population to provider ratio is 890:1. St. Joseph County has more mental health providers (585:1) than Indiana in general. However, mental health providers in Marshall County must care for more than twice as many (1809:1) than Indiana overall; in Noble County, mental health providers provide care for nearly three times as many residents (2163:1); in LaGrange County, mental health providers are obligated to care for an astounding six times as many patients (5360:1). As with mental health providers, St. Joseph County has a more favorable ratio of population to dental provider (1800:1) than Indiana overall (2015:1). Dentists in LaGrange County and Noble County must provide dental care for over twice as many patients (4169:1 and 4326:1, respectively). Medically underserved areas (MUAs) are defined by the U.S. Department of Health and Human Services Health Resource Services Administration as an area is which the Index of Medical Underservice (IMU) score is 62.0 or less.1 The IMU score is comprised of four variables (ratio of primary care physicians per population, infant mortality rate, population below the poverty level, population aged 65 and over) which are summed in a weighted score. Elkhart County and St. Joseph County have the most extensive MUAs; Marshall County and Kosciusko County have lesser MUAs. In Elkhart County, MUAs are Data Analysis for Community Health Needs Assessment Page 91
found in Simonton Lake, Elkhart, Dunlap and Goshen. No MUAs are found in LaGrange County or Noble County. Data Analysis for Community Health Needs Assessment Page 92
Table 1. Primary care providers (PCP) ratio PCP ratio Indiana 1539:1 Elkhart 2094:1 Kosciusko 2417:1 LaGrange 3398:1 Marshall 1568:1 Noble 2797:1 St. Joseph 1170:1 Figure 1. Primary care providers (PCP) ratio Population:Primary Care Providers
4000
3500
Ratio:1
3000
2500
2000
1500
1000
500
0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 93 Table 2. Other primary care providers (PCP) ratio Other PCP ratio Indiana 2045:1 Elkhart 2979:1 Kosciusko 3696:1 LaGrange 4690:1 Marshall 2351:1 Noble 11896:1 St. Joseph 2316:1 FIgure 2. Other primary care providers (PCP) ratio Population:Other Primary Care Providers
12000
Ratio:1
10000
8000
6000
4000
2000
0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 94 Table 3. Mental health providers (MHP) ratio MHP ratio Indiana 890:1 Elkhart 1134:1 Kosciusko 946:1 LaGrange 5360:1 Marshall 1809:1 Noble 2163:1 St. Joseph 585:1 Figure 3. Mental health providers (MHP) ratio Population:Mental Health Providers
6000
5000
Ratio:1
4000
3000
2000
1000
0
Indiana
Noble St. Joseph
Table 4. Dental providers ratio Dentist ratio Indiana 2015:1 Elkhart 3025:1 Kosciusko 3374:1 LaGrange 4169:1 Marshall 2612:1 Noble 4326:1 St. Joseph 1800:1 Figure 4. Dental providers ratio Population:Dentists
4500
4000
3500
Ratio:1
3000
2500
2000
1500
1000
500
0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 96 County Adams Allen Bartholomew Benton Blackford Boone Brown Carroll Cass Clark Clay Clinton Crawford Daviess Dearborn Decatur DeKalb Delaware Dubois Elkhart Fayette Floyd Fountain Franklin Fulton Gibson Grant Greene Hamilton Hancock Harrison Hendricks Henry Howard Huntington Jackson Jasper Jay Jefferson Primary care provider (2013) 4194 3365 2311 99999 1502 2463 4763 99999 2706 2439 4337 5191 5357 2261 2453 3900 3060 2236 2793 3605 2583 2537 5747 3981 3064 2327 5743 6142 1972 1966 2642 2570 2524 2079 5801 3473 3282 5313 27023 Population per Dentist (2012) 3821 2820 2793 4427 4255 2517 15242 999999 10391 3105 10756 3797 999999 4521 5133 3960 7037 2674 2889 4760 4414 1530 8620 6596 3473 3191 4379 3790 2053 4179 3280 2838 5819 2031 4790 4985 3826 7084 2316 Mental health provider (2012) 3355 1223 1356 5903 6383 3739 2651 10078 1325 1972 3841 4259 10713 4396 818 8445 4371 924 1499 1595 3237 1705 2463 7104 2977 8376 887 3015 1196 2276 4374 2010 2910 1146 2459 2779 2575 2725 1031 Data Analysis for Community Health Needs Assessment Page 97 County Jennings Johnson Knox Kosciusko LaGrange Lake LaPorte Lawrence Madison Marion Marshall Martin Miami Monroe Montgomery Morgan Newton Noble Ohio Orange Owen Parke Perry Pike Porter Posey Pulaski Putnam Randolph Ripley Rush Scott Shelby Spencer St. Joseph Starke Steuben Sullivan Switzerland Primary care provider (2013) 3396 3945 3626 3197 5157 2777 3337 5626 2254 1861 2673 3229 4500 3089 2444 6263 14244 4170 30640 4724 107875 2281 5089 4282 3010 5182 3942 3013 5234 1779 2805 4836 3366 4029 2691 2485 4070 3579 99999 Population per Dentist (2012) 8150 2551 3343 4688 3075 6751 2975 3618 2992 2065 3302 10334 3690 2746 3389 3204 14244 5942 6128 4668 10788 6936 6446 6423 2922 7403 7658 6327 13086 4803 5351 4030 4232 6984 2696 18690 4273 3068 10613 Mental health provider (2012) 3169 1725 1216 1898 2884 477 2355 3456 1515 662 1390 5905 3433 777 2148 3959 999999 3978 999999 4724 7192 2709 2763 4282 1420 25910 4124 2966 4362 4269 2399 8060 3555 2205 1077 4172 2671 2045 999999 Data Analysis for Community Health Needs Assessment Page 98
County Tippecanoe Tipton Union Vanderburgh Vermillion Vigo Wabash Warren Warrick Washington Wayne Wells White Whitley Primary care provider (2013) 5142 3320 37580 2340 3002 2532 3426 8508 1756 3819 2267 3948 5357 3783 Population per Dentist (2012) 3045 4250 7516 2558 5404 3126 5720 8508 3101 9421 3403 6909 4481 5549 Mental health provider (2012) 1409 15936 999999 805 4053 1031 1624 8508 2318 4915 980 3158 5188 3111 Data Analysis for Community Health Needs Assessment Page 99 Data Analysis for Community Health Needs Assessment Page 100 Data Analysis for Community Health Needs Assessment Page 101
Data Analysis for Community Health Needs Assessment Page 102 Data Analysis for Community Health Needs Assessment Page 103
Preventable hospital stays Preventable hospital stays related to ambulatory care‐sensitive conditions include: convulsions, chronic obstructive pulmonary disease, bacterial pneumonia, asthma, congestive heart failure, hypertension, angina, cellulitis, gastroenteritis, kidney/urinary infection and dehydration.6 This measure is calculated as the hospital discharge rate for ambulatory care‐sensitive conditions per 1,000 Medicare enrollees. Marshall County’s stay rate (50 per 1,000) is far lower than Indiana’s stay rate (76 per 1,000) while Noble County’s stay rate is far higher (90 per 1,000). Elkhart County’s stay rate is 73 per 1,000. Table 5. Preventable hospital stays Preventable hospitalizations per 1,000 Indiana 76 Elkhart 73 Kosciusko 76 LaGrange 57 Marshall 50 Noble 97 St. Joseph 56 Figure 5. Preventable hospital stays Preventable Hospital Stays
120
Rate per 1,000
100
80
60
40
20
0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 106 Diabetic screening Except for St. Joseph County (83.4%), the percentage of Medicare enrollees who receive HbA1c monitoring is higher in all of six contiguous counties than the proportion of Indiana Medicare enrollees (83.8%). In Elkhart County, 87.0% received appropriate diabetic screening. Table 6. Diabetic screening % Medicare enrollees receiving diabetic screening Indiana 83.8 Elkhart 87.0 Kosciusko 85.1 LaGrange 86.3 Marshall 83.9 Noble 87.8 St. Joseph 83.4 Figure 6. Diabetic screening Diabetic Screening
89.0
88.0
Percentage
87.0
86.0
85.0
84.0
83.0
82.0
81.0
Indiana
Noble St. Joseph
Breast cancer screening The proportion of Indiana female Medicare enrollees who received a mammogram to screen for breast cancer was 61.3%. The proportion was lower in each county with the exception of St. Joseph County, where the rate was slightly higher at 61.5%. Just over sixty percent (60.9%) of Elkhart County Medicare enrollees received breast cancer screening. Table 7. Breast cancer screening % female Medicare enrollees receiving breast cancer screening Indiana 61.3 Elkhart 60.9 Kosciusko 58.8 LaGrange 58.1 Marshall 51.4 Noble 51.3 St. Joseph 61.5 Figure 7. Breast cancer screening Breast Cancer Screening
70.0
60.0
Percentage
50.0
40.0
30.0
20.0
10.0
0.0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 108 Healthcare costs Healthcare costs as measured by spending per Medicare enrollee was lower in each of the six contiguous counties than in Indiana overall ($9,901 per Medicare enrollee). Healthcare costs were $9,011 in Elkhart County. Table 8. Healthcare costs Medicare spending per enrollee Indiana $9,901 Elkhart $9,011 Kosciusko $9,146 LaGrange $8,155 Marshall $8,795 Noble $8,830 St. Joseph $8,920 Figure 8. Healthcare costs Medicare Spending per Enrollee
$12,000
$10,000
Dollars
$8,000
$6,000
$4,000
$2,000
$0
Indiana
Noble St. Joseph
Could not see doctor due to cost In both Elkhart County and Noble County, increased proportions of residents were unable to see a physician due to cost (15.6% and 14.9%, respectively) in relation to Indiana overall (14.4%). Only 10.5% of Kosciusko County residents were unable to see a physician because of cost. Being unable to see a physician due to cost is a measure of ability to access health care; access to care was a fundamental community‐wide concern identified by Elkhart County Health Department leadership Table 9. Could not see doctor due to cost % Unable to see MD due to cost Indiana 14.4 Elkhart 15.6 Kosciusko 10.5 LaGrange 12.9 Marshall 12.7 Noble 14.9 St. Joseph 13.7 FIgure 9. Could not see doctor due to cost Could Not See Doctor Due to Cost
18.0
16.0
Percentage
14.0
12.0
10.0
8.0
6.0
4.0
2.0
0.0
Indiana
Noble St. Joseph
Social/environmental factors affecting health Adult smoking Smoking in Indiana remains a serious problem; 22.8% of adult Hoosiers are current smokers.6 With the exception of Noble County, where over one‐quarter (26.7%) of adults are current smokers, each of the other five contiguous counties has a lower proportion of current adult smokers. Just over one‐fifth (20.1%) of Elkhart County adults currently smoke. Tobacco use was also identified by Elkhart County Health Department leadership as a major problem of concern. Table 1. Smoking % Adult smokers Indiana 22.8 Elkhart 20.1 Kosciusko 21.9 LaGrange 19.3 Marshall 21.0 Noble 26.7 St. Joseph 20.8 Figure 1. Smoking Adult Smokers
30.0
Percentage
25.0
20.0
15.0
10.0
5.0
0.0
Indiana
Noble St. Joseph
Physical inactivity High rates of physical inactivity are linked to increased obesity, a major health problem in Indiana.6 All of the six contiguous Counties have lower proportions of physically active residents than Indiana overall, where less than one‐third (27.9%) are physically active. In Elkhart County, 26.9% residents are physically inactive. Elkhart County Health Department leadership cited inadequate exercise for community residents as a key area of concern. Table 2. Physical inactivity % Physically inactive Indiana 27.9 Elkhart 26.9 Kosciusko 26.3 LaGrange 25.1 Marshall 29.1 Noble 25.2 St. Joseph 26.2 Figure 2. Physical inactivity Physical Inactivity
30.0
Percentage
25.0
20.0
15.0
10.0
5.0
0.0
Indiana
Noble St. Joseph
Excessive drinking St. Joseph County is the only county with an increased proportion (19.1%) of residents who drink excessively in comparison with Indiana in general (15.9%). Only 10.3% of Elkhart County residents engage in excessive drinking. Table 3. Excessive drinking % Excessive drinking Indiana 15.9 Elkhart 10.3 Kosciusko 11.8 LaGrange 11.5 Marshall 11.1 Noble 15.6 St. Joseph 19.1 Figure 3. Excessive drinking Excessive Drinking
25.0
Percentage
20.0
15.0
10.0
5.0
0.0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 113 Access to exercise opportunities The six contiguous counties provide extreme representations of differences in access to exercise opportunities compared with Indiana (63.9% having access). In St. Joseph County, 78.1% have access to exercise opportunities while in LaGrange County, a mere 9.4% of residents have access to exercise opportunities. Over one‐half of Elkhart County residents have access to exercise opportunities. Elkhart County Health Department officials cited inadequate exercise for community residents as a significant area of concern. Table 4. Access to exercise opportunities % Having access Indiana 63.9 Elkhart 56.0 Kosciusko 47.8 LaGrange 9.4 Marshall 48.5 Noble 31.4 St. Joseph 78.1 Figure 4. Access to exercise opportunities Access to Exercise Opportunities
90.0
80.0
Percentage
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0
Indiana
Noble St. Joseph
Food insecurity Except for St. Joseph County (16.5%), the other five counties have lower proportions of residents who experience food insecurity in comparison with Indiana residents in general (16.3%). In Kosciusko County, 12.2% of the population was food insecure. Over fifteen percent (15.9%) of Elkhart County residents suffered food insecurity. Table 5. Food insecurity % Food insecure Indiana 16.3 Elkhart 15.9 Kosciusko 12.2 LaGrange 13.6 Marshall 13.5 Noble 13.6 St. Joseph 16.5 Figure 5. Food insecurity Food Insecurity
20.0
Percentage
15.0
10.0
5.0
0.0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 115 Limited access to healthy foods The six counties have extremes of limited access to healthy foods when compared to Indiana (6.3%). Nearly ten percent (9.2%) of St. Joseph County residents have limited access to healthy foods, while less than one percent (0.5%) of LaGrange County experience limited access to healthy foods. In Elkhart County, 5.8% of the population has limited access to healthy foods. Table 6. Limited access to healthy foods % Having limited access Indiana 6.3 Elkhart 5.8 Kosciusko 7.1 LaGrange 0.5 Marshall 4.4 Noble 3.1 St. Joseph 9.2 Figure 6. Limited access to healthy foods Limited Access to Healthy Foods
10.0
Percentage
8.0
6.0
4.0
2.0
0.0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 116 Inadequate social/emotional support Noble County (23.3%) and Elkhart County (21.0%) have higher percentages of their populations who feel that they lack adequate social/emotional support compared to 20.1% of residents in general statewide. Within the six contiguous counties, the population having the highest level of social/emotional support is Marshall County; only 17.6% report inadequate support. Table 7. Inadequate social/emotional support % Having inadequate support Indiana 20.1 Elkhart 21.0 Kosciusko 18.6 LaGrange 18.2 Marshall 17.6 Noble 23.3 St. Joseph 19.7 Figure 7. Inadequate social/emotional support Inadequate Social/Emotional Support
25.0
Percentage
20.0
15.0
10.0
5.0
0.0
Indiana
Noble St. Joseph
Severe housing problems Two counties – Elkhart County (14.4%) and LaGrange County (14.2%) have residents with higher proportions of severe housing problems (e.g., inadequate kitchen or bathroom facilities6) compared with 13.6% of Indiana residents. Marshall County has the least percentage of severe housing problems (11.1%). Table 8. Severe housing problems % Having severe housing problems Indiana 13.6 Elkhart 14.4 Kosciusko 11.6 LaGrange 14.2 Marshall 11.1 Noble 11.3 St. Joseph 13.6 Figure 9. Severe housing problems Severe Housing Problems
20.0
Percentage
15.0
10.0
5.0
0.0
Indiana
Noble St. Joseph
Driving alone to work Residents of all the six contiguous counties report lesser prevalence of driving to work alone when compared to 82.9% of residents who drive alone to work statewide. Eighty percent (80.0%) of Elkhart County’s population drive to work alone. Table 9. Driving alone to work % Driving alone Indiana 82.9 Elkhart 80.0 Kosciusko 80.2 LaGrange 53.0 Marshall 79.8 Noble 79.7 St. Joseph 82.4 Figure 9. Driving alone to work Driving Alone to Work
100.0
Percentage
80.0
60.0
40.0
20.0
0.0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 119 Long commute (driving alone) Given the rurality of the six county region, it is somewhat surprising that less Indiana residents overall (29.8%) report long commutes while driving alone than throughout Indiana. Only in Noble County does a higher proportion (32.9%) of residents make a long commute while driving alone than in Indiana overall. Perhaps unsurprisingly given their status as metropolitan statistical areas 2 4, Elkhart County (20.3%) and St. Joseph County (19.8%) report the lowest percentages of residents making long commutes while driving alone. Table 10. Long commute (driving alone) % Long commute (driving alone) Indiana 29.8 Elkhart 20.3 Kosciusko 20.1 LaGrange 29.7 Marshall 28.4 Noble 32.9 St. Joseph 19.8 Figure 10. Long Commute ‐ Driving Alone
35.0
30.0
Percentage
25.0
20.0
15.0
10.0
5.0
0.0
Indiana
Noble St. Joseph
Air pollution (particulate matter) Although all counties show less particulate matter than the Indiana PM2.5 average of13.5 daily, the levels of air pollution as measured by particulate matter average (PM2.5) are nearly identical for all of the counties. The average daily PM2.5 level in Elkhart County is 13.1. Table 11. Air pollution (particulate matter) Average daily PM2.5 Indiana 13.5 Elkhart 13.1 Kosciusko 13.2 LaGrange 13.0 Marshall 13.2 Noble 13.1 St. Joseph 13.1 Figure 11. Air pollution (particulate matter) Air Pollution (particulate matter)
Particulate Matte Average
15.0
10.0
5.0
0.0
Indiana
Noble St. Joseph
Data Analysis for Community Health Needs Assessment Page 121 Controlled substances dispensed Of opioids, CNS depressants, stimulants and other drugs classified as controlled substances dispensed across Indiana and in each of the six contiguous counties, opioids were the most commonly dispensed controlled substance. Table 12. Controlled substances dispensed % % CNS % Opioids Depressants Stimulants Indiana 50.4 29.8 14.8 Elkhart 46.5 26.2 23.5 Kosciusko 53.9 25.6 13.5 LaGrange 53.9 28.2 12.5 Marshall 47.9 29.1 18.8 Noble 54.4 29.2 11.7 St. Joseph 46.9 29.0 19.8 % Other 5.0 3.8 6.9 5.4 4.3 4.8 4.3 Total # 12,735,878
323,978
126,990
35,872
85,789
82,207
475,880
Figure 12. Controlled substances dispensed Controlled Substances Dispensed
60.0
50.0
Percentage
40.0
Opioids
CNS Depressants
30.0
Stimulants
Other
20.0
10.0
0.0
Indiana
Noble St. Joseph
Substance treatment admissions Data regarding substance abuse treatment admissions refers to the county in which treatment was received and does not necessarily reflect the residential county of the patient. Therefore, it is possible that these admissions reflect capacity of each county to treat substance abuse rather than the level of substance abuse per county. St. Joseph County had the same rate of substance abuse treatment admissions as did Indiana overall, 5.8 per 1,000. Elkhart County had the second lowest rate of treatment episodes at 3.6 per 1,000 while Kosciusko County had the lowest rate of treatment episodes (3.5 per 1,000). Table 13. Substance abuse treatment admissions Treatment episodes per 1,000 Indiana 5.8 Elkhart 3.6 Kosciusko 3.5 LaGrange 4.4 Marshall 4.8 Noble 4.6 St. Joseph 5.8 Figure 13. Substance abuse treatment admissions Substance Abuse Treatment Admissions
7.0
Rate per 1,000
6.0
5.0
4.0
3.0
2.0
1.0
0.0
Indiana
Noble
St. Joseph
Cluster analysis of polysubstance abuse Of residents treated for polysubstance abuse, Elkhart County had the highest proportion of individuals treated for marijuana/heroin abuse (8.7%), marijuana/methamphetamine abuse (14.3%) and marijuana/opiates‐synthetics (17.9%). Treatment for alcohol/cocaine abuse was most common in St. Joseph County (25.6%). Kosciusko County had the highest proportions of residents treated for alcohol/marijuana (38.9%) and alcohol/marijuana/cocaine (13.8%) abuse, while Marshall County treated more residents for alcohol/marijuana/other drug abuse (29.9%). Noble County treated more individuals for alcohol/other drug abuse (32.1%). The highest percentage of residents abusing heroin/methamphetamine was in St. Joseph County (13.5%); heroin/opiates‐synthetics (16.2%) and heroin/various other drugs (13.8%) were most commonly abused in Kosciusko County. More Marshall County residents were treated for marijuana/methamphetamine/heroin abuse (12.7%) while over one‐
