A shortage of health care workers - including doctors, specialists, nurses and other professionals - is a major concern in three-fourths of the 36 North Dakota communities surveyed in health needs assessments conducted over the past three years.

Other top priorities include mental health issues, including substance abuse, as well as health care costs, obesity and financial viability of hospitals, according to a new report from the Center for Rural Health at UND’s School of Medicine and Health Sciences.

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“There’s a workforce shortage statewide,” said Karin Becker who, along with Ken Hall, conducted assessments in 21 of the state’s 36 communities with critical access hospitals. The report also included results of a half-dozen surveys conducted by hospitals or other organizations.

The Community Health Needs Assessments are required every three years for nonprofit hospitals as part of the federal Patient Protection and Affordable Care Act. The first report covered 2011 through 2013.

“As a whole, the identified needs paint the current picture of health needs confronting rural communities and affecting the state,” Becker summarized in the report. “They provide a baseline for which to measure change in the future and a way to chart progress.”

The CHNA process involves a combination of surveys and community focus groups to identify communities’ most pressing health needs, according to Becker. The assessments involve several steps, including interviews with healthcare workers and community members.

Once tentative results are compiled, Center for Rural Health staff members then meet with community members, who vote on which items are the highest priorities.

“It’s a way for a community to articulate their needs. Then, depending on how they prioritize their needs, we choose a Top 5,” she said.

Top needs

Other top community health issues that emerged from the process were aging population services, alcohol/substance abuse, and maintaining emergency medical services, according to the report.

The only cities in which a health care worker shortage was not listed as a top priority were: Bismarck, Carrington, Cooperstown, Fargo, Grand Forks, Hillsboro, Langdon, Mayville, McVille and Valley City.

Ten communities listed financial viability of the local hospital as a top issue. They are located in: Ashley, Bottineau, Cando, Cavalier, Cooperstown, Grafton, Linton, Stanley, Watford City and Wishek.

“It’s a worry that if the hospital closes, the town will fold as well,” she said. “Sometimes, perception may be worse than it is. In some cases, it’s the opposite.”

Becker also said many communities are recognizing problems involving obesity and physical activity.

“That’s a good problem, because it’s more approachable,” she said.

The Center for Rural Health has provided grants to 12 rural communities to begin to address their identified needs, according to a news release.

“We think there is great value in providing the in-person service of conducting CHNAs for our rural communities,” Lynette Dickson, Center for Rural Health associate director, said in the release. “Our intent, going forward, is to share ideas and potential resources for developing and implementing projects that address the needs identified.”

For additional information, go to the Center for Rural Health website:www.ruralhealth.und.edu.