quarter (29.8%) of Noble County polysubstance abusers were treated for marijuana/methamphetamine/other drug. The marijuana/other drug polysubstance combination was seen most frequently in LaGrange County residents (17.4%). (Aggregate data for Indiana are unavailable for this metric.) Data Analysis for Community Health Needs Assessment Page 124 Table 14. Polysubstance abuse by county Elkhart Alcohol/marijuana Marijuana/opiates‐synthetics Marijuana/methamphetamine Alcohol/marijuana/cocaine Marijuana/other drug Marijuana/heroin Kosciusko Alcohol/marijuana Alcohol/other drug Alcohol/marijuana/other drug Marijuana/other drug LaGrange Alcohol/marijuana/other drug Alcohol/other drug Alcohol/marijuana/methamphetamine Marshall Alcohol/marijuana Alcohol/marijuana/other drug Alcohol/other drug Marijuana/methamphetamine/heroin Noble Alcohol/marijuana Alcohol/other drug Marijuana/methamphetamine/other drug St. Joseph Alcohol/marijuana Alcohol/cocaine Cocaine/marijuana Marijuana/opiates‐synthetics Heroin/methamphetamine N 115 60 48 43 40 29 N 69 54 48 36 N 51 41 40 N 52 47 38 20 N 64 54 50 N 295 245 144 143 129 % 34.3 17.9 14.3 12.8 11.9 8.7 % 33.3 26.1 23.2 17.4 % 38.6 31.1 30.3 % 33.1 29.9 24.2 12.7 % 38.1 32.1 29.8 % 30.9 25.6 15.1 15.0 13.5 Data Analysis for Community Health Needs Assessment Page 125 Elkhart
Kosciusko
LaGrange
Marshall
0
Noble
Data Analysis for Community Health Needs Assessment Heroin/methamphetamine
Marijuana/opiates‐synthetics
Cocaine/marijuana
Alcohol/cocaine
Alcohol/marijuana
Marijuana/methamphetamine/other…
Alcohol/other drug
Alcohol/marijuana
Marijuana/methamphetamine/heroin
Alcohol/other drug
Alcohol/marijuana/other drug
Alcohol/marijuana
Alcohol/marijuana/methamphetamine
Alcohol/other drug
Marijuana/other drug
Alcohol/other drug
Alcohol/marijuana
Marijuana/heroin
Marijuana/other drug
Alcohol/marijuana/cocaine
Marijuana/methamphetamine
Marijuana/opiates‐synthetics
Alcohol/marijuana
Percentage
Figure 14. Polysubstance abuse by county Polysubstance Abuse by County
45
40
35
30
25
20
15
10
5
St. Joseph
Page 126 Arrests for driving under the influence (DUI), public intoxication (PI), liquor law violations (LLV) Regarding arrests for DUI, Kosciusko County had by far the highest rate at 7.7 per 1,000 – this was more than double the Indiana rate (3.6 per 1,000). Marshall County’s 2.4 per 1,000 rate for PI slightly exceeded the Indiana rate (2.3 per 1,000). Marshall County also had the highest rate (3.6 per 1,000) for liquor law violations; this was over 1.5 times the Indiana rate of 2.0 per 1,000. Table 15. DUI, PI, LLV arrests DUI per PI per 1,000 1,000 Indiana 3.6 2.3 Elkhart 3.4 0.8 Kosciusko 7.7 1.3 LaGrange 2.5 0.2 Marshall 6.5 2.4 Noble 3.7 1.4 St. Joseph 2.4 0.4 LLV per 1,000 2.0 1.4 1.9 2.6 3.6 2.9 1.2 Total of alcohol arrests per 1,000 7.9 5.6 10.9 5.3 12.5 8.0 4.0 Figure 15. DUI, PI, LLV arrests DUI*, PI*, LLV* Arrests
10.0
Rate per 1,000
8.0
6.0
4.0
2.0
0.0
Indiana
Elkhart
Kosciusko
LaGrange
Marshall
Noble
St. Joseph
DUI
3.6
3.4
7.7
2.5
6.5
3.7
2.4
PI
2.3
0.8
1.3
0.2
2.4
1.4
0.4
LLV
2.0
1.4
1.9
2.6
3.6
2.9
1.2
Arrests for possession and sale/manufacture of marijuana Arrests for possession and sale/manufacture of cocaine/opiates Arrests for possession and sale/manufacture of synthetic drugs Arrests for possession and sale/manufacture of other drugs (including barbiturates/Benzedrine) The highest rate for possession of marijuana was in Marshall County (2.9 per 1,000); this was higher than the Indiana rate of 1.7 per 1,000. Arrests for sale/manufacture of marijuana were negligible throughout Indiana. Arrests for possession and sale/manufacture of other drug classes (i.e., cocaine/opiates) were negligible throughout Indiana for 2012 (most recent year reported in the Federal Bureau of Investigation’s Uniform Crime Reports data).23 Table 16. Marijuana arrests Possession Sale per 1,000 per 1,00 Indiana 1.7 0.3 Elkhart 1.5 0.0 Kosciusko 1.9 0.5 LaGrange 1.2 0.1 Marshall 2.9 0.0 Noble 1.8 0.2 St. Joseph 1.7 0.1 Table 17. Cocaine/opiates arrests Sale Possession per 1,000 per 1,000 Indiana 0.2 0.2 Elkhart 0.2 0.3 Kosciusko 0.3 0.2 LaGrange 0.3 1.9 Marshall 0.7 0.4 Noble 0.2 0.2 St. Joseph 0.2 0.1 Data Analysis for Community Health Needs Assessment Page 128
Table 18. Synthetic drugs arrests Sale Possession rate rate Indiana 0.3 0.1 Elkhart 0.1 0.0 Kosciusko 0.4 0.3 LaGrange 0.2 0.1 Marshall 1.4 0.2 Noble 0.6 0.2 St. Joseph 0.3 0.0 Table 19. Other drugs arrests Possession Sale rate rate Indiana 0.4 0.2 Elkhart 0.1 0.0 Kosciusko 0.5 0.4 LaGrange 0.1 0.0 Marshall 0.6 0.2 Noble 0.5 0.1 St. Joseph 0.3 0.0 Data Analysis for Community Health Needs Assessment Page 129 Violent crime St. Joseph County had a higher rate for violent crime (393 per 100,000) than Indiana as a whole (329 per 100,000). LaGrange County had one‐tenth the violent crime rate of St. Joseph County (40 per 100,000); this was also the lowest rate of violent crime among the six contiguous counties. Elkhart County’s violent crime rate is 124 per 100,000. Table 21. Violent crime Violent crime per 100,000 Indiana 329 Elkhart 124 Kosciusko 64 LaGrange 40 Marshall 80 Noble 53 St. Joseph 393 Figure 21. Violent crime Violent Crime
400
Rate per 100,000
350
300
250
200
150
100
50
0
Indiana
Noble St. Joseph
Homicide Mirroring the violent crime rate, St. Joseph County had a higher homicide rate (6 per 100,000) than Indiana as a whole (5 per 100,000). The only other of the six contiguous counties reporting homicide was Elkhart County (3 per 100,000). Table 22. Homicide Homicides per 100,000 Indiana 5 Elkhart 3 Kosciusko 0 LaGrange 0 Marshall 0 Noble 0 St. Joseph 6 Figure 22. Homicide Homicide
10
Rate per 100,000
8
6
4
2
0
Indiana
Noble
St. Joseph
Summary To understand what their service catchment area population believes are the most pressing healthcare needs within their community, IU Health Goshen collected data by administering a ten item (including three optional demographic data points) survey identical to the survey previously used to gather data for the 2012 Community Health Needs Assessment (see Appendix C). The survey was administered online and paper surveys were mailed. More than three times (n=464) surveys were returned online compared to surveys that were mailed (n=150). Fourteen (14) records were excluded from the original dataset because responses to the question regarding residential county was left blank or was invalid. The final dataset for analysis consisted of 600 records. The most common residential county for respondents was Elkhart County (n=559, 93.2%), while 42.1% (n=252) of respondents listed 46526 as their home zip code. The four Amish respondents who included their zip code noted residing in 46517, 46528 and 46550. Sixty percent (n=9, 60%) of the 15 Hispanic/Latino respondents recorded their zip code as 46526 while remainder resided in 46517, 46528, 46550 and 46567. The majority (n=401, 72.4%) of respondents were 50 years of age or older. More elderly respondents were seen among the Amish (n=17, 65.4%) while nearly three‐quarters (n=24, 72.7%) of Hispanic/Latino respondents were under age 50. Nearly two‐thirds (65.4%) of respondents identified as having European heritage (Western European, n=195, 53.1%; Eastern European, n=45, 12.3%). Less than ten percent of respondents identified as Hispanic/Latino (n=34, 9.3%) and 27 individuals (7.4%) identified as Amish. The greatest amount of diversity in heritage was seen in Elkhart County. Sixty‐two percent (n=318, 62.35%) of survey respondents reported household income of less than $50,000. More Amish respondents reported earning less than $50,000 (n=17, 65.3%) as did slightly more Hispanic/Latino respondents (n=21, 63.6%). Slightly over 85% (n=506, 85.1%) of respondents ranked their personal health status as very healthy or somewhat healthy and more than sixty percent (n=336, 61.7%) ranked the health of their overall community as very healthy or somewhat healthy. Fewer Amish residents reported their personal health status as very healthy or somewhat healthy (n=21, 77.7%) while over 90% of Hispanic/Latino residents claimed very healthy or somewhat healthy personal health status. In contrast to personal health status, more Amish respondents (n=23, 88.4%) felt that the health of their community was very healthy or somewhat healthy while 58.8% (n=20) of Hispanic/Latino residents believed that their community health status was very healthy or somewhat healthy. Data Analysis for Community Health Needs Assessment Page 132 The five greatest community‐level health needs identified by respondents were: (1) obesity/exercise/healthy eating; (2) access to health services; (3) treatment of chronic diseases; (4) mental health/addictions/depression; and (5) poverty. Less than one‐half (n=223, 39.3%) of respondents agreed that there are enough community programs to address these needs. Interestingly, the rankings for greatest community health needs differed among Amish and Hispanic/Latino residents. Amish residents ranked health needs thusly: (1) obesity/exercise/healthy eating; (2) treatment of chronic diseases; (3) access to health services; (4) injuries/safety and mental health/addictions/depression (tie); (5) health literacy. Hispanic/Latino residents prioritized health needs thusly: (1)
obesity/exercise/healthy eating; (2) mental health/addictions/depression; (3) access to health services;
(4) health literacy and poverty and tobacco use/smoking (tie); (5) treatment of chronic diseases and
injuries/safety and other (tie).
To gain a public health‐oriented view of community health needs, IU Health Goshen requested input from the Elkhart County Health Department (ECHD). The ECHD Health Officer reported that health department leadership cited the following as priority health concerns (in no particular order): access to healthcare (including mental health services); tobacco use; obesity, poor diet and inadequate exercise; Infant mortality. These concerns echo the priority health issues identified by community survey respondents: obesity/exercise/healthy eating and access to health services were the two highest‐
ranked priority needs and mental health/addictions/depression was ranked fourth. Tobacco use was ranked as a top five priority health issue only by respondents identifying as Hispanic/Latino. Perhaps because the survey did not list infant mortality as one of the forced choices among community health needs to be ranked, it was not identified as a priority concern among respondents. Elkhart County Health personnel did note that the Indiana State Department of Health has identified infant mortality as a health outcome of primary concern. Sixty percent (n=344, 60.9%) of regional residents did not believe that there are enough programs within their communities to address the needs identified above. The proportions of individuals who felt there is sufficient programming were nearly opposite for Amish respondents and Hispanic/Latino respondents. One‐third (n=8, 33.3%) of Amish respondents did not feel that there is sufficient programming available to address health needs, while 71.9% (n=23) of Hispanic/Latinos believed that programming to address health needs is insufficient. Data Analysis for Community Health Needs Assessment Page 133
Survey respondents’ positive perception of personal and community health are borne out by secondary data. Of the 14 morbidity and mortality measures examined from secondary data sources, Elkhart County performs better than Indiana overall in all but three measures (sexually transmitted infection rate, infant mortality and motor vehicle crash mortality rate). Respondents ranked access to health services as their #2‐level concern and US Department of Health and Human Services Health Resources and Services Administration (HRSA) data confirm respondents’ perception that healthcare access is problematic in the six‐county region. Medically Underserved Areas/Populations (MUAs/MUPs) are areas or populations designated by the HRSA as having too few primary care providers, high infant mortality, high poverty or a high elderly population.1 The HRSA also defines shortage areas specific to primary care (HPSAs) and mental health providers (MPSAs) based upon geography (county or service area), population (e.g., low income) or facility (e.g., federally qualified health center); areas which suffer shortages of dental providers are designated as DPSAs.2 According to HRSA data, the Goshen service area in Elkhart County is a designated medically underserved area (MUA) based upon income and geography.1 In addition, all of Elkhart County is a HRSA‐designated primary medical care health professional shortage area (HPSA)2 and a mental health provider shortage area (MPSA).2 Northwest Elkhart County (census tracts 16.01, 16.02, 17.01, 17.02, 19.01, 19.02, 21.01, 21.02, 22‐24, 26, 27, 29) is a designated DPSA.2 In Kosciusko County, the Warsaw service area is a low income‐designated MUP as is the Mishawaka service area in St. Joseph County.2 The Plymouth service area in Marshall County and the St. Joseph service area in St. Joseph County are MUA‐
designated areas.2 LaGrange County and Noble County have no medically underserved areas or populations.2 All of LaGrange County and Noble County and the South Bend service area in St. Joseph County are primary care shortage areas (HPSAs); no HPSAs are found in Kosciusko County or Marshall County.2 Mental health provider shortage areas (MPSAs) exist county‐wide in Kosciusko County, LaGrange County, Marshall County, Noble County and St. Joseph County.2 LaGrange County and St. Joseph County also suffer from shortages in dental providers (DPSAs); Kosciusko County, Marshall County and Noble County have no DPSA designations.2
St. Joseph County and Elkhart County are the fifth and sixth most populous Indiana counties (respectively) and as such their demographic characteristics differ from their contiguous counties which are considerably less populated.7 The region comprised of Kosciusko County, LaGrange County, Marshall County and Noble County is markedly less racially and ethnically diverse than Elkhart County and St. Joseph County as well as Indiana overall.8 As a whole, Elkhart County and the other contiguous counties Data Analysis for Community Health Needs Assessment Page 134 have lower populations of individuals aged 18 or less than found throughout Indiana. Except for Elkhart County and St. Joseph County, the region is decidedly more rural than found elsewhere in Indiana.9 This high degree of rurality is undoubtedly reflected in respondents ranking access to health services as their #2‐ranked concern. Teenaged maternity is a risk factor for low birth weight births4 and although Elkhart County has a far higher teen birth rate (55.2 per 1,000) than Indiana (40.2 per 1,000), the percentage of low birth weight births is still lower (7.3%) than Indiana’s percentage of low birth weight births (8.3%). All of the counties included in this report have higher proportions of uninsured children and adults than in Indiana overall (8.3% and 20.0%, respectively); over one‐tenth (11.2%) of Elkhart’s children were uninsured and over one‐quarter (25.9%) of adults were uninsured in Elkhart County.10 (Data related to insurance status are from 2011 and may not accurately reflect changes made as a result of enactment of the Patient Care and Patient Protection and Affordable Care Act.) Lack of insurance coverage is a likely factor in residents ranking access to health services as their #2‐ranked concern. Regarding education, with the exception of St. Joseph County, all of the neighboring counties including Elkhart County have lower rates of high school graduation and fewer residents who have attained at least some post‐
secondary education than found throughout Indiana. Elkhart County’s population not proficient in English (3.9%) is more than double that of Indiana state wide (1.6%). Marshall County (2.5%) and Noble County (2.6%) also have fewer residents proficient in English than other Indiana counties. Two‐thirds of the contiguous counties experience higher rates of unemployment compared with Indiana (8.4%) as a whole; Elkhart County’s (9.6%) and St. Joseph County’s (9.7%) rates were a full percentage point higher. Elkhart County’s median household income ($45,806) is higher than Noble County’s ($44,192) and St. Joseph County’s ($45,248) median household income. However Elkhart County’s median household income is lower than LaGrange County’s ($47,870) and Kosciusko County’s ($50,153) median household income, both of which were higher than the State median household income ($46,954). Despite having more children and adults without insurance, decreased rates of education, lower rates of English proficiency and reduced income, fewer children live in poverty in the six county region than in Indiana overall (22.1%) including slightly less in Elkhart County (21.2%). Conversely, at least the same percentage or more children are eligible for free school lunches in two‐thirds of these counties than elsewhere in Indiana (38.9%); Elkhart County has the highest proportion (46.2%). St. Joseph County (35.6%) is the sole county of the neighboring counties to have a higher percentage of children living in single parent households than throughout Indiana (32.8%); Elkhart County has a slightly lower proportion (32.6%). (See pp. 15 ‐ 32 for details.) Data Analysis for Community Health Needs Assessment Page 135
Regarding morbidity, diabetes prevalence in the six county region is very close to prevalence throughout Indiana (10.5%); Elkhart County (9.3%) and St. Joseph County (9.5%) have lower prevalence rates. St. Joseph County’s HIV prevalence rate (197 per 100,000) exceeds the state wide rate (159 per 100,000); all of the other counties have lower rates, including Elkhart County (95 per 100,000). The high rate of HIV prevalence in St. Joseph County may contribute to primary data showing treatment of chronic disease as the #3‐ranked health concern for survey respondents. Except for Kosciusko County (17.8%), when compared to Indiana (16.1%), less people within the six county region considered themselves to have poor or fair health status. In Elkhart County, 15.0% rated themselves as having poor or fair health. Residents of Noble County reported the same average of physically unhealthy days (3.6) as the rest of Indiana residents; Elkhart County averaged 3.1 physically unhealthy days. Noble County residents averaged more (3.9) mentally unhealthy days when compared to other Indiana residents (3.7); Elkhart County averaged 3.6 mentally unhealthy days. Mental health/addictions/depression was ranked as the #3 health concern for survey respondents. With 31.4% of its citizens categorized as obese16, Indiana is ranked the ranked ninth in nationwide obesity rates.17 Marshall County has the same proportion of obese residents (31.4%), while LaGrange County’s rate (32.7%) and Noble County’s (33.9%) rates are even higher. Even though Elkhart County has the second lowest rate of obese residents (29.5%), these region wide high obesity rates are likely reflected in the ranking of obesity/exercise/healthy eating as the #1 concern for survey respondents. All six counties have lower rates of sexually transmitted infections (as measured by chlamydia cases) than in the remainder of Indiana (427 per 100,000), with the exception of Elkhart County (430 per 100,000) where the rate is slightly higher. (See pp. 16 ‐ 39 for details.) In relation to mortality measures, Elkhart County had lower rates than the rest of Indiana except for cases of infant mortality (Indiana, 7.7 per 1,000 live births; Elkhart County, 7.9 per 1,000 live births) and motor vehicle crash deaths (Indiana, 13 per 100,000; Elkhart County, 14 per 100,000). Infant mortality was higher in Noble County (8.7 per 1,000 live births and St. Joseph County (8.5 per 1,000 live births. Child mortality was also higher in St. Joseph County (70.9 per 10,000) and LaGrange County (68.4 per 100,000) than elsewhere in Indiana. In 26.2% of Indiana driving deaths, alcohol was a factor. Over one‐quarter (25.4%) of Elkhart County driving deaths involved alcohol while in LaGrange County 34.0% involved alcohol and in Kosciusko County 38.9% involved alcohol; 32.3% of St. Joseph County driving deaths involved alcohol. Except for St. Joseph County, all of the counties have higher motor vehicle crash rate than Indiana (13 per 100,000) overall; Elkhart County’s rate is slightly higher (14 per 100,000) Data Analysis for Community Health Needs Assessment Page 136
but LaGrange County (20 per 100,000) and Marshall County (21 per 100,000) have rates more than 1.5 times the state rate. Indiana rates for deaths due to injury (61 per 100,000) and drug poisoning (12 per 100,000) were lower throughout the six county region; in Elkhart County, 51 deaths per 100,000 were as a result of injury and 8 per 100,000 deaths were attributed to drug poisoning. (See pp. 40 ‐ 46 for details.) Many of the health disparities seen in the six‐county area are likely related to the lack of health workforce personnel, as demonstrated by HRSA designations of medically underserved areas, etc., and Indiana Health Workforce data.1, 2, 25 Respondents categorized access to health services as their #2‐
ranked concern. With the exception of mental and dental health providers in St. Joseph County, ratios of population to primary care providers, other primary care providers (for example, nurse practitioners who practice in primary care), mental health providers and dentists are much higher than in Indiana as a whole. Providers are generally obligated to care for up to two to three times as many patients as in other counties; in LaGrange County, mental health providers care for five times as many patients than other mental health providers state wide. (See pp. 47 ‐ 51 for details.) Even though there are serious shortages of providers in the six county region, two‐thirds of the counties have lower rates of preventable hospital stays related to ambulatory‐care sensitive conditions than in Indiana overall6, higher percentages of female Medicare enrollees receive appropriate breast cancer screening through mammography6, and five of the six counties provide diabetic screening for Medicare enrollees6 equivalent to diabetic screening percentages throughout Indiana or higher. Healthcare costs as measured by Medicare screening per enrollee are higher in Indiana ($9,901) as a whole than anywhere in Elkhart County ($9,011) and neighboring counties.6 It is important to remember, however, that no ‘ideal’ amount of spending per Medicare enrollee has yet been determined so these figures do not represent trending toward or away from an ideal spending amount.6 Perhaps related to lower proportions of children or adults having insurance coverage, more Elkhart County (15.6%) and slightly more Noble County (14.9%) residents were unable to see a doctor due to cost compared to other residents throughout Indiana (14.4%); seeing a physician was more affordable in the other counties.6 Inability to see a physician due to cost likely contributed to area residents citing access to health services as their #2‐ranked priority. (See pp. 51 ‐ 56 for details.) For the most part, social and environmental factors affecting health are more positive for Elkhart County than for Indiana, but these indicators for other neighboring counties negatively affect Data Analysis for Community Health Needs Assessment Page 137 Elkhart County’s community health profile. For example, over one‐quarter (26.7%) of Noble County adult residents are current smokers ( versus 20.1% of Elkhart County residents and 22.8% statewide).6 Since smoking is linked to chronic diseases such as asthma, heart disease, and cancer, Noble County’s high percentage of adult smokers may contribute to survey respondents’ ranking treatment of chronic disease as their #3‐ranked health priority. Nearly twenty percent (19.1%) of St. Joseph County’s population engages in excessive drinking (defined as binge or heavy drinking patterns) ( versus 10.3% for Elkhart County and 15.9% of Indiana residents).6 Except for St. Joseph County (78.1%) when compared to Indiana overall, fewer residents in the catchment area have access to exercise opportunities to promote fitness (Elkhart County, 56.0%, and only 9.4% in LaGrange County).6 St. Joseph County is the only county that has a higher proportion of residents (16.5%) than Indiana (16.3%) residents who suffer from food insecurity (compared with Elkhart County, 15.9%) and limited access to healthy foods (9.2% in St. Joseph County; 6.3% in Indiana; 5.8% in Elkhart County).6 Primary data collection showed residents’ concern with access to exercise and limited access to healthy foods in ranking obesity/exercise/healthy eating as their #1‐ranked priority. In regard to psychological influences affecting health, over one‐fifth (21.0%) of Elkhart County’s population report inadequate available social or emotional support compared with Indiana overall (20.1%).6 Elkhart County has the highest proportion of residents with severe housing problems (lacking complete kitchen facilities; lacking complete plumbing facilities; severe overcrowding; severely cost burdened) (14.4%) of all the contiguous counties; this is higher than the statewide percentage reported of severe housing problems (13.6%). Transportation affects community health, and driving alone to work is considered detrimental to community health.6 More Indiana residents overall (82.9%) drive alone to work when compared to all of the counties included in this report; 80.0% of Elkhart County residents drive alone to work and just over one‐half (53.0%) of LaGrange County residents drive alone to work.6 Even more hazardous than driving to work alone is driving alone on a long commute (at least thirty minutes to arrive at work), because this practice contributes to physical inactivity and is also correlated with higher blood pressure and body mass index.6 Nearly one‐third (32.9%) of Noble County drive alone on a long commute as do one‐fifth (20.3%) of Elkhart County residents compared with 29.8% of Indiana residents overall.6 Environmental issues such as air pollution also contribute to decreased community health. All of the contiguous counties have air pollution (particulate matter) averages which are slightly lower than Data Analysis for Community Health Needs Assessment Page 138 the Indiana average (13.5 PM2.5). The Elkhart County average daily PM2.5 was measured at 13.1.6 Although mental health/addictions/depression were prioritized as the #3‐ranked health concern for survey respondents, in comparison with dispensation of controlled substances (opioids, central nervous system [CNS] depressants, stimulants and other drugs categorized as controlled substances) in Indiana as a whole, fewer opioids and other controlled substances were dispensed in Elkhart County; however, more stimulants (23.8%) were dispensed.21 More opioids were dispensed in Noble County (54.9% of controlled substances) than in Indiana overall and a higher proportion of other controlled substances were dispensed in Kosciusko County (6.9% versus 5.0% in Indiana).21 The number of admissions to substance abuse treatment programs for Indiana was 36,764. Among the six county region, St. Joseph County had the greatest number (1,543) of admissions to substance abuse treatment programs; at 722, the number of admissions for Elkhart County was less than half of St. Joseph County’s number but still over 2.5 times the number of admissions for the next highest admission rate in Kosciusko County (270).22 These numbers are likely a reflection of the total population of Indiana and of each individual county. County‐level data show that of residents treated for polysubstance abuse, Elkhart County had the highest proportion of individuals treated for marijuana/heroin abuse (8.7%), marijuana/ methamphetamine abuse (14.3%) and marijuana/opiates‐synthetics (17.9%).22 Treatment for alcohol/cocaine abuse was most common in St. Joseph County (25.6%). Kosciusko County had the highest proportions of residents treated for alcohol/marijuana (38.9%) and alcohol/marijuana/cocaine (13.8%) while Marshall County treated for more residents for alcohol/marijuana/other drug. Noble County treated more individuals for alcohol/other drug (32.1%).22 The highest percentage of residents abusing heroin/methamphetamine was in St. Joseph County (13.5%); the highest proportion of heroin/opiates‐synthetics (16.2%) and heroin/various other drugs (13.8%) occurred in Kosciusko County.22 More Marshall County residents were treated for marijuana/methamphetamine/heroin abuse (12.7%) while over one‐quarter (29.8%) of Noble County polysubstance abusers were treated for marijuana/methamphetamine/other drug.22 The marijuana/other drug polysubstance combination was seen most frequently in LaGrange County residents (17.4%).22 (Aggregate data for Indiana are unavailable for this polysubstance abuse treatment admissions.) Among the contiguous counties, Kosciusko County generally has the highest rate of criminal activity related to alcohol as demonstrated by the arrest rate for driving under the influence (7.7 per 1,000 as compared to 3.4 per 1,000 for Elkhart County and 3.6 per 1,000 for Indiana). Marshall County Data Analysis for Community Health Needs Assessment Page 139 had the highest rate for public intoxication (2.4 per 1,000 versus 0.8 per 1,000 for Kosciusko County and 2.3 for Indiana) and for liquor law violations (3.6 per 1,000 compared to 1.4 per 1,000 for Kosciusko County and 2.0 per 1,000 for Indiana).22 Arrests related to marijuana possession also occurred more frequently in Marshall County (2.9 per 1,000 versus 1.5 per 1,000 for Kosciusko County and 1.7 per 1,000 for Indiana); rates of marijuana sales were negligible throughout Indiana.22 Possession and sales of cocaine/opiates, synthetic drugs and other drugs were less than 1.0 per 1,000 for 2012 in all of Indiana.22 The rates for violent crime were highest in St. Joseph County (393 per 100,000) and Elkhart County (124 per 100,000); St. Joseph County’s rate was higher than Indiana’s rate (329 per 100,000).22 Homicides were reported only in St. Joseph County (6 per 100,000) and Elkhart County (3 per 100,000) but St. Joseph County’s homicide rate was greater than Indiana’s rate overall (5 per 100,000).22 (See pp. 57 ‐ 77 for details.) Conclusion Primary data collected from online and mailed surveys and secondary data gathered from various health and social databases illustrate that Elkhart County’s most challenging issues are related to access to healthcare, poverty, preventive health and education. These priority concerns are echoed by Elkhart County Health Department leadership as well. IU Health Goshen leadership will gain a greater understanding of their community’s health profile from this data analysis and may utilize these data to support their community health needs assessment implementation strategy to better meet the identified needs of their service community. Data Analysis for Community Health Needs Assessment Page 140 References 1.
Health Services and Resources Administration. Find Shortage Areas: MUA/P by State and
County. (n.d.) [cited 2015 February 8]; Available from: http://muafind.hrsa.gov/.
2.
Health Resources and Services Administration. Find Shortage Areas: HPSA by State & County.
(n.d.) [cited 2015 February 8]; Available from: http://hpsafind.hrsa.gov/.
3.
Internal Revenue Service. New Requirements for 501(c)(3) Hospitals Under the Affordable Care
Act. December 19, 2014 [cited 2015 February 8]; Available from: http://www.irs.gov/Charities‐&‐Non‐
Profits/Charitable‐Organizations/New‐Requirements‐for‐501%28c%29%283%29‐Hospitals‐Under‐the‐
Affordable‐Care‐Act.
4.
March of Dimes. Your premature baby. 2014; Available from:
http://www.marchofdimes.org/baby/low‐birthweight.aspx.
5.
International Diabetes Federation. Risk factors. 2014; Available from: http://www.idf.org/about‐
diabetes/risk‐factors.
6.
University of Wisconsin Population Health Institute. County Health Rankings and Roadmaps:
Building a Culture of Health, County by County. 2014 February 8, 2015]; Available from:
http://www.countyhealthrankings.org/.
7.
US Census Bureau. County Totals: Vintage 2012. 2013 February 8 2015]; Available from:
http://www.census.gov/popest/data/counties/totals/2012/index.html.
8.
US Census Bureau. Population Estimates. 2013 June 13 2013 February 8 2015]; Available from:
http://www.census.gov/popest/data/counties/asrh/2012/PEPAGESEX.html.
9.
US Census Bureau. Geography. 2015; Available from:
http://www.census.gov/geo/reference/ua/urban‐rural‐2010.html.
10.
US Census Bureau. Small Area Health Insurance Estimates (SAHIE). 2014; Available from:
http://www.census.gov/did/www/sahie/data/index.html.
11.
data.gov, Adjusted_Cohort_Grdtn_Rates_LEA_SY_2010‐11.csv. 2014.
12.
US Census Bureau, American Fact Finder. (n.d.).
13.
US Census Bureau. Small Area Income and Poverty Estimates. 2014; Available from:
http://www.census.gov/did/www/saipe/data/index.html.
14.
Espinola, A.C. Single‐parent households often key to poverty, inequality. The Tribune, 2013.
15.
Centers for Disease Control and Prevention. Diabetes interactive atlas. 2013; Available from:
http://www.cdc.gov/diabetes/atlas/countydata/County_ListofIndicators.html.
16.
Centers for Disease Control and Prevention. Diabetes home. 2014; Available from:
http://www.cdc.gov/diabetes/data/county.html.
17.
Robert Wood Johnson Foundation. The state of obesity. 2014; Available from:
http://stateofobesity.org/states/in/.
18.
Centers for Disease Control and Prevention. CDC Wonder Compressed Mortality File. 2015;
Available from: http://wonder.cdc.gov/mortSQL.html.
19.
National Highway Traffic Safety Administration, Fatality Analysis Reporting System (FARS). (n.d.).
20.
Health Resources and Services Administration Health Workforce. Area Health Resource File.
(n.d.); Available from: http://ahrf.hrsa.gov/.
21.
Indiana Professional Licensing Agency. INSPECT Home. Available from:
http://www.in.gov/pla/inspect/.
22.
Inter‐university Consortium for Political and Social Research, Treatment Episode Data Set. 2014.
23.
Federal Bureau of Investigation. Uniform crime reports. (n.d.); Available from:
http://www.fbi.gov/about‐us/cjis/ucr/ucr.
Data Analysis for Community Health Needs Assessment Page 141 24.
US Census Bureau. Metropolitan and Micropolitan. Retrieved from
http://www.census.gov/population/metro/.
25.
Department of Family Medicine Health Workforce Studies. Resources. Retrieved from
http://family.medicine.iu.edu/hws/resources/
26.
Wright, E. R., Watson, D. P., Greene, M. S., Kooreman, H. E., Williams, M. J., Jackson, J.,
Buchanan, V. (2014). The Consumption and Consequences of Alcohol, Tobacco, and Drugs in Indiana: A
State Epidemiological Profile 2014.
27. Centers for Disease Control. (1986, Dec 19). Premature mortality in the United States: Public
health issues in the years of potential life lost. Retrieved from
http://www.cdc.gov/mmwr/preview/mmwrhtml/00001773.htm.
Data Analysis for Community Health Needs Assessment Page 142 Appendix A – Detailed Report Data Sources Data Analysis for Community Health Needs Assessment Page 143 Measure Source Year(s) Reporting Census Population Estimates Census Population Estimates Census Population Estimates 2012 2012 2012 Quantity Percentage Percentage Census Population Estimates 2012 Percentage Census Population Estimates Census Population Estimates 2012 2012 Percentage Percentage 2012 2012 2012 2008‐2012 2012 2010 Percentage Percentage Percentage Percentage Percentage Percentage HIV prevalence rate Census Population Estimates Census Population Estimates Census Population Estimates American Community Survey Census Population Estimates Census Population Estimates Nat’l Ctr for Chronic Disease Prevention and Health Promotion Nat’l Ctr for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Infant mortality Health Indicators Warehouse Child mortality CDC WONDER mortality data Population % below 18 years of age % 65 and older % Non‐Hispanic African American % American Indian/ Alaskan Native % Asian % Native Hawaiian/Other Pacific Islander % Hispanic % Non‐Hispanic white % not proficient in English % Females % Rural Diabetes prevalence rate Premature death Nat’l Ctr for Health Statistics Behavioral Risk Factor Surveillance Poor or fair health System Behavioral Risk Factor Surveillance Poor physical health days System Behavioral Risk Factor Surveillance Poor mental health days System Low birth weight National Center for Health Statistics Behavioral Risk Factor Surveillance Adult smoking System Nat’l Ctr for Chronic Disease Prevention Adult obesity and Health Promotion Nat’l Ctr for Chronic Disease Prevention Physical inactivity and Health Promotion OneSource Global Business Browser, Access to exercise opportunities Delorme map data, ESRI, & US Census Behavioral Risk Factor Surveillance Excessive drinking System Alcohol‐impaired driving deaths Fatality Analysis Reporting System 2010 Percentage Rate per 2010 100,000 Per 1,000 2002‐2008 live births Rate per 2007‐2010 100,000 Rate per 2008‐2010 100,000 2006‐2012 Percentage 2006‐2012 Average 2006‐2012 Average 2005‐2011 Percentage 2006‐2012 Percentage 2010 Percentage 2010 2010; 2012 Percentage Percentage 2006‐2012 Percentage 2008‐2012 Percentage Data Analysis for Community Health Needs Assessment Page 144 Measure Source Year(s) Sexually transmitted infections (chlamydia) Nat’l Ctr for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Teen births National Center for Health Statistics Motor vehicle crash deaths National Center for Health Statistics Drug poisoning deaths Food insecurity Limited access to healthy foods Primary care physicians Dentists Other primary care providers Mental health providers CDC WONDER mortality data Map the Meal Gap USDA Food Environment Atlas HRSA Area Resource File HRSA Area Resource File CMS, National Provider Identification CMS, National Provider Identification Preventable hospital stays Diabetic screening Mammography screening Uninsured adults Uninsured children Dartmouth Atlas of Health Care Dartmouth Atlas of Health Care Dartmouth Atlas of Health Care Small Area Health Insurance Estimates Small Area Health Insurance Estimates Health care costs Could not see doctor due to cost High school graduation Dartmouth Atlas of Health Care Behavioral Risk Factor Surveillance System Data.gov Rate per 2011 100,000 Rate per 2005‐2011 1,000 Rate per 2004‐2010 100,000 Rate per 2004‐2010 100,000 2011 Percentage 2012 Percentage 2011 Ratio 2012 Ratio 2013 Ratio 2013 Ratio Rate per 2011 1,000 2011 Percentage 2011 Percentage 2011 Percentage 2011 Percentage Medicare spending 2011 per enrollee Some college Unemployment American Community Survey Bureau of Labor Statistics Small Area Income and Poverty Estimates Behavioral Risk Factor Surveillance System 2008‐2012 Percentage 2012 Percentage American Community Survey 2008‐2012 Percentage Rate per 2009‐2011 100,000 Rate per 2006‐2010 100,000 Dollar 2012 amount 2011 Percentage Rate per 2004‐2010 100,000 Children in poverty Inadequate social support Children in single‐parent households Violent crime Uniform Crime Reports Injury deaths Median household income Children eligible for free lunch CDC WONDER mortality data Small Area Income and Poverty Estimates National Center for Education Statistics Homicide rate National Center for Health Statistics Reporting 2006‐2012 Percentage 2011 Percentage 2012 Percentage 2005‐2010 Percentage Data Analysis for Community Health Needs Assessment Page 145 Measure Source Year(s) Reporting 2011 Average Severe housing problems Driving alone to work Long commute ‐ driving alone CDC WONDER Environmental data Comprehensive Housing Affordability Strategy (CHAS) data American Community Survey American Community Survey Controlled substances Indiana Board of Pharmacy / Prescription Drug Monitoring 2014 Number Substance abuse treatment admissions Treatment Episode Dataset 2014 Number Driving under the influence arrests Uniform Crime Reports 2012 Rate per 1,000 Public intoxication arrests Uniform Crime Reports 2012 Rate per 1,000 Uniform Crime Reports 2012 Rate per 1,000 Possession, sale or manufacture of marijuana arrests Uniform Crime Reports 2012 Rate per 1,000 Possession, sale or manufacture of cocaine or opioids arrests Uniform Crime Reports 2012 Rate per 1,000 Possession, sale or manufacture of synthetic drugs arrests Uniform Crime Reports 2012 Rate per 1,000 2012 Rate per 1,000 Air pollution ‐ particulate matter Liquor law violations arrests Possession, sale or manufacture of other drugs Uniform Crime Reports 2006‐2010 Percentage 2008‐2012 Percentage 2008‐2012 Percentage Data Analysis for Community Health Needs Assessment Page 146 Appendix B – Health Indicators Variance Report Data Analysis for Community Health Needs Assessment Page 147 Variance Report Measure Population % below 18 years of age % 65 and older % Non‐Hispanic African American % American Indian/ Alaskan Native % Asian % Native Hawaiian/Other Pacific Islander % Hispanic % Non‐Hispanic white % not proficient in English % Females % Rural Diabetes prevalence rate HIV prevalence rate Infant mortality Child mortality Premature death Poor or fair health Indiana 6,597,000
Elkhart County 199,619
More (+) or less (‐) than State? ‐‐
Elkhart County variance ‐‐
Kosciusko County 77,609
LaGrange County 37,521
Marshall County 47,024
Noble County 47,582
St. Joseph County 266,344
Percentage Percentage 24.3 13.6
28.1 12.7
+ ‐
3.8 ‐0.9
25.0 14.4
34.0 12.2
26.0 15.5
26.3 13.6
24.2 13.8
32 Percentage 9.1 5.6 ‐ ‐3.5 0.7 0.3 0.4 0.4 12.6 2012 2012 32 32 Percentage Percentage 0.4 1.7
0.6 1.1
+ ‐
0.2 ‐0.6
0.4 1.0
0.2 0.3
0.3 0.5
0.3 0.4
0.5 2.1
2012 2012 32 33 Percentage Percentage 0.1 6.2
0.1 14.4
= +
‐‐ 8.2
0.0 7.5
0.0 3.6
0.1 8.8
0.0 9.7
0.1 7.5
2012 2008‐
2012 2012 2010 32 Percentage 81.3 77.0 ‐ ‐4.3 89.6 95.0 89.1 88.3 75.3 42 34 35 Percentage Percentage Percentage 1.6 50.8
27.6
3.9 50.7
20.6
+ ‐
‐
2.3 ‐0.1
‐7.0
1.3 50.3
46.6
3.3 49.7
91.6
2.5 50.6
63.3
2.6 50.0
68.0
1.4 51.5
9.0
2010 48 10.5 9.3 ‐ ‐1.2 10.7 10.9 10.3 10.2 9.5 2010 2002‐
2008 2007‐
2010 2008‐
2010 2006‐
2012 49 159 95 ‐ ‐64 55 22 44 33 197 7.7 7.9 + 0.2 6.3 6.5 4.4 8.7 8.5 63.6 56.6 ‐ ‐7.0 51.1 68.4 58.7 54.0 70.9 55 Percentage Rate per 100,000 Per 1,000 live births Rate per 100,000 Rate per 100,000 382 326 ‐ ‐56 359 292 349 373 369 50 Percentage 16.1 15.0 ‐ ‐1.1 17.8 13.9 11.2 14.8 14.3 Year(s) 2012 Detailed data on page 30 Reporting Quantity 2012 2012 31 32 2012 56 57 Data Analysis for Community Health Needs Assessment Page 148 Measure Poor physical health days Poor mental health days Low birth weight Adult smoking Adult obesity Physical inactivity Access to exercise opportunities Excessive drinking Alcohol‐
impaired driving deaths Sexually transmitted infections (chlamydia) Teen births Injury deaths Motor vehicle crash deaths Drug poisoning deaths Food insecurity Limited access to healthy foods Year(s) 2006‐
2012 2006‐
2012 Indiana Elkhart County More (+) or less (‐) than State? Elkhart County variance Kosciusko County LaGrange County Marshall County Noble County St. Joseph County Average 3.6 3.3 ‐ ‐0.5 3.2 3.0 3.0 3.6 3.5 52 Average 3.7 3.6 ‐ ‐0.1 3.2 3.7 3.1 3.9 3.4 Detailed data on page Reporting 51 2010 2010 2010; 2012 36 82 Percentage Percentage 8.3 22.8
7.3 20.1
‐ ‐
‐1.0 ‐2.1
7.0 21.9
5.4 19.3
6.5 21.0
7.7 36.7
8.4 20.8
53 Percentage 31.4 29.5 ‐ ‐1.9 30.8 32.7 31.4 33.9 28.7 2012 83 Percentage 27.9 26.9 ‐ ‐1.0 26.3 25.1 29.1 25.2 26.2 2012 2006‐
2012 85 Percentage 63.9 56.0 ‐ ‐7.9 47.8 9.4 48.5 31.4 78.1 84 Percentage 15.9 10.3 ‐ ‐5.6 11.8 11.5 11.1 15.6 19.1 2008‐
2012 58 Percentage 26.2 25.4 ‐ ‐0.8 34.0 38.9 13.9 23.3 32.3 427 430 + 3 211 86 96 196 415 40.2 55.2 + 15.0 41.1 26.4 36.6 47.0 40.4 61 51 ‐ ‐10 57 49 60 55 53 13 14 + 1 15 20 21 19 9 60 86 Rate per 100,000 Rate per 1,000 Rate per 100,000 Rate per 100,000 Rate per 100,000 Percentage 12 16.3
8 15.9
‐ ‐
‐4 ‐0.4
10 12.2
0 13.6
8 13.5
10 13.6
8 16.5
78 Percentage 6.3 5.8 ‐ ‐0.5 7.1 0.5 4.4 3.1 9.2 2011 2005‐
2011 2004‐
2010 2004‐
2010 54 2011 2012 2006‐
2012 37 61 59 Data Analysis for Community Health Needs Assessment Page 149 Measure Population to PCPs Population to dentists Population to other PCPs Population to MH providers Preventable hospital stays Diabetic screening Breast cancer screening Uninsured adults Uninsured children Health care costs Could not see doctor due to cost High school graduation Some college Unemployment Children in poverty Indiana Elkhart County More (+) or less (‐) than State? Elkhart County variance Kosciusko County LaGrange County Marshall County Noble County St. Joseph County Ratio 1539:1 2094:1 + 555:1 2417:1 3398:1 1568:1 2797:1 1170:1 67 Ratio 2015:1 3025:1 + 1010:1 3374:1 4169:1 2612:1 4326:1 1800:1 2013 65 Ratio 2045:1 2979:1 + 934:1 3696:1 4690:1 2351:1 11896:1 2316:1 2011 66 890:1 1134:1 + 244:1 946:1 5360:1 1809:1 2163:1 585:1 2011 77 Ratio Rate per 1,000 70 73 + 3 76 57 50 97 56 2011 78 Percentage 83.8 87.0 + 3.2 85.1 86.3 86.9 87.8 83.4 2011 79 Percentage 61.3 60.9 ‐ ‐0.4 58.8 58.1 51.4 51.3 61.5 2011 2006‐
2012 39 Percentage 20.0 25.9 + 5.9 23.0 31.4 23.1 23.6 21.7 38 8.3 11.2 + 2.9 12.2 15.3 10.4 11.2 9.2 2011 80 Percentage Medicare spending per enrollee $9,901 $9,011 ‐ ‐$890 $9,146 $8,155 $8,795 $8,830 $8,920 2008‐
2012 81 Percentage 14.4 15.6 + 1.2 10.5 12.9 12.7 14.9 13.7 2012 2012 2011 40 41 43 Percentage Percentage Percentage 86.5 59.7
8.4
85.4 44.9
9.6
‐ ‐
+
‐1.1 ‐14.8
1.2
87.8 52.6
7.4
83.2 28.7
7.9
85.3 48.2
8.9
85.2 46.1
9.2
82.8 63.7
9.7
2012 45 Percentage 22.1 21.2 ‐ ‐0.9 16.4 20.8 18.6 21.2 24.0 Year(s) Detailed data on page Reporting 2011 64 2013 Data Analysis for Community Health Needs Assessment Page 150
Measure Inadequate social support Children in single parent households Violent crime Injury deaths Median household income Children eligible for free lunch Severe housing problems Driving alone to work Long commute (driving alone) Air pollution Substance abuse treatment admissions Total alcohol arrests Marijuana possession arrests Marijuana sales arrests Indiana Elkhart County More (+) or less (‐) than State? Elkhart County variance Kosciusko County LaGrange County Marshall County Noble County St. Joseph County Percentage 20.1 21.0 + 0.9 18.6 18.2 17.6 23.3 19.7 32.8 32.6 ‐ ‐0.2 22.6 13.1 22.0 34.5 35.6 329 124 ‐ ‐205 64 40 80 53 393 61 Percentage Rate per 100,000 Rate per 100,000 61 51 ‐ ‐10 57 49 60 55 53 2012 44 Dollar amount $46,954 $45,806 ‐ ‐$1,148 $50,153 $47,870 $46,129 $44,192 $45,248 2011 2006‐
2010 2008‐
2012 2008‐
2012 46 Percentage 38.9 46.2 + 7.3 37.6 35.5 38.9 41.8 45.2 89 Percentage 13.6 14.4 + 0.8 11.6 14.2 11.1 11.3 13.6 90 Percentage 82.9 80.0 ‐ ‐2.9 80.2 53.0 79.8 79.7 82.4 91 29.8 20.3 ‐ ‐9.5 20.1 29.7 28.4 32.9 19.8 2011 92 Percentage Average daily PM2.5 13.5 13.1 ‐ ‐0.4 13.2 13.0 13.2 13.1 13.1 2014 94 5.8 3.6 ‐ ‐2.2 3.5 4.4 4.8 4.6 5.8 2012 98 7.9 5.6 ‐ ‐2.3 10.9 5.3 12.5 8.0 4.0 2012 999 1.7 1.5 ‐ ‐0.2 1.9 1.2 2.9 1.8 1.7 2012 99 0.3 0.0 + ‐0.3 0.5 0.1 0.0 0.2 0.1 Year(s) 2005‐
2010 2008‐
2012 2009‐
2011 2006‐
2010 Detailed data on page Reporting 88 47 101 Rate per 1,000 Rate per 1,000 Rate per 1,000 Rate per 1,000 Data Analysis for Community Health Needs Assessment Page 151 Measure Cocaine/opiates possession arrests Cocaine/opiates sales arrests Synthetic drugs possession arrests Synthetic drugs sales arrests Other drugs possession arrests Other drugs sales arrests Homicide Year(s) Detailed data on page 2012 99 2012 99 2012 99 2012 99 2012 99 2012 2004‐
2010 99 102 Reporting Rate per 1,000 Rate per 1,000 Rate per 1,000 Rate per 1,000 Rate per 1,000 Rate per 1,000 Rate per 100,000 Indiana Elkhart County More (+) or less (‐) than State? Elkhart County variance Kosciusko County LaGrange County Marshall County Noble County St. Joseph County 0.2 0.2 = ‐‐ 0.3 0.3 0.7 0.2 0.2 0.2 0.3 + 0.1 0.2 1.9 0.4 0.2 0.1 0.3 0.1 ‐ ‐0.2 0.4 0.2 1.4 0.6 0.3 0.1 0.0 ‐ ‐0.1 0.3 0.1 0.2 0.2 0.0 0.4 0.1 ‐ 0.3 0.5 0.1 0.6 0.5 0.3 0.2 0.0 ‐ 0.2 0.4 0.0 0.2 0.1 0.0 5 3 ‐ 2 0 0 0 0 6 Data Analysis for Community Health Needs Assessment Page 152 Appendix C – IU Health Goshen Community Needs Survey (English & Spanish) Data Analysis for Community Health Needs Assessment Page 153
Data Analysis for Community Health Needs Assessment Page 154 Data Analysis for Community Health Needs Assessment Page 155
Appendix II
IU Health Goshen
Services / Membership Setup
Contact - Name and Address List - Type Order
COMMB - Community Based
(First United Pantry) First UMC Goshen
214 S 5th St
Goshen, IN 46528
Phone Number 1: 574-533-9518
Fax Number:
(NAMI) National Alliance on Mental Illness
3803 N Fairfax Dr Suite 100
Arlington, VA 22203
Phone Number 1: 1-800-950-6264
Fax Number:
A New Beginning
211 East Washington St
Goshen, IN 46528
Phone Number 1: 574-534-5778
Fax Number:
A Place for Mom
Phone Number 1: 866-344-8005
Fax Number:
A.C.T. (Advanced Care Transport)
P.O Box 609
Plymouth, IN 46563
Phone Number 1: 574-936-9142
Fax Number:
AARP
Phone Number 1:
Fax Number:
ABG Dental of Elkhart
2549 Prairie St Woodland Crossing Plaza
Elkhart, IN 46517
Phone Number 1: 574-389-8300
Fax Number:
ABG Dental of Goshen
622 Lincoln Ave
Goshen, IN 46526
Phone Number 1: 574-534-8777
Fax Number:
ACE CAB
300 East High Street
Elkhart, IN 46516
Phone Number 1: 574-295-6886
Fax Number:
Report id: LVM12357_S
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IU Health Goshen
Addiction Recovery Center-Elkhart
204 S Main ST
Elkhart, IN 46516
Phone Number 1: 574-293-1086
Fax Number: 574-534-3951
ADEC
19670 SR 120
PO Box 398 Bristol, In 46507
Elkhart, IN 46515
Phone Number 1: 574-848-7451
Adoption Services
28 Central Blvd
Camp Hill, PA 17011
Phone Number 1: 1-800-943-0400
Fax Number: 574-848-5917
Fax Number:
Adult Children of Alcoholics (ACOA)
209 Lincoln Way E.
Mishawaka, IN
Phone Number 1: 574-254-0767
Fax Number:
AEGIS Dental Group
4568 Elkhart Rd.
Suite 500
Elkhart, IN 46517
Phone Number 1: 574-875-7711
Fax Number:
Afdent Dental Services
605 W. Douglas Road
Mishawaka, IN 46545
Phone Number 1: 800-325-1593
Fax Number:
Agape Baptist Church Food Pantry
248 W. Wolf Ave.,
Elkhart, IN 46516
Phone Number 1: 574-522-2649
Fax Number:
AIDS / HIV+ Support Group
616 S Main St
Elkhart, IN 46516
Phone Number 1: 574-293-9743
Fax Number:
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IU Health Goshen
AIDS Ministries
616 S Main st
Elkhart, IN 46516
Phone Number 1: 574-293-9743
Fax Number:
Al-Anon, Alateen of Elkhart County
Phone Number 1: 574-236-5736 SoB
Fax Number:
ALICKS HOME MEDICAL Corporate office
17187 SR 23
South Bend, IN 46635
Phone Number 1: 1-800-633-4144
Fax Number: 574-247-8199
ALICKS HOME MEDICAL Elkhart
1612 W Lexington Ave
Elkhart, IN 46517
Phone Number 1: 1-800-633-4144
Fax Number: 574-522-4563
ALICKS HOME MEDICAL Michigan City
3219 South Franklin St
Michigan City, IN 46360
Phone Number 1: 1-800-633-4144
Fax Number: 219-879-1917
ALICKS HOME MEDICAL Plymouth
1920 W Lake Ave
Plymouth, IN 46563
Phone Number 1: 1-800-633-4144
Fax Number: 574-941-4440
Alzheimer Caregiver Support Group
Elkhart, IN 46516
Phone Number 1: 574-232-4121
Fax Number:
Alzheimer Disease Center--Indianapolis
355 West 16th St
Indianapolis, IN 46202
Phone Number 1: 317-963-5500
Fax Number: 317-963-7547
Alzheimer's Disease & Dementia Services of Northern Indiana
922E Colfax Ave
Phone Number 1: 574-232-4121
Fax Number: 574-232-4235
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IU Health Goshen
Alzheimer's Foundation of America
322 8th Ave 7th floor
New York, NY 10001
Phone Number 1: 866-232-8484
Fax Number: 646-638-1546
Alzheimer's Services of Northern Indiana
922 E Colfax Ave
Phone Number 1: 574-232-4121
Fax Number: 574-232-4235
American Liver Foundation
39 Broadway Suite 2700
New York, NY 10005
Phone Number 1: 1-800-465-4837
Fax Number: 212-483-8179
American Parkinson Disease Association
135 Parkinson Avenue
Staten Island, NY 10305
Phone Number 1: 1-800-223-2732
Fax Number: 1-718-981-4399
American Psychiatric Association
1000 Wilson Boulevard Suite 1825
Arlington, VA 22209
Phone Number 1: 1-888-357-7924
Fax Number:
American Red Cross - Elkhart County Chapter
721 Riverview Ave.
Elkhart, IN 46516
Phone Number 1: 574-293-6519
Fax Number: 574-293-1451
Amputee Coalition
9303 Center St Suite 100
Manassas, VA 20110
Phone Number 1: 1-888-267-5669
Fax Number:
Amputees in Action Support Group
4141 Shore Dr Main Conference room
Phone Number 1: 317-696-5248
Fax Number:
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IU Health Goshen
Anxiety Disorders association of America
8730 Georgia Ave
Silver Spring, MD 20910
Phone Number 1: 1-240-485-1001
Fax Number: 240-485-1035
Arthritis Foundation
1330 W Peachtree st Suite 100
Atlanta, GA 30309
Phone Number 1: 404-872-7100
Fax Number:
ASAP Transportation Services
601 W Washington St
Phone Number 1: 574-387-4989
Fax Number:
ASPEN Dental of Goshen
2909 County Home Rd.
Suite 1
Goshen, IN 46526
Phone Number 1: 1-877-277-4479
Fax Number:
Avilla Food Pantry (Calvary United)
PO Box 229
101 S cherry St
Avilla, IN 46710
Phone Number 1: 260-897-3190
Fax Number:
Beacon Medical Group Behavioral Health Elkhart
1506 Osolo Road, Suite A
Elkhart, IN 46514
Phone Number 1: 574-523-3347
Fax Number:
Beacon Medical Group Behavioral Health-- South Bend
707 N. Michigan Street, Suite 400
Phone Number 1: 574-647-8470
Fax Number: 574-647-8475
Beacon of Hope Counseling Center
28765 County Road 4
Elkhart, IN 46514
Phone Number 1: 574-262-9341
Fax Number:
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IU Health Goshen
Benchmark Human Services. ... AWS (Anthony Wayne Services) rehabilitation Cente
8515 Bluffton Rd
Fort Wayne, IN 46809
Phone Number 1: 260-744-6145
Fax Number:
Best Podiatry Center
1755 Fulton St Suite A
Elkhart, IN 46514
Phone Number 1: 574-266-4555
Fax Number: 574-266-1315
BETHANY CHRISTIAN SERVICES
Phone Number 1: 1-800-238-4269
Fax Number:
Bethel College
1001 Bethel Circle
Mishawaka, IN 46545
Phone Number 1: 157-480-7732 4
Fax Number:
Blind & Visually Impaired Services
Phone Number 1:
Fax Number:
Bowen Center
Phone Number 1: 800-342-5653
Fax Number:
Boys and Girls Club of Elkhart
102 W Lincoln Ave Suite 240
P.O. Box 614
Goshen, IN 46527
Phone Number 1: 574-534-5933
Fax Number:
Bridges to Access
PO Box 29038
Phoenix, AZ 85038
Phone Number 1: 866-728-4368
Fax Number: 1-855-474-3063
Bristol Food Pantry
101 West Vistula Street
Bristol, IN 46507
Phone Number 1: 574-333-8959
Fax Number:
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IU Health Goshen
Bristol Police Department
301 Vistula St
P.O. Box 325
Bristol, IN 46507
Phone Number 1: 574-848-4464
Fax Number:
Bureau of Developmental Disabilities Services
100 W. South Street, Suite 100
Phone Number 1: 574-232-1412
Fax Number: 855-455-4266
CANI (Community Action of Northeast IN)
1416 Cassopolis St Suite D
Elkhart, IN 46514
Phone Number 1: 574-830-5376
Fax Number: 574-830-5564
Carriage House of Elkhart-Low Income Senior Appartments
1200 Burr Oak Court
Elkhart, IN 46517
Phone Number 1: 574-293-6717
Fax Number: 574-389-9197
CELEBRATE RECOVERY
17285 CR 34
Goshen, IN 46528
Phone Number 1: 574-534-3528
Celiac Sprue Association
PO Box 31700
Omaha, NE 68131-0700
Phone Number 1: 1-877-272-4272
Center for Community Justice
121 S 3rd St,
Elkhart, IN 46516
Phone Number 1: 574-295-6149
Fax Number: 888-290-8375
Fax Number:
Fax Number:
CENTER FOR DISEASE CONTROL NATIONAL STD HOTLINE
Phone Number 1: 1-800-232-4636
Fax Number:
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IU Health Goshen
Center for Homeless
813 S Michigan St.
Phone Number 1: 574-282-8700
Fax Number: 574-287-5023
Center for Hospice Care
22579 Old US 20
Elkhart, IN 46516
Phone Number 1: 800-413-9083
Fax Number:
Chain Reaction
P.O. Box 732
Goshen, IN 46527
Phone Number 1: 574-903-3056
Fax Number:
Child and Parent Services (CAPS) (fmr Child Abuse Prevention Services)
1000 W. Hively Ave.
P.O. Box 773
Elkhart, IN 46515
Phone Number 1: 574-295-2277
Fax Number: 574-295-7642
Child Molestation Reseach & Prevention Institute
2515 Snata Clara Ve Suite 208
Alameda, CA 94501
Phone Number 1: 1-888-773-8368
Fax Number:
Childhelp National Hotline
15757 N. 78th Street Suite #B
Scottsdale, AZ 85260
Phone Number 1: 1-800-422-4453
Fax Number:
Christ's Commissary
24197 County Road 16 East
Elkhart, IN 46516
Phone Number 1:
Fax Number:
Christopher J Magiera MD
1205 Provident Drive Suite A
Warsaw, IN 46580
Phone Number 1: 574-269-8383
Fax Number:
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IU Health Goshen
Church Community Services
907 Oakland Ave.
PO Box 2346
Elkhart, IN 46515
Phone Number 1: 574-295-3673
Fax Number: 574-522-0784
Church Without Walls Inc.
731 Wagner Ave
Elkhart, IN 46516
Phone Number 1: 574-293-0776
Fax Number:
CLEFT PALATE FOUNDATION
1504 East Franklin St Suite 102
Chapel Hill, NC 27514
Phone Number 1: 800-242-5338
Fax Number: 919-933-9604
Cochlear Implant Support Group
Phone Number 1: 574-261-8638
Fax Number:
COMFORT CARE (HOSPICE)
22579 Old US 20
Suite C
Elkhart, IN 46516
Phone Number 1: 574-264-3321
Fax Number: 574-264-5892
Comfort Keepers
6910 N Main St, Ste 17A, Unit 47,
Granger, IN 46530
Phone Number 1: 574-277-4121
Fax Number:
Commitment to Access
Phone Number 1: 1-888-825-5249
Fax Number:
COMMON GRACE OF NOBLE COUNTY
2004 Dowling St
Mailing Po Box 203
Kendallville, IN 46755
Phone Number 1: 260-349-1942
Fax Number:
Community Assistance Program--Free Drug Card
Phone Number 1: 1-440-708-6092
Fax Number:
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IU Health Goshen
Community Occupational Medicine
2312 Eisenhower Dr. N.
22818 Old US 20 Elkhart
Goshen, IN 46526
Phone Number 1: 574-534-1231
Fax Number:
Community Partners for Child Safety
1575 Dr Martin Luther King Jr. St
Phone Number 1: 317-634-5050
Fax Number:
Compassionate Caregivers
320 N. Chicago Ave., Suite 6
Goshen, IN 46528
Phone Number 1: 574-533-5627
Fax Number:
COMPASSIONATE FRIENDS
, IN
Phone Number 1: 574-875-0111
Fax Number:
Compulsion Solutions
43 Quail Ct Suite 208
Walnut Creek, CA 94596
Phone Number 1: call 925-932-0201
Fax Number: 925-932-0201
Contraception--Emergency Website
Phone Number 1:
Fax Number:
COUNCIL ON AGING
230 E Jackson Blvd
Elkhart, IN 46516
Phone Number 1: 574-295-1820
Fax Number: 574-294-5924
Covenant House Crisis Support
461 Eighth ave
New York, NY 10001
Phone Number 1: 800-388-3888
Fax Number:
Crisis Intervention
Phone Number 1: 574-293-8671
Fax Number:
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IU Health Goshen
Crohn's & Colitis Foundation of America
733 Third Avenue, Suite 510,
New York, NY 10017
Phone Number 1: 800-932-2423
Fax Number:
Crossing Educational Center
2930 S Nappanee st
Elkhart, IN 46517
Phone Number 1: 574-226-0671
Fax Number:
Crystal Valley Manor
114 Krider Dr.
Middlebury, IN 46540
Phone Number 1: 574-825-5161
Fax Number: 574-825-3681
CVS Health Savings Pass
Phone Number 1: 888-616-2273
Fax Number:
CVS Minute Clinic Goshen
410 S Main
Goshen, IN 46526
Phone Number 1: 574-533-9051
Fax Number:
CVS Minute Clinic Granger
130 E Cleveland Road
(near Heritage Square Plaza)
Granger, IN 46530
Phone Number 1: 574-247-2221
Fax Number:
CVS Minute Clinic Warsaw
100 N Detroit
Warsaw, IN 46580
Phone Number 1: 574-267-6208
Fax Number:
CVS Pharmacy - N. Nappanee, Elk
1210 N. Nappanee St.
Elkhart, IN 46514
Phone Number 1: 574-266-9009
Fax Number:
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IU Health Goshen
CVS Pharmacy - Bristol Ave. Elk.
900 E. Bristol St.
Elkhart, IN 46514
Phone Number 1: 574-206-8476
Fax Number:
CVS Pharmacy - Cassopolis, Elk
3600 Cassopolis St (SR 19 & CR 4)
Elkhart, IN 46514
Phone Number 1: 574-262-8247
Fax Number:
CVS Pharmacy - Jackson Blvd, Elk.
551 E. Jackson Blvd.
Elkhart, IN 46514
Phone Number 1: 574-293-0040
Fax Number:
CVS Pharmacy - Ligonier
101 West US 6
Ligonier, IN 46767
Phone Number 1: 260-894-4700
Fax Number:
CVS Pharmacy - Main St., Goshen
410 S. Main Street
Goshen, IN 46526
Phone Number 1: 574-533-9051
Fax Number:
CVS Pharmacy - Middlebury
102 US 20 East
Phone Number 1: 574 825-2485
Fax Number:
CVS Pharmacy - Mishawaka
210 North Main (downtown)
Mishawaka, IN
Phone Number 1: 574-259-1130
Fax Number:
CVS Pharmacy - N. Webster
618 South 8th St.
North Webster, IN 46555
Phone Number 1: 574-834-4772
Fax Number:
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IU Health Goshen
CVS Pharmacy - Nappanee
1654 E. Market St.
Nappanee, IN
Phone Number 1: 574-773-4311
Fax Number:
CVS Pharmacy - Pierre Moran Mall
104 W. Hively Ave.
Elkhart, IN
Phone Number 1: 574-293-2231
Fax Number:
CVS Pharmacy - Syracuse
308 S. Huntington Street
Syracuse, IN 46567
Phone Number 1: 574-457-4000
Fax Number:
CVS Pharmacy - Warsaw
100 N. Detroit St
Warsaw, IN 46580
Phone Number 1: 574-267-6208
Fax Number:
CVS Pharmacy kendalville
224 West North ST
Phone Number 1: 260-347-1499
Fax Number:
CVS Pharmacy-Bristol Street Elk.
900 E Bristol St
Elkhart, IN 46514
Phone Number 1: 574-206-8476
Fax Number:
Cystic Fibrosis Council-Education & Support
58156 Ox Bow Dr,
Elkhart, IN 46516
Phone Number 1: 574-296-9000
Fax Number: 574-296-9000
Deaf & Hard of Hearing Services
402 W. Washington St., Rm. W453
P.O. Box 7083
Phone Number 1: 800-545-7763
Fax Number:
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IU Health Goshen
Del Pilar Medical & Urgent Care
4215 Edison Lakes Parkway, Suite 300
Mishawaka, IN 46545
Phone Number 1: 574-271-0268
Fax Number:
Depression and Bipolar Support Alliance
55 E. Jackson Blvd, Suite 490
Chicago, IL 60604
Phone Number 1: 1-800-826-3632
Fax Number:
Disabled Veterans National Foundation
1020 19th St NW Suite 475
Washington, DC 20036
Phone Number 1: 202-737-0522
Fax Number:
Divorce Care Classes
Indiana 19 North of Nappanee
Nappanee, IN 46550
Phone Number 1: 574-773-7773
Fax Number:
Doctors Express
7115 Heritage Square Dr
Granger, IN 46530
Phone Number 1: 574-485-2433
Fax Number:
Doctors NeuroPsychiatric Hospital & Research Institute
417 S Whitlock Street
Bremen, IN 46506
Phone Number 1: 574-546-0330
Fax Number: 574-546-0311
Domestic Abuse Helpline for Men and Women
Phone Number 1: 888-743-5754
Fax Number:
Domestic Violence Shelter
Phone Number 1: 574-294-1811
Fax Number:
Dr. Bigler DDS
21781 Omega Ct.
Goshen, IN 46526
Phone Number 1: 574-875-6531
Fax Number:
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IU Health Goshen
Dr. David Lehman
1908 W Lincoln Ave.
Goshen, IN 46526
Phone Number 1: 574-533-7399
Fax Number:
Dr. Gregory Robbins DDS
4420 E Bristol St.
Elkhart, IN 46517
Phone Number 1: 574-264-9499
Fax Number:
Dr. James Macri
926 E Jefferson
Phone Number 1: 574-234-2143
Fax Number:
Dr. Janice Wenger
805 Waterbury Park Dr.
Elkhart, IN 46517
Phone Number 1: 574-293-9222
Fax Number:
Dr. Jeffrey Burden DDS
1100 College Ave.
Goshen, IN 46526
Phone Number 1: 574-533-0961
Fax Number:
Dr. Thomas Rykovich
937 Galen Ct.
Goshen, IN 46526
Phone Number 1: 574-533-5015
Fax Number:
Drug Alcohol Helpline
Phone Number 1: 855-435-5596
Fax Number:
East Goshen Mennonite Church
17861 SR 4
Goshen, IN 46528
Phone Number 1: 574-533-7161
Fax Number: 574-534-9974
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IU Health Goshen
ECHD-Community Health
608 Oakland
Elkhart, IN 46514
Phone Number 1: 877-523-2283
Fax Number:
ECHD-General Information
608 Oakland
Elkhart, IN 46514
Phone Number 1: 877-523-2283
Fax Number: 574-523-2145(north)
ECHD-WIC
1400 Hudson St.
Elkhart, IN 46516
Phone Number 1: 574-522-0104
Fax Number:
EGH Fast-Trak Urgent Care
EGH
Elkhart,
Phone Number 1: 574-523-7894
Fax Number:
Elder Haus Senior Center
451 N. Main St
Nappanee, IN 46550
Phone Number 1: 574-773-2424
Fax Number:
Elkhart Career Center ~ CNA Classes
2424 California Rd.
Elkhart, IN 46514
Phone Number 1: 574-262-5650
Fax Number:
Elkhart Career Center ~ Dental Assisting
2424 California Rd.
Elkhart, IN 46514
Phone Number 1: 574-262-5650
Fax Number:
Elkhart Career Center ~ Medical Terminology Other courses
2424 California Rd.
Elkhart, IN 46514
Phone Number 1: 574-262-5678
Fax Number:
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173
IU Health Goshen
Elkhart Child Development Center
2121 Prairie Street
Elkhart, IN 46517
Phone Number 1: 574-293-5316
Fax Number: 574-293-2737
Elkhart City Department of Community Development
229 S. Second Street
Elkhart, IN 46516
Phone Number 1: 574-294-5471 ex124
Fax Number: 574-295-7501
Elkhart Clinic Urgent Care
303 S. Nappanee St.
Elkhart, IN 46514
Phone Number 1: 574-296-3200
Fax Number: 574-296-3921
Elkhart Clinic-Gastroenterology Practice
303 South Nappanee Street
Elkhart, IN 46514
Phone Number 1: 574-296-3200
Fax Number:
Elkhart Co. AIDS Community Action Group
608 Oakland Avenue
Elkhart, IN 46516
Phone Number 1: 574-523-2118 JimS
Fax Number: :57-452-3215 8
Elkhart Community Schools/English as a New Language Classes
2424 California Rd
Elkhart, IN 46514
Phone Number 1: 574-262-5678
Fax Number: :57-426-2567 5
Elkhart County Bar Association
Phone Number 1:
Fax Number:
Elkhart County Clubhouse
114 S fifth St
Goshen, IN 46528
Phone Number 1: 574-971-5210
Fax Number:
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174
IU Health Goshen
Elkhart County Department of Family Resources & Child Services
1120 N Main St Suite 201
Elkhart, IN 46514
Phone Number 1: 1-800-403-0864
Fax Number: 574-293-3878
Elkhart County Doula Association
Phone Number 1: 574-537-0170
Fax Number:
Elkhart County Drug Task Force
Phone Number 1: 574-294-3784
Fax Number:
Elkhart County Health Depart Sexually Transmitted Infections (STI) Clinic
Phone Number 1: 574-523-2128
Fax Number:
Elkhart County Health Department - Community Health Nursing
608 Oakland Ave
Elkhart, IN 46516
Phone Number 1: 574-523-2127
Fax Number: 574-523-2163
Elkhart County Health Department - Vital Records
608 Oakland Ave Elkhart for 1 phone No.
117 N 2nd Goshen for 2 phone No.
Phone Number 1: 574-523-2283
Fax Number:
Elkhart County Purdue Extension Office
17746 E CR 34
Goshen, IN 46528
Phone Number 1: 574-533-0554
Fax Number: 574-533-0254
Elkhart County Sheriff Department
26861 CR 26
Elkhart, IN 46517
Phone Number 1: 574-891-2100
Fax Number:
Elkhart County Special Ed. Cooperative
704 W Lincoln Ave
Goshen, IN 46526
Phone Number 1: 574-533-3151
Fax Number: 574-534-9159
Elkhart County Trustees
Phone Number 1: 574-533-2066 ELK
Fax Number:
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175
IU Health Goshen
Elkhart County WIC - Elkhart
1400 Hudson ST
Elkhart, IN 46516
Phone Number 1: 574-522-0104
Fax Number: 574-522-1902
Elkhart County WIC- Goshen
117 N 2nd st Room 112
Goshen, IN 46526
Phone Number 1: 574-535-6765
Fax Number:
Elkhart General Home Medical Equipment
225 E Jackson
Elkhart, IN 46516
Phone Number 1: 574-523-3100
Fax Number:
Elkhart Legal Aid Services, Inc
330 W. Lexington Ave
Elkhart, IN 46516
Phone Number 1: 574-294-2658
Fax Number: 574-294-2650
Elkhart Oral Surgery
117 S. Nappanee St.
Elkhart, IN 46517
Phone Number 1: 574-293-8211
Fax Number:
Elkhart Podiatry Clinic
1723 East Bristol St
Elkhart, IN 46514
Phone Number 1: 574-264-7180
Fax Number: 574-264-1875
Employee Assistance Program- New Avenues (GHS employees)
Phone Number 1: 800-731-6501
Fax Number:
Epworth Center
420 N. Niles Ave.
Phone Number 1: 574-647-8400
Fax Number:
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176
IU Health Goshen
Faith Mission
801 Denham
Elkhart, IN 46516-3237
Phone Number 1: 574-293-3406 24hrs
Families First
1000 W Hively Ave.
Elkhart, IN 46516
Phone Number 1: 574-295-2277
Fax Number: 574-293-0358
Fax Number: 574-295-7642
Family Christian Development Center
151 S Locke St.
Nappanee, IN 46550
Phone Number 1: 574-773-2149
Fax Number: 574-773-5337
Fellowship Missions--Warsaw
P.O. Box 382
Winona Lake, IN 46590
Phone Number 1: 574-268-9555
Fax Number:
First Church of God-Nappanee
72036 Co Rd 7
Nappanee, IN 46550
Phone Number 1: 574-773-7743
Fax Number:
First Steps
700 E Beardsley
Elkhart, IN 46517
Phone Number 1: 574-293-2813
Fax Number: 574-293-2300
Fort Wayne VA Hospital
2121 Lake Avenue
Phone Number 1: 260-426-5431
Fax Number:
FRESENIUS MEDICAL CARE Nephrology Goshen
2257 Karisa Dr
Goshen, IN 46526
Phone Number 1: 574-533-9031
Fax Number:
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177
IU Health Goshen
Friendship Food Pantry
303 W Rush St
Phone Number 1: 260-349-1623
Fax Number:
Geneele Crump LCSW
59216 Merrimac Ln
Elkhart, IN 46517
Phone Number 1: 574-875-6399
Fax Number:
Generations- Geriatric Services
700 Broadway
Phone Number 1: 260-425-3000
Fax Number:
Good RX
225 Santa Monica Blvd 5th floor
Santa Monica, CA 90401
Phone Number 1: 888-799-2553
Fax Number:
Goodwill Industries Retail Stores
Phone Number 1:
Fax Number:
Goshen College Student Health Services
Phone Number 1: 574-535-7000
Fax Number:
Goshen Family Dentistry
1625 Sunny Field Dr.
Goshen, IN 46526
Phone Number 1: 574-534-5528
Fax Number:
Goshen Foot and Ankle Clinic
1773 Strafford Ct
Goshen, IN 46526
Phone Number 1: 574-533-4025
Fax Number: 574-533-2848
Goshen Home Medical Equipment
1501 S Main St
Goshen, IN 46526
Phone Number 1: 574-533-0626
Fax Number:
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178
IU Health Goshen
Goshen Interfaith Hospitality Network
105 S 3rd St.
Goshen, IN 46526
Phone Number 1: 574-534-2300
Fax Number:
Granger Family Dentistry
1245 SR 23
Granger, IN 46530
Phone Number 1:
Fax Number:
Griefshare
Phone Number 1:
Fax Number:
GUIDANCE MINISTRIES
216 N 2nd St.
Elkhart, IN 46517
Phone Number 1: 574-296-7192
Fax Number:
Habitat for Humanity of Elkhart County
2526 Peddlers Village Rd
Goshen, IN 46526
Phone Number 1: 574-533-6109 off
Fax Number:
Healthy Beginnings (Healthy Babies)
117 N. 2nd Street Goshen
1400 Hudson st in Elkhart
Goshen, IN 46526
Phone Number 1: 574-535-6765 gosh
Hearing Loss Association
7910Woodmont Ave Suite 1200
Bethesda, MD 20814
Phone Number 1: 1-301-657-2248
Heart City Dental Center
236 Simpson Ave.
Elkhart, IN 46517
Phone Number 1: 574-970-1937
Help Rx ---Rx relief card
Phone Number 1: 1-877-839-5689
Fax Number: 574-535-6765 gosh
Fax Number:
Fax Number: 574-970-1939
Fax Number:
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179
IU Health Goshen
Holistic Moms Network:
PO box 408
Caldwell, NJ 07006
Phone Number 1: 1-877-HOL-MOMS
Fax Number:
Hoosier Healthwise (Medicaid)
1120 N. Main St., Suite 201
Elkhart, IN 46514
Phone Number 1: 800-403-0864
Fax Number:
Hoosier Healthwise Medicaid
1120 N Main Suite 201
Elkhart, IN 46514
Phone Number 1: 800-889-9949
Fax Number: 574-293-3878
HoosierRx
, OH
Phone Number 1: 877-793-0765
Fax Number:
Hope Ministries (Hope Rescue Mission)
Mens Center 532 South Michigan
Family Life Center-432 S. Lafayette
Phone Number 1: 574-235-4150
Fax Number: 574-289-7801
Hopebridge
625 N. Union St.
Kokomo, IN 46901
Phone Number 1: 765-454-9748
Fax Number:
Hospital - ELKHART GENERAL
600 E Boulevard
Elkhart, IN 46516
Phone Number 1: 574-294-2621
Fax Number:
Hospital - Indiana Health University
550 N University Blvd.
Phone Number 1: 317-944-5000
Fax Number:
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180
IU Health Goshen
Hospital - Kosciusko Community Hospital
2101 E Dubois Drive
Warsaw, IN 46580
Phone Number 1: 574-267-3200
Fax Number:
Hospital - Memorial Hospital of South Bend
615 N. Michigan Street
Phone Number 1: 574-647-1000
Fax Number:
Hospital - Parkview LaGrange
207N Townline Rd.
Lagrange, IN 46761
Phone Number 1: 260-463-9000
Fax Number:
Hospital Care for the indigent
Phone Number 1:
Fax Number:
Hotlines
Phone Number 1:
Fax Number:
Human Relations Commission of Elkhart County
229 S. Second St. third floor
Elkhart, IN 46516
Phone Number 1: 574-294-5471 EX310
Fax Number: 574-293-2816
I.U. Medical Center Physician Referral Service
Phone Number 1: 888-944-3627
Fax Number:
Immergrun, Inc.(Anabaptist Asistantance)
International Drive Suite D
Holland, OH 43538
Phone Number 1: 1-800-333-3561
Fax Number:
Indiana Bureau of Disability Determination
402 W. Washington St., #W451
P.O. Box 7083, MS26
Phone Number 1: 800-545-7763
Fax Number: 317-232-1240
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181
IU Health Goshen
Indiana Center for Immigration & naturalization
312 S Main St
Goshen, IN 46528
Phone Number 1: 574-534-9403
Fax Number:
Indiana Child Abuse and Neglect Hotline
Phone Number 1: 1-800-800-5556
Fax Number:
Indiana Coalition Against Domestic Violence (ICADV)
1915 W. 18th Street, Suite B
Phone Number 1: 317-917-3685
Fax Number: 317-917-3695
Indiana Department of Transportation (INDOT)
Phone Number 1: 260-969-8219
Fax Number:
INDIANA HEALTH CENTERS, INC
1901 W. Western Ave.
Suite B
Phone Number 1: 574-234-9033
Fax Number:
Indiana Medical Access Communication System
Phone Number 1: 800-622-4989
Fax Number:
Indiana Perinatal Network
1991 E 56th St
Phone Number 1: 866-338-0825
Fax Number: 317-924-0831
Indiana Protection & Advocacy Services
4701 N. Keystone Ave., Suite 222
Phone Number 1:
Fax Number:
Indiana State Department of Health
2 North Meridian St
Phone Number 1: 317-233-1325
Fax Number:
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182
IU Health Goshen
Indiana State Department of Health -Children's Special Health Care Services
ISDH/CSHCS, Section 7-B
2 North Meridian St.
Phone Number 1: 1800-475-135 5
Fax Number:
INDIANA STATE MEDICAL ASSOCIATION
322 Canal Walk
Phone Number 1: 317-261-2060
Fax Number:
INDIANA TOBACCO QUITLINE
Phone Number 1: 1-800-784-8669
Indiana University Health
550 University Blvd
Phone Number 1: 317-944-5000
Fax Number:
Fax Number:
Indiana's Health Insurance Marketplace
Phone Number 1: 800-318-2596
Fax Number:
Interfaith Hospitality
105 South 3rd Street
Goshen, IN 46526
Phone Number 1: 574-534-2300
Fax Number: 574-534-2300
International Community Center
312 S Main St
Goshen, IN 46526
Phone Number 1: 574-534-9403
Fax Number:
International Consortium for Emergency Contraception
588 Broadway Suite 503
New York, NY 10012
Phone Number 1: 212-941-5300
Fax Number:
IU South Bend Dental Hygiene Clinic
1002 South Esther St
Phone Number 1: 574-520-4156
Fax Number:
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183
IU Health Goshen
Ivy Tech State College
22531 CR 18
Goshen, IN 46528
Phone Number 1: 574-830-0375
Fax Number:
Kentucky-Indiana Chapter Paralyzed Veterans of America
1030 Goss Avenue
Louisville, KY 40217
Phone Number 1: 502-635-6539
Fax Number: 502-379-4143
Kool Smiles Dentistry--Elkhart
3701 S Main St Suite A 150
Concord Mall
Elkhart, IN 46517
Phone Number 1: 574-830-8176
Fax Number:
Kosciusko County Combined Community Services
1195 Mariners
Warsaw, IN 46582
Phone Number 1: 574-269-6019
Fax Number:
KOSCIUSKO COUNTY HEALTH DEPARTMENT
100 West Center St
Warsaw, IN 46580
Phone Number 1: 574-372-2349
Fax Number: 574-269-2023
Kosciusko County Voucher Program
827 S Union St
Warsaw, IN 46580
Phone Number 1:
Fax Number:
Kroger Pharmacy - Elkhart
901 Johnson St.
Elkhart, IN 46514
Phone Number 1: 574-264-5996
Fax Number:
Kroger Pharmacy - Goshen
209 Chicago Ave.
Goshen, IN 46526
Phone Number 1: 574-534-9223
Fax Number:
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184
IU Health Goshen
La Casa Estates
908 S Main St,
Phone Number 1: 46516
Fax Number: Fax-:57-4293 1078
La Leche League-Elkhart County
Elkhart, IN 46517
Phone Number 1: 574-349-5510
Fax Number:
LaCasa Goshen
202 N. Cottage Ave.
Goshen, IN 46528
Phone Number 1: 574-533-4450
Fax Number: 574-533-4399
LaGrange County Health Dept
304 N Townline Rd Suite 1
Lagrange, IN 46761
Phone Number 1: 260-499-4182
Fax Number:
LaGrange Redi Care
2120 N. Detroit St.
Lagrange, IN 46761
Phone Number 1: 260-463-2468
Fax Number: 260-463-4237
LCP Transportation
4308 Guion Rd. suite-D
Phone Number 1: 317-291-9318
Fax Number: 317-291-9446
LCSW (Licensed Clinical Social Worker )
, IN
Phone Number 1:
Fax Number:
League for the Blind and Disabled
5821 S. Anthony Blvd
Phone Number 1: 260-441-0551
Fax Number: 260-441-7760
Life Treatment Centers
1402 S Michigan St
Phone Number 1: 574-233-5433
Fax Number: 574-239-6407
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185
IU Health Goshen
Lifelong Learning Institute
Phone Number 1: 574-533-6352
Fax Number:
Lighthouse Autism Center
3730 Edison Lakes Parkway
Mishawaka, IN 46545
Phone Number 1: 574-387-4313
Fax Number:
Ligonier Dental Care
907 Lincolnway South
Ligonier, IN 46767
Phone Number 1: 574-894-4044
Fax Number:
LIGONIER POLICE DEPARTMENT
301 Calvin
Ligonier, IN 46767
Phone Number 1: 260-894-4111
Fax Number: 260-894-3999
Lincoln Therapeutic
113 Lincolnway E
Mishawaka, IN 46544
Phone Number 1: 574-255-4976
Fax Number:
Lions Club
300 W 22nd St
Oak Brook, IL 60523
Phone Number 1: 630-571-5466
Fax Number:
LOCKS OF LOVE
234 Southern Blvd
West Palm Beach, FL 33405
Phone Number 1: 1-888-896-1588
Logansport State Hospital
1098 S SR 25
Logansport, IN 46947
Phone Number 1: 574-722-4141
Fax Number: 561-833-7962
Fax Number:
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186
IU Health Goshen
Love Way
54151 County Road 33
Phone Number 1: 574-825-5666
Fax Number: 574-825-8117
Lutheran Hospital of Indiana
7950 W Jefferson Blvd.
Phone Number 1: 260-435-7001
Fax Number:
MACOG (Michiana Area Council of Governments)
Phone Number 1: 574-287-1829
Fax Number:
Maple City Counseling Center
209-C Tanglewood Dr
Goshen, IN 46526
Phone Number 1: 574-220-0220
Fax Number:
Maple City Health Care Center
213 Middlebury Street
Goshen, IN 46528
Phone Number 1: 574-534-3300
Fax Number: 574-534-5412
Maple Court Place
2932 Elkhart Road
, 574-535-08
Phone Number 1: 574-535-0438
Fax Number:
McArthur Counseling Center
3040A Windsor Court
Elkhart, IN 46514
Phone Number 1: 855-267-1700
Fax Number: 574-267-0017
MDC Goldenrod --Residential Programs
1514 College Ave
Goshen, IN 46526
Phone Number 1: 574-533-9720
Fax Number: 574-534-9817
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187
IU Health Goshen
Meals on Wheels of Goshen
223 S. Main Street
Goshen, IN 46526
Phone Number 1: 574-533-1367
Fax Number:
Med-Point @Elkhart Family Practice
3301 CR 6
Elkhart, IN 46516
Phone Number 1: 574-266-5342
Fax Number:
Med-Point At Erskine Plaza- South Bend
1815 Ireland rd
Phone Number 1: 574-647-1750
Fax Number:
Med-Point At Main St - Granger
6913 N. Main
Between SR 23 & Tollroad across from Tar
Granger,
Phone Number 1: 574-647-1550
Fax Number: 574-243-4306
Med-Point At Martin's - Elkhart
3900 East Bristol Street
Elkhart, IN 46514
Phone Number 1: 574-266-4546
Fax Number:
Med-Point Express in lobby Memorial Hospital
615 N Michigan St
Phone Number 1: 574-647-6260
Fax Number:
Med-Point Express--Goshen
1527 Bashor Rd
Goshen, IN 46526
Phone Number 1: 574-533-0120
Fax Number:
Medicaid Indiana State Assistance-Hoosier Healthwise
Phone Number 1: 1-800-889-9949
Fax Number:
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188
IU Health Goshen
Medicare Assistance Programs
7500 Security Blvd
Windsor Mill, MD 21244
Phone Number 1: 1-800-633-4227
Fax Number:
MedStat--Syracuse
107 W Pickwick Dr Suite A
Syracuse, IN 46567
Phone Number 1: 574-457-8682
Fax Number:
Meijer Pharmacy - Dunlap
4522 Elkhart Rd (US 33)
Elkhart, IN 46517
Phone Number 1: 574-875-3010
Fax Number:
Memorial Epworth Center
420 N Niles Ave
So Bend, IN
Phone Number 1: 574-647-8400
Fax Number:
Memorial Pediatric Specialists
100 Navarre Pl Ste 5550
Phone Number 1: 574-647-2550
Fax Number: 574-647-1140
Mental Health America of Indiana
1431 N Delaware St
Phone Number 1: 1-800-555-6424
Fax Number:
Mental Health Matters
Phone Number 1:
Fax Number:
Mental Health.Net
Phone Number 1:
Fax Number:
Merrill Pharmacy
606 N Main st
Mishawaka, IN 46545
Phone Number 1: 574-255-2988
Fax Number: 574-258-5945
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189
IU Health Goshen
Methodist Hospital
1801 Senate Blvd.
Phone Number 1: 317-962-2000
Michiana Behavioral Health Center
1800 North Oak Drive
Plymouth, IN 46563
Phone Number 1: 1-800-795-6252
Fax Number:
Fax Number:
Michiana Counseling Group
56218 Parkway Ave Suite D
Elkhart, IN 46516
Phone Number 1: 574-293-0005
Fax Number:
Michiana Gastroenterology
17501 Generations Drive
Phone Number 1: 574-243-7740
Fax Number:
Michiana Multiple Myeloma Support Group
Phone Number 1: 574-647-1100
Fax Number:
Michiana Parents of Multiples Club
P.O. Box 11173
Phone Number 1: 574-258-9913
Fax Number:
Middlebury Police Department
418 North Main St
Phone Number 1: 574-825-9111
Fax Number:
Midwifery of Michiana (St Joseph Medical Center)
611 E Douglas Suite 408
Mishawaka, IN 46545
Phone Number 1: 574-335-6440
Fax Number: 574-335-0806
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190
IU Health Goshen
Millersburg Police Department
201 W Washington St
Millersburg, IN 46543
Phone Number 1: 574-642-4500
Fax Number:
Milton Adult Day Services
922 East Colfax Avenue
Phone Number 1: 547-232-2666
Fax Number: 574-232-4235
Minority Health Coalition- Elkhart County
PO Box 218
312 Wagner Ave
Elkhart, IN 46515
Phone Number 1: 574-522-0128
Fax Number: 574-293-1403
MISHAWAKA POLICE
200 North Church ST
Mishawaka, IN 46544
Phone Number 1: 574-258-1678
Fax Number: 574-258-1690
MMJ Life Management Services LLC
17855 CLEVELAND RD
Phone Number 1: 574-440-3902
Fax Number:
MOM's Meals
3210 SE 72nd St.
Ankeny, IA 50021
Phone Number 1: 877-508-6667
Fax Number: 515-963-0671
MOPS (Mothers of preschoolers)
Phone Number 1: 574-534-3528
Fax Number:
Mother Matters, a Postpartum Mood Disorder Group
Phone Number 1: 574-647-3243
Fax Number:
MOTHERS AND MORE
PO box 6751
Phone Number 1: 574-329-5405
Fax Number:
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191
IU Health Goshen
MS Foundation Support groups
, IN
Phone Number 1:
Fax Number:
Mustard Seed Pantry
29064 County Rd 16
Elkhart, IN 46515
Phone Number 1: 574-293-1833
Fax Number:
Nancy Rodriguez-Lora LSW
400 W Lincoln
Goshen, IN 46526
Phone Number 1: 574-533-7133
Fax Number:
Nappanee Open Door
292 S Main st
Nappanee, IN 46550
Phone Number 1: 574-773-3820
Fax Number: 574-773-9253
NAPPANEE POLICE DEPARTMENT
301 W Lincoln st
Nappanee, IN 46550
Phone Number 1: 574-773-4111
Fax Number:
National Center for Missing & Exploited Children
699 Prince St
Alexandria, VA 22314
Phone Number 1: 800-843-5678
Fax Number: 703-224-2122
National Center on Elder Abuse (NCEA)
Phone Number 1: 1-800-677-1116
Fax Number: 714-456-7933
National Children's Alliance
516 C ST NE
Phone Number 1: 202-548-0090
Fax Number: 202-548-0099
National Council on Disability
1331 F Street, NW, Suite 850
Phone Number 1: 202-272-2004
Fax Number: 202-272-2022
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192
IU Health Goshen
National Diabetes Education Program
One Diabetes Way
Bethesda, MD 20814
Phone Number 1: 301-496-3583
Fax Number:
National Domestic Violence Hotline
Phone Number 1: 1-800-779-7233
Fax Number:
NATIONAL HOPELINE NETWORK SUICIDE PREVENTION HOTLINE
Phone Number 1: 180-044-2467 3
Fax Number:
National Human Trafficking Resource Center Hotline
PO Box 53315
Phone Number 1: 1-888-373-7888
Fax Number:
National Institute of Neurological Disorders and Stroke
PO BOX 5801
Bethesda, MD 20824
Phone Number 1: 800-352-9424
Fax Number:
National Parkinson Foundation
1501 N.W. 9th Avenue / Bob Hope Road
Miami, FL 33136
Phone Number 1: 1-800-473-4636
Fax Number: 305-243-6073
National Runaway Switchboard
3080 N. Lincoln Ave.
Chicago, IL 60657
Phone Number 1: 1-800-RUNAWAY
National Stroke Association
9707 E. Easter Lane
Centennial, CO 80112
Phone Number 1: 1-800-STROKES
National Veterans Foundation
9841 Airport Blvd Suite 418
Los Angeles, CA 90045
Phone Number 1: 1-888-777-4443
Fax Number: 773-929-5150
Fax Number:
Fax Number: 310-642-0258
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193
IU Health Goshen
National Youth Crisis Hotline Programs and Services
, CA
Phone Number 1:
Fax Number:
NEUROPSYCHIATRIC HOSPITALS
1625 Jefferson Boulevard
Mishawaka, IN 46545
Phone Number 1: 574-255-1400
Fax Number: 574-255-1840
New Avenues- Employee Assistance Program
PO BOX 360
Phone Number 1: 800-731-6501
Fax Number: 574-271-5980
New Eden Care Center
7980 West 100 South
Topeka, IN 46571
Phone Number 1: 260-768-4401
Fax Number:
New Eyes for the Needy
549 Milburn ave
PO Box 332
Short Hills, NJ 07078
Phone Number 1: 973-376-4903
Fax Number:
New Hope UMC Church food Pantry
28765 County Road 4West
Elkhart, IN 46514
Phone Number 1: 574-262-9341
Fax Number:
NIPSCO - gas leak or Assistance
Phone Number 1: 1-800-634-3524
Fax Number:
Noble County Division of Family Resources and Food Stamp Program
702 Goodwin Place, Suite A
Phone Number 1: 800-403-0864
Fax Number:
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194
IU Health Goshen
NOBLE COUNTY HEALTH DEPARTMENT
2090 N SR 9 Suite C
Albion, IN 46701
Phone Number 1: 260-636-2191
Fax Number: 260-636-2192
Noble County- WIC-Women, Infants & Children
774 Trail Ridge Road, Suite B
Albion, IN 46701
Phone Number 1: 260-636-2600
Fax Number:
Noble House /Pilot House Shelters
205 E Highland
Albion, IN 46701
Phone Number 1: 260-636-7160
Fax Number:
Northeastern Center
220 S Main St
PO Box 817
Phone Number 1: 800-790-0118 Emerg
Northern Indiana Food Bank
702 S Chapin St
Phone Number 1: 574-232-9986
Fax Number: 260-347-2456
Fax Number:
Northwood Circle Apartments-Low Income Housing
900 Northwood Circle
Nappanee, IN 46550
Phone Number 1:
Fax Number:
Northwood Family Dentistry, Inc. (Nappanee)
1001 N Main St.
Suite 2
Nappanee, IN 46550
Phone Number 1: 574-773-7979
Fax Number:
Oaklawn Apartments
2518 Oakland Avenue
Elkhart, IN 46517
Phone Number 1: 574-294-8905
Fax Number:
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195
IU Health Goshen
Office of Minority Health
P.O. Box 37337
Phone Number 1: 800-444-6472
Fax Number:
One Care Family Medicine
1712 Lincolnway West Suite A
Osceola, IN 46561
Phone Number 1: 574-675-9630
Fax Number:
Open Door Food Pantry
292 S Main St
Nappanee, IN 46550
Phone Number 1: 574-773-3820
Fax Number:
Open Gate Praise and Deliverance Ministries
137 Division Street
Elkhart, IN 46516
Phone Number 1: 574-522-8250
Fax Number:
Osceola Dental Care
103 Osceola Ave.
Osceola, IN 46561
Phone Number 1: 574-674-8757
Fax Number:
OSCEOLA POLICE
850 Lincolnway West
Osceola, IN 46561
Phone Number 1: 574-674-8685
Fax Number:
OSMC-Goshen
1775 East Kercher Road
Goshen, IN 46526
Phone Number 1: 574-533-0300
Fax Number:
Parents Against Meth (PAM)
Phone Number 1: 574-264-9777
Fax Number:
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196
IU Health Goshen
Parkinson's Disease Foundation
1359 Broadway, Suite 1509
New York, NY 10018
Phone Number 1: 1-800-457-6676
Fax Number:
Parkview First Care Walk-IN Clinic
512 N Professional Way
Phone Number 1: 260-347-8556
Fax Number:
Parkview Gastroenterology
11104 Parkview Circle Drive Suite 310
Phone Number 1: 260-266-5230
Fax Number:
Parkview LaGrange Hospital
207 North Townline Rd
Lagrange, IN 46761
Phone Number 1: 260-463-9000
Fax Number:
Partnership for Prescription Assistance
Phone Number 1:
Fax Number:
Patient Advocate Foundation
421 Butler Farm Rd
Hampton, VA 23666
Phone Number 1: 1-800-532-5274
Pet Poison Help Line
Phone Number 1: 855-764-7661
Pfizer Patient Assistance Programs
235 East 42nd st
New York, NY 10017
Phone Number 1: 1-866-706-2400
Fax Number:
Fax Number:
Fax Number:
Pharmacy - General
Phone Number 1:
Fax Number:
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197
IU Health Goshen
Pharmacy CVS- Syracuse (old Park Pharmacy, Syracuse)
308 S. Huntington Street
Syracuse, IN 46567
Phone Number 1: 574-457-4000
Fax Number:
Phyllis Stutzman
307 South 5th Street
Goshen, IN 46526
Phone Number 1: 574-534-9099
Fax Number:
Physicians Urgent Care--Elkhart
900 Johnson St
Elkhart, IN
Phone Number 1: 574-747-8004
Fax Number:
Physicians Urgent Care--Mishawaka
505 W Cleveland Rd
Mishawaka, IN 46545
Phone Number 1: 574-235-3135
Fax Number:
Physicians Urgent Care--Warsaw
2680 Escalade Way
Warsaw, IN 46582
Phone Number 1: 574-306-4128
Fax Number: 574-267-5023
Pierre Moran Middle School
200 W Lusher
Elkhart, IN 46517
Phone Number 1: 574-262-5678
Fax Number:
Pill Box Pharmacy and Home Medical Equpment
2306 Du Bois Dr
Warsaw, IN 46580
Phone Number 1: 574-267-4900
Fax Number:
Planned Parenthood of Indiana--Mishawaka
3005 Grape Rd
Mishawaka, IN 46545
Phone Number 1: 574-255-9555
Fax Number: 574-259-5761
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198
IU Health Goshen
Planned Parenthood--Elkhart
505 South 3rd Street, Suite 160
Elkhart, IN 46516
Phone Number 1: 574-294-7561
Fax Number: 574-293-5479
Poison Control Center - Indiana
Phone Number 1: 800-222-1222
Fax Number:
Postpartum Support International
6706 SW 54th Ave
Portland, OR 97219
Phone Number 1: 800-944-4773
Fax Number: 503-894-9452
Pregnancy Help Services
300 W. High Street
Elkhart, IN 46516
Phone Number 1: 574-522-4357
Fax Number: 574-293-5368
Project Homecoming Medical Clinic
701 S Main St
Phone Number 1: 574-235-7990
Fax Number: 574-234-4959
Prompt Ambulance Service
Phone Number 1: 574-289-5736
Fax Number: 574-289-4662
Psychological and Family Consultants
926 East Jackson Boulevard
Elkhart, IN 46516
Phone Number 1: 574-522-6292
Fax Number:
Public Housing Authority-Elkhart
1396 Benham Avenue
Elkhart, IN 46516
Phone Number 1: 574-295-8392
Fax Number: 574-293-6878
Public Library--Elkhart and Goshen
Phone Number 1:
Fax Number:
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199
IU Health Goshen
Rabies Shots
Phone Number 1:
Fax Number:
Rape, Abuse & Incest National Network--RAINN
1220 L St NW Suite 505
Phone Number 1: 1-800-656-4673 hot
Fax Number:
Real Services
1151 S Michigan St
Phone Number 1: 1-800-552-7928
Fax Number:
Recovery Dimension Inc.
204 S Main
Elkhart, IN 46516
Phone Number 1: 574-293-1086
Fax Number:
Recovery Journey
3110 Windsor Ct
Elkhart, IN 46514
Phone Number 1: 574-264-5840
Fax Number: 574-264-5495
Redi-Care--Lagrange
2120 N Detroit
Lagrange, IN 46761
Phone Number 1: 260-463-2468
Fax Number:
Rehabilitation Hospital of Indiana (RHI)
4140 Shore Drive
Phone Number 1: 317-329-2000
Fax Number:
Rescued Hearts Youth Ranch
12970 County Road 4 Suite 200
Phone Number 1: 574-825-1299
Fax Number:
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200
IU Health Goshen
Ribbon Of Hope-Cancer Support
600 E. Blvd
Elkhart, IN 46514
Phone Number 1: 574-389-7379
Fax Number: 574-389-5643
Richard Koch Counseling Services
501 W Bristol St
Elkhart, IN 46514
Phone Number 1: 574-266-5700
Fax Number:
Riley Children's Hospital
705 Riley Hosptial Dr
Phone Number 1: 317-944-5000
Fax Number:
River Run Apartments
740 Prairie St
Elkhart, IN 46516
Phone Number 1: 574-294-3124
Fax Number:
RX HOPE
PO Box 42886
Cincinnati, OH 45242
Phone Number 1: 1-877-267-0517
Fax Number:
Ryan's Place
203 N 5th St
PO Box 73
Goshen, IN 46526
Phone Number 1: 574-535-1000 gosh
SAFE (Stop Abuse for Everyone)
10030 Scenic View terrace
Vienna, VA 22182
Phone Number 1: 503-389-2111
Fax Number:
Fax Number:
Saint Joseph Health Center (plymouth)
1915 Lake Ave
Plymouth, IN 46563
Phone Number 1: 574-948-4000
Fax Number:
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201
IU Health Goshen
Salvation Army-Elkhart
300 North Main Street
Elkhart, IN 46516
Phone Number 1:
Fax Number: 574-295-8945
Salvation Army-Goshen
1013 North Main Street
PO Box 114, Goshen 46527 mailing
Goshen, IN 46526
Phone Number 1:
Fax Number: 574-534-2070
SAMARITAN HEALTH AND LIVING CENTER
221 E. Crawford St
Elkhart, IN 46514
Phone Number 1: 574-262-3597
Fax Number: 574-262-3599
Section 8 Housing
Phone Number 1:
Fax Number:
Seifert Drug
1028 E Waterford St just east SR 19
Wakarusa, IN 46573
Phone Number 1: 574-862-1454
Fax Number:
Select Care Benefits Network (SCBN)
Phone Number 1: 1-888-331-1002
Fax Number:
Senior Health Insurance Information Program (SHIIP)
714 W 53rd st
Anderson, IN 46013
Phone Number 1: 800-452-4800
Fax Number:
Senior Mobility
9695 Old Port Cove
Bristol, IN 46507
Phone Number 1: 574-584-4383
Fax Number:
Senior Net
5237 Summerlin Commons Blvd Suite 314
Fort Myers, FL 33907
Phone Number 1: 239-275-2202
Fax Number:
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202
IU Health Goshen
SEXUAL ADDICTION--DEFINITION
Phone Number 1:
Fax Number:
Sheldon Swartz
109 E. Clinton, Suite 11
Goshen, IN 46528
Phone Number 1: 574-533-2812
Fax Number:
Shetler Psychological Services
1930 W Lincoln Ave
Goshen, IN 46526
Phone Number 1: 574-534-2161
Fax Number:
SHIP (The State Health Insurance Assistance Program )
714 West 53rd Street
Anderson, IN 46013
Phone Number 1: 800-452-4800
Fax Number:
Shopko Pharmacy
1101 N Indiana
Syracuse, IN 46567
Phone Number 1: 574-457-3109
Fax Number:
Shriners Hospitals for Children
Phone Number 1:
Fax Number:
Single Parent Housing
Phone Number 1:
Fax Number:
Small Smiles Dental Centers of South Bend
2332 Miracle Lane
Mishawaka, IN 46545
Phone Number 1: 574-259-5437
Fax Number:
Smoking Indiana Tobacco Quitline
Phone Number 1: 1-800-784-8669
Fax Number:
South Bend Clinic-Gastroenterology
211 North Eddy Street
Phone Number 1: 574-234-8161
Fax Number:
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203
IU Health Goshen
South Bend Family Dental Care
1605 N. Ironwood
Phone Number 1: 574-271-9693
Fax Number:
South Bend Family Dentistry
1637 Portage Ave.
Phone Number 1: 574-233-8444
Fax Number:
SPA Women's Ministry Home
512 1/2 S Main ST
Elkhart, IN 46516
Phone Number 1: 574-522-8338
Fax Number:
St Joseph Family Medicine Center
611 E Douglas
Mishawaka, IN 46545
Phone Number 1: 574-335-6550
Fax Number:
St Jude Childrens Research Hospital
262 Danny Thomas Place
Memphis, TN 38105
Phone Number 1: 901-595-3300
Fax Number:
St Vincent De Paul of Elkhart Food Pantry
1101 Main St
Elkhart, IN 46516
Phone Number 1:
Fax Number:
St. John The Evangelist Episcopal Church Food Pantry
226 W Lexington Ave.
Elkhart, IN 46516
Phone Number 1: 574-295-1725
Fax Number:
St. Joseph County (Police Dept) Sheriff
401 W Sample
Phone Number 1: 574-235-9611
Fax Number:
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204
IU Health Goshen
St. Joseph Medical Center--Ft Wayne
700 Broadway
Phone Number 1: 260-425-3000
Fax Number:
St. Joseph Regional Medical Center
5215 Holy Cross Parkway
Mishawaka, IN 46545
Phone Number 1: 574-335-5000
Fax Number:
St. Vincent Hospital
2001 W 86th St.
Phone Number 1: 317-338-2345
Fax Number:
Stepping Forward Food Pantry
110 High St
Elkhart, IN 46516
Phone Number 1: 574-903-4114
Fax Number:
Stratford Commons
2601 Oakland Ave
Elkhart, IN 46517
Phone Number 1: 574-522-0550
Fax Number:
Stutsman Dentistry
1801 Charlton Ct.
Goshen, IN 46526
Phone Number 1: 574-533-8934
Fax Number:
Substance Abuse and Mental Health Services AdminTreatment referral line (SAMHSA)
Phone Number 1: 1-800-662-4357
Fax Number:
Survivors of Domestic Violence Support Group
533 North Niles Avenue
Phone Number 1: 574-234-6900
Fax Number:
Susan G Komen
Phone Number 1: 1-877-465-6636 mam
Fax Number:
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205
IU Health Goshen
Target Pharmacy
3938 Midway Rd
Goshen, IN 46526
Phone Number 1: 574-875-6410
Fax Number:
Teen Challenge (North Central)
PO Box 4603
1111 W Bristol St
Elkhart, IN 46514
Phone Number 1: 574-226-0789
Fax Number: 574-333-3097
Teenage Parent Program
Phone Number 1: 574-262-5833
Fax Number:
The Dental Center of Goshen
4024 Elkhart Rd Suite 15
Goshen, IN 46526
Phone Number 1: 574-807-0441
Fax Number:
The Dental Center of South Bend
1005 E LaSalle
Phone Number 1: 574-367-7000 adult
The Dental Center--Mishawaka
112 Ironworks Ave., Suite B1
Mishawaka, IN 46544
Phone Number 1: 574-285-0460
The Life Treatment Center
1332 West Indiana Ave
Elkhart, IN 46516
Phone Number 1: 1-888-411-5433
The Master's Handyman Service
69456 CR 19
New Paris, IN 46553
Phone Number 1: 574-536-5497
Fax Number:
Fax Number:
Fax Number: 574-389-8686
Fax Number:
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206
IU Health Goshen
The Mayo Clinic-Florida
4500 San Pablo
Jacksonville, FL 32224
Phone Number 1: 904-953-0853
Fax Number: 904-953-2898
The Mayo Clinic-Minnesota
200 1st Street SW
Rochester, MN 55905
Phone Number 1: 507-284-2511
Fax Number: 507-284-0161
The Nation's Health
PO Box 11127
Birmingham, AL 35202
Phone Number 1: 800-633-4931
Fax Number: 205-995-1588
The People's Clinic
5218 Beck Dr Suite 12
Elkhart, IN 46516
Phone Number 1: 574-226-0274
Fax Number: 574-333-2974
The Post
P.O. Box 124
301 East Lincoln Avenue
Goshen, IN 46528
Phone Number 1: 574-534-7678
Fax Number:
The Villages - Transitional Living Services
3132 Old US 20 Suite H10
Elkhart, IN 46514
Phone Number 1: 800-765-5075
Fax Number: 574-294-2821
The Willows
400 The Willows
Goshen, IN 46526
Phone Number 1: 574-875-0121
Fax Number:
The Young Widows and Widower Support Group
111 Sunnybrook Ct
South Bend,
Phone Number 1: 800-467-7423
Fax Number:
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207
IU Health Goshen
TheFamilyGateway.net
Phone Number 1:
Fax Number:
Tina Weldy Mental Health Counseling
120 W. Lexington Ave
Elkhart, IN 46516
Phone Number 1: 574-536-7580
Fax Number:
Topping Dental Group--Nappanee
102 W Market St.
Nappanee, IN 46550
Phone Number 1: 574-773-9700
Fax Number:
TOPS-Take off the pounds Sensibly
Phone Number 1:
Fax Number:
TOXNET--LactMed
Phone Number 1:
Fax Number:
Tricounty Ambulance Services
615 Nelsons Pkwy
Wakarusa, IN 46573
Phone Number 1: 1-888-606-5050
Fax Number:
United Cancer Srvices of Elkhart County, Inc.
23971 US 33
Elkhart, IN 46516
Phone Number 1: 574-875-5158
Fax Number:
United Health Services
6910 N main St
Building 9, Mall Unit 10
Granger, IN 46530
Phone Number 1: 574-247-6047
Fax Number: 574-247-6060
US Citizenship and Immigration Services
Phone Number 1:
Fax Number:
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208
IU Health Goshen
US HealthWorks Medical Clinic - Elkhart
700 E. Beardsley Ave.
Elkhart, -IN
Phone Number 1: 574-206-1080
Fax Number:
US HealthWorks Medical Clinic - Goshen
2014 Lincolnway east
Goshen,
Phone Number 1: 574-537-1709
Fax Number: 574-537-1736
US HealthWorks Medical Clinic -Warsaw
3151 E. Center St.
Warsaw,
Phone Number 1: 574-267-3070
Fax Number:
VA Northern Indiana Health Care System (Clinics)
Phone Number 1:
Fax Number:
Veteran Services of Elkhart county
320 West High Street
Elkhart, IN 46516
Phone Number 1:
Fax Number:
Veterans Suicide Prevention Hotline
Phone Number 1: 1-800-273-8255
Fax Number:
Vets Helping Vets
4800 Memorial Dr bldg #7 Rm 1C-118
Waco, TX 76711
Phone Number 1: 254-297-3221
Fax Number:
VICTIM ASSISTANCE SERVICES OF ELKHART COUNTY
301 S Main St. Sutie 100
Elkhart, IN 46517
Phone Number 1: 574-523-2237
Fax Number: 574-293-4558
Victory Clinical Services
4218 Western Ave
Phone Number 1: 574-233-1524
Fax Number: 574-233-1612
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209
IU Health Goshen
VISION USA
243 N Lindbergh Blvd Floor 1
Saint Louis, MO 63141
Phone Number 1: 800-365-2219 ext0
Fax Number:
Vista Community Health Center (2nd Maple City Health Center)
808 N 3rd
Near the intersection of Main and Wildon
Goshen, IN 46526
Phone Number 1: 574-534-0088
Fax Number: 574-971-8434
Vocational Rehabilitation Services
Phone Number 1:
Fax Number:
Wakarusa Police Department
102 S Spring
Wakarusa, IN 46573
Phone Number 1: 574-862-4200
Fax Number:
Walgreen Pharmacy - Elkhart
102 E Hively
Elkhart, IN 46517
Phone Number 1: 574-522-2197
Fax Number:
Walgreen Pharmacy - Elkhart (24 hr)
1400 Cassopolis St
Elkhart, IN 46514
Phone Number 1: 574-262-2756
Fax Number:
Walgreen Pharmacy - Ft. Wayne
2410 N. Coliseum Blvd.
Phone Number 1: 260-483-5612
Fax Number:
Walgreen Pharmacy - Ft. Wayne
222 E Pettit Ave
East Pettit and Lafayette (27)
Phone Number 1: 260-744-4351
Fax Number:
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210
IU Health Goshen
Walgreen Pharmacy - Goshen
429 Pike St.
Goshen, IN 46526
Phone Number 1: 574-534-7616
Fax Number:
Walgreen Pharmacy - South Bend
1010 E. Ireland Rd
Phone Number 1: 574-299-0154
Fax Number:
Walgreen Prescriptions Savings Club
Phone Number 1: 866-922-7312
Fax Number:
Walgreen--Elkhart Nappanee St
200 S Nappanee ST
Elkhart, IN 46514
Phone Number 1: 574-293-2063
Fax Number:
Walgreens--Close to Target
4430 Elkhart Rd
Goshen, IN 46526
Phone Number 1: 574-875-0236
Fax Number:
Walmart $4 Pharmacy program
Phone Number 1:
Fax Number:
Walmart Pharmacy - Goshen
2304 E. Lincolnway
Goshen, IN 46526
Phone Number 1: 574-534-4094
Fax Number:
Walmart Pharmacy - Dunlap
4024-2 Elkhart Rd. (US 33)
Elkhart, IN 46517
Phone Number 1: 574-875-6601
Fax Number:
Warsaw Med Stat
1500 Provident Dr.
Phone Number 1: 574-372-7637
Fax Number: 574-372-7689
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211
IU Health Goshen
Welfare Office - State of Indiana
1120 N Main St Suite 201
Phone Number 1:
Fax Number:
Welfare- Indiana State
, IN
Phone Number 1: 1-800-889-9949
Wellington & Weddell Eye Care
116 W. Washington St
Goshen, IN 46526
Phone Number 1: 574-533-7345
Fax Number:
Fax Number:
West Noble Food and Clothing Pantry
519 Gerber
Ligonier, IN 46767
Phone Number 1: 260-894-4670
Fax Number:
Wheelchair Help
1201 Richmond
Elkhart, IN 46516
Phone Number 1: 574-295-2230
Fax Number: 888-670-2221
Williamsburg on The Lake Apartments
1000 Portsmouth Drive
Elkhart, IN 46517
Phone Number 1: 574-294-7471
Fax Number: 574-296-0943
Windsor Work Care--Elkhart
3100 Windsor Crt.
Elkhart, IN 46514
Phone Number 1: 574-266-6555
Fax Number:
Windsor Work Urgent Care--Middlebury
410 Main st
Phone Number 1: 574-825-3400
Fax Number:
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212
IU Health Goshen
WINONA LAKE POLICE DEPARTMENT
1310 Park Ave
Winona Lake, IN 46590
Phone Number 1: 574-267-8622
Fax Number:
Work One
430 Waterfall Drive
Elkhart, IN 46516
Phone Number 1: 574-295-0105
Fax Number:
Xubex Pharmacutical Patient Assistance Programs
Phone Number 1: 1-866-699-8239
Fax Number:
Youth Services Bureau, Inc
222 Middlebury Street
Elkhart, IN 46516
Phone Number 1: 574-294-3549
Fax Number:
YWCA-South Bend (North Central)
1102 S Fellows St
Phone Number 1: 574-233-9491
Fax Number:
Zion Luthern Church
20943 CR 6
Bristol, IN 46507
Phone Number 1: 574-848-4880
Fax Number:
Adult Protective Services
Adult Abuse or neglect for Elkhart County
2614 S Michigan St
Elkhart, IN 46514
Phone Number 1: 1-800-626-8320
Fax Number: 574-293-4558
American Heart Association
6100 W 96th St Suite 200
Phone Number 1: 800-242-8721
Fax Number: 317-873-3070
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213
IU Health Goshen
HeartHub for Patients
7272 Greenville Ave
Dallas, TX 75231
Phone Number 1: 1-800-242-8721
Fax Number:
American Red Cross, St Joseph County Chapter
American Red Cross - South Bend Office
Phone Number 1: 574-234-0191
Fax Number: 574-234-0194
American Tinnitus Ass National Headquarters
American Tinnitus Association
522 S. W. Fifth Ave suite 825
Mailing: PO box 5 portland, OR 97207
Portland, OR 97204
Phone Number 1: (800) 634-8978
Fax Number: 503-248-0024
Anna Beachy
Aphasia Support Group
200 High Park Ave
755 W. Cenntenial Nappanee IN 46550
Goshen, IN 46526
Phone Number 1: 574-221-1033 cell
Fax Number:
At Memorial Hospital
Second Wind (COPD support group)
Phone Number 1: 574-647-7178
Fax Number:
Attention: Crystal Valley Manor Apartments
Crystal Valley Manor Apartments-Low Income Housing Seniors
114 Krider Drive
P.O. Box 400
Middlebury, IN 46540-0400
Phone Number 1: 574-825-5161
Fax Number: 574-825-3681
Barb
Elkhart County Suicide Prevention Coalition
Phone Number 1: 574-523-2119
Fax Number:
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214
IU Health Goshen
Bashor Childrens Home
Bashor Home of United Methodist Church
62226 CR 15
PO box 843
Goshen, IN 46527
Phone Number 1: 574-875-5117
Fax Number: 574-875-5284
Behavioral Health and Family Studies Institute
Indiana Suicide Prevention Coalition
2101 E Coliseum Blvd. 134 Neff Hall
Phone Number 1: 1-800-273-8255
Fax Number:
Big Brothers/Big Sisters of Elkhart County
BIG BROTHER/BIG SISTER
59029 CR 13
Elkhart, IN 46517
Phone Number 1: 574-875-1039
Fax Number: 574-875-1039
Bill
CAPS-- Elkhart
1000W Hively Ave
Elkhart, IN 46517
Phone Number 1: 574-295-2277 elk
Fax Number: 574-295-7642
Boston University Center for Neurorehabilitation
Parkinson's Rehab Resource Center
635 Commonwealth Ave 6th floor
Boston, MA 02215
Phone Number 1: 617-353-7525
Fax Number:
Boys Town National Headquarters
Boy's Town National Hotline
14100 Crawford St
Boys Town, NE 68010
Phone Number 1: 1-800-448-3000
Fax Number:
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215
IU Health Goshen
Calvary Assembly of God
Shepherd's Cove Food Pantry and Clothing Pantry
1010 E Mishawaka Rd
Elkhart, IN 46517
Phone Number 1: 574-293-5963
Fax Number:
CancerCare
Cancercare Connect Workshops
275 Seventh Ave
New York, NY 10001
Phone Number 1: 1-800-813-4673
Fax Number:
Carol Scribner
Parkinson's Support Group
Senior Center
1820 Greencroft BLVD
Goshen, IN 46526
Phone Number 1: 574-537-4105
Fax Number:
Carrie Horvak
Heart City Health Center
236 Simpson Avenue
Elkhart, IN 46516
Phone Number 1: 574-293-0052
Fax Number: 574-293-7635
Cathy Berry-Berg
Spouse and Sibling Loved One Support group for anyone in a Nursing Home
Manor 3 Garden Room
Goshen, IN 46526
Phone Number 1: 574-537-4049
Fax Number:
CDC
International Travelers' Vaccine Hotline
Phone Number 1: 404-332-4559
Fax Number:
Centers for Disease Control and Prevention
WISEWOMAN
1600 Clifton Road
Atlanta, GA 30329
Phone Number 1: 800-CDC-INFO
Fax Number:
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216
IU Health Goshen
Central Service office
Alcoholics Anonymous
949 A Middlebury Street
Elkhart, IN 46516
Phone Number 1: 574-295-8188
Fax Number:
CHASA
Children's Hemiplegia and Stroke Association
4101 W Green Oaks, Suite 305 #149
Arlington, TX 76016
Phone Number 1:
Fax Number:
Child and Family Advocacy Center
Child Advocacy Center
1000 W. Hively Ave
Elkhart, IN 46517
Phone Number 1: 574-295-2277
Fax Number: 574-522-0465
Child And Parent Services (CAPS)
Child and Parent Services--Healthy Families program of CAPS
1000 W. Hively Ave.
Elkhart, IN 46514
Phone Number 1: 574-295-2277
Fax Number:
Christine Guth
Asperger-Autism Parent Group of Goshen
Phone Number 1: 574-534-2718
Fax Number:
Claire Coleman
Catholic Charities
1817 Miami St.
Phone Number 1: 574-234-3111 ext 33
Fax Number: 574-289-1034
Clare Krabill, Executive Director, CCH
Center For Healing and Hope (CCH)
Plymouth United Church of Christ
902 S Main St
Goshen, IN 46526
Phone Number 1: 574-534-4744
Fax Number: 574-537-1186
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IU Health Goshen
Coordinators: John, Tanya, and Scott
CWE - EMS Education
Phone Number 1: 877-566-4660
Fax Number:
Corporate Headquarters
AEP---American Electric Power
1 Riverside Plaza
Columbus, OH 43215
Phone Number 1: 614-716-1000
Fax Number:
Corporate Office
Greencroft-Goshen
1721 Greencroft Blvd.
P.O. Box 819
Goshen, IN 46527-0819
Phone Number 1: 574-537-4000
Fax Number: 574-537-4058
CrossRoads Community Church
Divorce Care Group
3322 Middlebury ST
Elkhart, IN 46514
Phone Number 1: 574-848-0891Donita
Dawn M. Renze
The Window
223 S. Main Street
Goshen, IN 46526
Phone Number 1: 574-533-9680
Fax Number: 574-533-9311
Dee Swartz and Goshen Hospice
Greencroft Grief Support Group
1820 Greencroft Blvd
Goshen, IN 46526
Phone Number 1: 574-537-4159Dee
Director Suzanne McPherren
Legacy CNA Training
922 E Wayne St
Phone Number 1: 574-239-8973
Fax Number:
Fax Number:
Fax Number: 574-239-0003
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IU Health Goshen
District 24
Indiana State Police
1425 Miami Trail
Bremen, IN 46506
Phone Number 1: 574-546-4900
Fax Number:
DNA Technology Park
DNA DIAGNOSTIC CENTER
One DDC Way
Fairfield, OH 45014
Phone Number 1: 800-613-5768
Fax Number: 1-513-881-7803
Dr Daniel kragt
Dayspring Christian Health Care
1155 N 1200
Phone Number 1: 574-825-3888
Fax Number:
Dr David Regan
Crystal Valley Family Dentistry
1004 Spring Arbor Dr.
Phone Number 1: 574-825-4040
Fax Number:
Dr Sangyoung Lee
Dental Care Clinic
125 S Nappanee St.
Elkhart, IN 46517
Phone Number 1: 574-522-0156
Fax Number:
Dr, Joseph W. Cochran
Cochran Family Dentistry
1206 College Avenue Suite 2
Goshen, IN 46526
Phone Number 1: 574-533-7500
Fax Number: 574-533-7550
Dr. David Sonego and Associates
The Eating Disorder Recovery Center
230 E. Day Road Suite 160
Mishawaka, IN 46545
Phone Number 1: 574-271-8222
Fax Number: 574-271-8896
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IU Health Goshen
Dr. Richard C. Boling
Boling Vision Center
1615 Winsted Drive
2746 Old US Highwy 20 West Elkhart 46514
Goshen, IN 46526
Phone Number 1: 574-533-8633
Fax Number: 574-533-9314
EGH "Nurse Call Center"
EGH-Physician Referral Service/HealthLine
600 East Blvd.
Elkhart, IN 46514
Phone Number 1: 888-344-6773
Fax Number:
Elkhart Career Center
Community Education
2424 California Rd
Elkhart, IN 46517
Phone Number 1: 574-262-5650
Fax Number:
Elkhart County Health Dept
Safe Kids Elkhart County
608 Oakland Ave
Elkhart, IN 46516
Phone Number 1: 574-523-2112
Fax Number: 574-523-2158
Elkhart County Prosecuting Attorney
Adult Protective Services-Elkhart County
301 S Main St Suite 100
Elkhart, IN 46616
Phone Number 1: 574-296-1888
Fax Number: 574-293-4558
Elkhart County Solid waste District
Needles and Sharps Disposal
500 N Nappanee St
Elkhart, IN 46514
Phone Number 1: 574-293-2269
Fax Number:
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IU Health Goshen
Elkhart County Suicide Prevention Coalition
National Suicide Prevention Lifeline - Elkhart County
608 Oakland
Elkhart, IN 46516
Phone Number 1: 800-273-8255
Fax Number:
Elkhart General Hospital
Breastfeeding for Success Class
600 East Boulevard
Elkhart, IN 46514
Phone Number 1: 574-523-3444
Fax Number:
Emotions Anonymous
600 East Boulevard
Elkhart, IN 46514
Phone Number 1: 574-523-3347
Fax Number:
Motherhood Connection
Phone Number 1: 574-523-3276
Fax Number:
Physician Referral - EGH
600 East Blvd.
Elkhart, IN 46514
Phone Number 1: 888-344-6773
Fax Number:
Elkhart Housing Authority Building
Learning Generation Initiative
1396 Benham Ave Suite A
Elkhart, IN 46516
Phone Number 1: 1-866-898-3908
Fax Number:
Elkhart Office
Center for Problem Resolution-Elkhart
211 S. 5th. Street
Elkhart, IN 46517
Phone Number 1: 574-294-7447
Fax Number:
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IU Health Goshen
Emily Mills RN
Elkhart County Health Department - Communicable Disease/TB
608 Oakland Ave
Elkhart, IN 46516
Phone Number 1: 574-523-2127
Fax Number:
Erica Costello
Adult Protective Services Investigator--State
912 E LaSalle Ave
Phone Number 1: 1-800-626-8320
Fax Number:
Evelyn Zumfelde
Macular Degeneration Support Group
1325 Greencroft Dr
Goshen, IN 46526
Phone Number 1: 574-537-4074
Fax Number:
Family Medicine Center
Healthy Family Center (Mishawaka)
611 E Douglas rd Suite 407
Mishawaka, IN 46545
Phone Number 1: 574-335-6500
Fax Number:
Fibromyalgia Network
Fibromyalgia Network
Po box 31750
Tucson
Tucson, AZ 85751
Phone Number 1: 520-290-5508
Fax Number: 520-290-5550
First Brethern Church of New Paris
Good Neighbor Food Pantry
19076 3rd St.
New Paris, IN 46553
Phone Number 1: 574-831-2766
Fax Number:
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IU Health Goshen
First Church of God-Goshen
Lifepoint Church Food Pantry
1006 S. 16th St.
Goshen, IN 46526
Phone Number 1: 574-533-1191
Fax Number:
For residents St Joe County, IN
Brannick Health Center
326 Chapin St
Phone Number 1: 574-335-8222
Fax Number:
Geneele Crump LCSW
Waterside Counseling
Phone Number 1: 574-875-6399
Fax Number:
Goshen Addictions Program
Addiction Recovery Centers Inc.-Goshen
114 North Main St
Goshen, IN 46526
Phone Number 1: 574-533-6154
Fax Number: 574-534-3951
Goshen Office
Center For Problem Resolution-Goshen
117 W. Washington
Goshen, IN 46526
Phone Number 1: 574-533-0664
Fax Number:
Government of Northwest Territories
Department of Health and Social Services in Canada
PO Box 1320
, X1A 2L9
Phone Number 1: 1-800-661-0830
Fax Number:
Grossnickle Eye CenterGrossnickle Eye Center--Elkhart
1510 Osolo Rd
Phone Number 1: 855-266-6100
Fax Number: 574-266-8708
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IU Health Goshen
Grossnickle Eye Center-Mishawaka Office
Grossnickle Eye Center-Mishawaka
4330 Edison Lakes Parkway, Suite A
Mishawaka, IN 46545-1421
Phone Number 1: 888-223-2030
Fax Number: 574-273-4108
Grossnickle Eye Center-Warsaw Office
Grossnickle Eye Center--Warsaw
2251 DuBois Drive
Warsaw, IN 46580-3212
Phone Number 1: 800-992-6975
Fax Number: 574-269-9828
Head office
ColonoscopyAssist
5918 N Northwest Highway
Chicago, IL 60631
Phone Number 1: 847-986-8999
Fax Number: 847-847-2888
Health Services Pavilion
Kosciusko County Health Services Pavilion
1515 Provident Dr
Warsaw, IN 46580
Phone Number 1: 574-372-3500
Fax Number:
Healthy Indiana Plan
HIP
Phone Number 1: 1-877-438-4479
Fax Number:
HHS, Administration For Children and Families
Low Income Home Energy Assistance Program (LIHEAP)
370 L'Enfant Promenade, S.W.
Aerospace Building, 5th Floor West
Phone Number 1: 202-401-9351
Fax Number: 202-401-5661
Hollie Lambert, program coordinator
Elkhart County Health Department - Health Education
608 Oaklawn Ave
Phone Number 1: 574-523-2112
Fax Number:
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IU Health Goshen
IFit
Women's Shelter - Elkhart County
Po Box 2684
Elkhart, IN 46515
Phone Number 1: Crisis Number:
IMF International Headquarters
International Myeloma Foundation
12650 Riverside Dr Suite 206
North Hollywood, CA 91607
Phone Number 1: 1-800- 452-2873
Fax Number: 574-294-1259
Fax Number:
Indiana Department of Veterans Affairs
Indiana Department of Veterans' Affairs
575 Pennsylvania ST
Phone Number 1: 317-232-3910
Fax Number: 317-232-7721
Indiana Legal Services South Bend
Indiana Legal Services
401 E Colfax Suite 116
Phone Number 1: 574) 234-8121
Fax Number: (574) 239-2185
Indiana State Dept of Health
Children's Special Health Care Services
2 North Meridian St., Section 7B
Phone Number 1: 800-475-1355 Helpli
Ingrid Bowser NP
MD to You
140 Whittington Parkway #100
Louisville, Kentucky 40222
Syracuse, IN 46567
Phone Number 1: 574-325-5454
Fax Number:
Fax Number:
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IU Health Goshen
ISO of SAA
Sex Addicts Anonymous
PO Box 70949
Houston, TX 77270
Phone Number 1: 1-800-477-8191
Fax Number:
IU Health La Porte
Lifeplex Urgent Care Plymouth
2855 Miller Dr Suite 119
Plymouth, IN 46563
Phone Number 1: 574-941-1000
Fax Number:
Janet Quatman- Care at home
GRIEF SUPPORT GROUP
Phone Number 1: 574-364-2700
Fax Number:
Joe Zychik
Sexual Control.com
9732 Pyramid Way #327
, 89441
Phone Number 1: 866-414-2668
Fax Number:
Joshua Villela
Servants of the Streets
803 W.Wolf Avenue
Elkhart, IN 46516
Phone Number 1: 574-522-5511
Fax Number:
Judy Jackson
Susana's Kitchen
431 S 3rd. Street
Elkhart, IN 46517
Phone Number 1: 574-522-5893
Fax Number: 574-293-3132
Julia Mohney
Mailing List/Delete
Phone Number 1: 574-364-2603
Fax Number:
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IU Health Goshen
Kay
CHRISTIAN FAMILY DEVELOPMENT CENTER
151 S. Locke
Nappanee, IN 46550
Phone Number 1: 574-773-2149
Fax Number: 574-773-5337
Laboratory
South Bend Medical Foundation
530 N Lafayette Blvd
Phone Number 1: 574-234-4176
Fax Number:
Lenny Carl MSW, LCSW
Circle of Hope Breast Cancer Support Group
Phone Number 1: 574-262-8116
Fax Number:
Leo Kenworthy
Community Based HealthCare
2014 Lincolnway East Suite 3
Goshen, IN 46526
Phone Number 1: 877-222-VETS 8387
Linda Rothrock
UNITED LABOR AGENCY
3322 Middlebury St
Elkhart, IN 46516
Phone Number 1: 574-522-2899
Fax Number: 574-534-9201
Fax Number:
Lisa Davis, Chair
American Foundation Suicide Prevention
14350 Mundy Dr
Suite 800, #199
Noblesville, IN 46060
Phone Number 1: 317-517-5073
Fax Number:
Luscinia Health (Corporate offices)
Simple Savings Card
Houston, TX 77069
Phone Number 1: 1-800-451-0133
Fax Number:
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IU Health Goshen
Maria
WOMEN'S CARE CENTER
229 W. Marion St.
Elkhart, IN 46517
Phone Number 1: 574-296-6603
Fax Number:
Martha Knepper Pam Jones,
Riverview Adult Day Center
2715 E. Jackson Blvd.(housed at Trinity
(2-3 miles E. of Main Street on E. Jacks
Elkhart, IN 46516
Phone Number 1: 574-293-6886
Fax Number: 574-295-9290
Mary Heck
Breast and Cervical Cancer Program (BCCP)
711 E. Colfax
Phone Number 1: 574-247-6053
Fax Number:
Matt Rodway
Developmental Disability Waiver Ombudsman
402 W. Washington St., #W451
P.O. Box 7083, MS26
Phone Number 1: 800-622-4484
Fax Number:
Memorial Hospital of South Bend
Physician Referral - SB Memorial
615 North Michigan Street
Phone Number 1: 574-647-6800
Fax Number:
Michiana Eye Center
Dr John S Kim--Ophthmagist
319 N Niles Ave
Phone Number 1: 574-282-2020
Fax Number: 574-288-2020
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IU Health Goshen
Michiana Eye Center
Dr John S. Kim
319 N Niles Ave Ste 100
Phone Number 1: 574-288-1451
Fax Number:
Michigan Colorectal Cancer Early Detection PrograM
Colorectal Cancer Control Program (CRCCP)
Washington Square Building, 5th Floor
109 Michigan Avenue
Lansing, MI 48913
Phone Number 1: 1-877-588-6224
Fax Number:
National Information Line
Elkhart Area ALNON/LATEEN
Phone Number 1: 1-888-241-8385
Fax Number:
Needing appointment-ask for access services X800
Oaklawn Psychiatric Center
330 Lakeview Drive
P.O. Box 809
Goshen, IN 46528-0809
Phone Number 1: 574-533-1234
Fax Number: 574-537-2673
NeedyMeds, Inc
Needy Meds
PO Box 219
Gloucester, MA 01931
Phone Number 1: 800-503-6897
Fax Number: 206-260-8850
Noble County Family Support
CANI-Community Action of NE Indiana Noble County
200 S Cavin St
Ligonier, IN 46767
Phone Number 1: 260-894-3048
Fax Number:
Norma Monik, Coordinator
CWE - Fitness and Nutrition Education
Phone Number 1:
Fax Number:
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IU Health Goshen
North Central Area of Narcotics Anonymous
Narcotics Anonymous
PO Box 175
Osceola, IN 46561
Phone Number 1: 574-674-1685
Fax Number:
North West Indiana Area Service Center
American Cancer Society
130 Red Coach Dr
Mishawaka, IN 46545
Phone Number 1: 574-257-9789
Fax Number:
Northeast IN Ft Wayne IN
Overeaters Anonymous
PO Box 44020
Albuquerque, NM 87174-4020
Phone Number 1: 260-460-4958
Fax Number:
Northern Indiana Hispanic Health Coalition
Hispanic/Latino Health Coalition
444 North Nappanee St
Elkhart, IN 46514
Phone Number 1: 574-522-0966
Fax Number: 574-522-0354
Office of the Prosecuting Attorney
Child Support Division of Elkhart county
301 S. Main St., Suite 100
Elkhart, IN 46516
Phone Number 1: 574-522-3074
Fax Number: 574-522-4965
Paige Quist
Concord Foot and Ankle Clinic
24021 US Highway 33 Suite B
Elkhart, IN 46517
Phone Number 1: 574-875-8698
Fax Number: 574-875-8749
Pam Bingaman
Middlebury Food Pantry
203 East Lawrence St
Phone Number 1: 574-825-5135
Fax Number:
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IU Health Goshen
Pam Kennedy, Director
Public Housing Authority-Goshen
109 W. Catherine Street
P.O. Box 387
Milford, IN 46542
Phone Number 1: 574-533-9925
Fax Number:
Parkview Regional Medical Center
Parkview Hospital
11109 Parkview Plaza Dr
Phone Number 1: 260-266-1000
Fax Number:
PatientAssistance.com, Inc.
Patient Assistance
11608 Darryl Dr
Baton Rouge, LA 70815
Phone Number 1: 888-788-7921
Fax Number:
Phone no below Indy Hot line
Gamblers Anonymous
Phone Number 1: 855-222-5542
Fax Number:
Prevent Child abuse Indiana
Child Abuse Hotline
Phone Number 1: 800-800-5556
Fax Number:
Program Manager Richard Patton
The Enchanted Hills Community Partnership Center
9799 E Excalibur Place
Cromwell, IN 46732
Phone Number 1: 260-856-2136
Fax Number: 260-856-2360
Raquel Rivera
Harm to Self or Others
IU Health Goshen Hospital
200 High Park Avenue
Goshen, IN 46526
Phone Number 1: 574-364-2866
Fax Number:
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IU Health Goshen
Rebecca Gascho, Interim Executive Director, CCH
Center For Healing and Hope - Elkhart
831 W Marion St (Grace Lutheran Church)
3rd floor
Elkhart, IN 46516
Phone Number 1: 574-534-4744
Fax Number:
Rebecca Oyer-Myers
Rebecca Oyer-Meyers
1204 College Ave
Goshen, IN 46526
Phone Number 1: 574-534-7100
Fax Number: 574-537-5010
Recca Gascho, Interim Executive Director
Center For Healing and Hope - Goshen
902 S Main St(Plymouth United Church ofC
PO Box 195
Goshen, IN 46526
Phone Number 1: 574-534-4744
Fax Number: 574-537-1186
Relay Indiana
Relay Indiana
Phone Number 1: 711
Fax Number:
Robin Bowen
SEAL INDIANA
Oral Health Research Institute
415 Lansing st
Indianapolis, IN 46202-2876
Phone Number 1: 317-278-0750 Man
Fax Number: 317-278-7873
Ruth Mark
ADOPTION RESOURCES SERVICES
218S 3rd St. Suite 2
Elkhart, IN 46517
Phone Number 1: 574-293-0229
Fax Number: 574-295-5626
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IU Health Goshen
Scott Dueker
Behavior Analysis Center for Autism
53633 County Road 7
Elkhart, IN 46514
Phone Number 1: 574-343-2001
Fax Number: 574-343-2156
See Physician Referral DatabaseHearing Testing
Phone Number 1:
Fax Number:
Serenity House, Inc
The Serenity House
2438 CR 50
Auburn, IN 46706
Phone Number 1: 260-927-8902
Fax Number:
South Bend office
St Joseph County Health Dept
227 W Jefferson BLvd -9th floor
Phone Number 1: 574-235-9750
Fax Number:
South Bend Police Dept
SOUTH BEND POLICE
701 W Sample St
Phone Number 1: 574-235-9201
Fax Number: 574.288.0268
St Joseph Hospital
St. Joseph Behavioral Health and the Lutheran Health Network
700 Broadway
Phone Number 1: 260-425-3606
Fax Number:
St Joseph Regional Medical C Medical Office Bldg.
ALICKS HOME MEDICAL Mishawaka
611 E Douglass Suite 124
Mishawaka, IN 46545
Phone Number 1: 1-800-633-4144
Fax Number: 574-855-8475
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IU Health Goshen
St. Joseph Regional Medical Center
Physician Referral - St. Joe Med Center
5125 Holy Cross Parkway
Mishawaka, IN 46545
Phone Number 1: 866-757-6248
Fax Number:
Substance Abuse and Mental Health Services Admin
Disaster Distress Helpline
Phone Number 1: 1-800-985-5990
Fax Number:
Telephone information operator
Information
Phone Number 1: 411
Fax Number:
Texas Tech University Health Sciences Center
Infant Risk Center
Phone Number 1: 806-352-2519
Fax Number:
The Michael J. Fox Foundation for Parkinson's Resh
The Michael J. Fox Foundation for Parkinson's Research
P.O. Box 4777
New York, NY 10163
Phone Number 1: 1-800-708-7644
Fax Number:
Tim Wall or Vonda Maust leaders
Parents Sharing Hope
Phone Number 1: T-574-533-6081
Fax Number:
Tony Sommer-Director
Child Protection Services of Elkhart County
1659 Mishawaka St
Elkhart, IN 46514
Phone Number 1: 574-266-2401
Fax Number: 574-266-2106
Tonya
RETA
300 W High
Elkhart, IN 46516
Phone Number 1: 574-522-4357
Fax Number:
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IU Health Goshen
Toxicology Data Network
TOXNET
Phone Number 1:
Fax Number:
UNITED WAY funded
211-United Way
Phone Number 1: 211
Fax Number:
Volunteers in Health Care
RX Assistance
111 Brewster St
Pawtucket, RI 02860
Phone Number 1:
Fax Number:
Wade Branson
GOSHEN POLICE DEPARTMENT
111E Jefferson St.
Goshen, IN 46526
Phone Number 1: 574-533-8661
Fax Number:
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235
Use Or
In SQL
Compare
Types
Data Fields
SR.SRTYPE -- Service Type (C)
EQ
Data Values
COMMB
Chain
Fields
X
SR.SRCLIENT -- Client id (C)
X
SR.SRGPCODE -- Group Code (C)
X
SR.HSID -- Facility id (C)
X
SR.SRDATELREF -- Date of Last
Referral Given (T)
X
SR.SRDONTUSE -- Don't Use (L)
N
X
SR.SRECSET -- Set (S,M,B) (C)
X
Main Database
ECProd
Base Database
ECProd
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236
Appendix III
Health Officer
608 Oakland Ave.
I
Elkhart, IN 46516
I
574-523-2105
elkhartcountyhealth.org
Elkhart County Health Department
Art Wager
Indiana University Health Goshen
Director of Marketing
200 High Park Ave, Goshen, IN 46526
RE:
Community Health Needs Assessment (CHNA)
Dear Art:
I informally surveyed my managers (and based on my own experience) I consider
the following items to represent our most important community health needs:
•
•
•
•
Access to healthcare including mental health services- this relates to poverty,
the lack of health insurance, the challenge of navigating complex health
systems and low numbers of primary care providers
Tobacco use- still the leading cause of preventable death in the United States
Obesity and its partners in the metabolic syndrome which are consequences
of poor diet, inadequate exercise and genetics
Infant mortality- this is the number one priority of the state health
department and I expect it to worsen after we close our prenatal care
coordination program on September 3Qth of this year
Sincerely,
�tl��
Daniel A Nafziger, MD, MS
Health Officer
237
Public Health
Prevent. Promote. Protect.
Appendix IV
Summary Statement of the
2015 Community Health Needs Assessment
October 7, 2015
In pursuit of our core mission to improve the health of our community,
IU Health Goshen has conducted a community health needs assessment (CHNA). This assessment
is an IRS requirement of all not-for-profit community hospital systems, such as ours, and helps us to
understand, prioritize, and develop strategies to respond to the unmet health concerns of the people
in our community.
The CHNA was comprised of three component parts. A survey of over 600 members of the
community was administered by IU Health Goshen, representing the views of a broad cross section
of local residents. Analysis of this survey, along with numerous demographic, health and economic
data sets regarding Elkhart County, was conducted by the Bowen Research Center of the Indiana
University School of Medicine. In addition, Elkhart County Health Department officials were
queried to discover the public health-oriented view of priority health concerns.
Respondents to the survey perceived themselves and their communities to be generally
healthy by a factor of about eighty-five percent. However, this varied among specific demographic
groups. Those who identified as Amish, for example, perceived their community to be healthier than
did members of the Hispanic/Latino community. Another key finding is that nearly sixty percent of
all respondents feel that there are not enough programs to address the health needs of their
community. The community health needs identified in the survey largely correspond to the concerns
of the Health Department as well as with the findings of the secondary data analysis, with some
notable differences. Taking these and other factors into consideration, leadership of IU Health
Goshen has determined a set of community health needs it can impact positively, which it will
address in the coming months and years in an implementation plan. These needs represent a slight
adjustment to the 2012 CHNA. They are as follows:
200 High Park Ave.
Goshen, IN 46626
238
1. Obesity
2. Access to Health Services
3. Mental Health
4. Treatment of Chronic Conditions
-focusing specifically on diabetes and hypertension, potentially cancer
5. Tobacco Use/Smoking
Two findings that also emerged from the CHNA, which IU Health Goshen will address less
directly, are poverty and infant mortality. Through ongoing program development and monitoring,
we will be vigilant with regard to infant mortality. We are mindful of the impact other health needs
have on this concern, particularly access to health services and tobacco use. Similarly, we are
sensitive to the needs of all members of our community, and seek innovative ways to provide
improved access to health services for those who struggle with poverty. These are pressing concerns
and important priorities in overall public health policy, and receive careful consideration within the
organization. From a direct impact perspective, however, the capabilities and expertise of IU Health
Goshen are more suited to address formally the five priority needs identified above.
Details of the studies used to form the CHNA can be found in the document, titled Data
Analysis for Community Needs Assessment, prepared by The Bowen Research Center of Indiana
University Health School of Medicine.
Randal E. Christophel, CPA, MBA, FACHE
President and Chief Executive Officer
239

Data Analysis for Community Health Needs Assessment

Transcription

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