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Lewis County Health Department presents six‑year community health assessment; proposes housing, mental health and tobacco priorities
Summary
The county health department presented a new community health assessment that shifts focus to social determinants of health and recommends housing stability, anxiety and stress, suicide, tobacco and e‑cigarette use, and adverse childhood experiences as priority areas for the next six‑year cycle.
Ashley Waite, director of public health for Lewis County, presented the county's community health assessment to the Human Services Committee and described a shift in statewide public‑health planning from health outcomes to social determinants of health.
Waite said the assessment — required of local health departments — now follows a six‑year cycle and draws on a mix of state dashboards, vital records, insurance claims, community surveys and key‑informant interviews. The assessment will inform the county’s community health improvement plan and be submitted to New York State by December.
Why this matters: The new focus on social determinants means the county intends to address upstream factors such as housing, transportation and economic stability rather than only clinical outcomes. Priorities chosen by the Lewis County Priorities Council and presented to the committee were housing stability and affordability, anxiety and stress, suicide prevention, tobacco and e‑cigarette use, and adverse childhood experiences (ACEs).
Waite summarized recent trends: adult and childhood obesity have continued to rise, suicide deaths have declined slightly but remain about three times the state goal, smoking rates have increased, and immunization coverage that historically was near 80% has fallen to about 65.7%. She said Lewis County reports higher self‑reported rates of hypertension than neighboring counties and lower willingness among residents to participate in chronic‑disease self‑management classes.
The assessment highlights a mixed picture on social determinants: Waite said Lewis County meets state objectives on overall poverty and unemployment at the county level, but poverty among residents age 65 and older is rising and survey respondents reported higher housing insecurity (16.1%) than neighboring counties. She also noted the county's aging population and a higher regional rate of unpaid caregiving hours.
Waite said tobacco product use in Lewis County differs from the region: the county survey shows higher cigarette and chewing‑tobacco use and lower use of nicotine pouches and vaping products compared with nearby counties, and that nicotine use increases as household income declines. Waite emphasized the need to tailor prevention and education efforts to these usage patterns.
The county and its partners will use the assessment to select evidence‑based interventions. Waite described one intervention type under consideration — a land bank — as a potential tool to improve housing stability. She said the priorities were chosen based on data and the lived experience of human‑service agencies; next month she plans to return with proposed interventions tied to those priorities.
Committee members asked whether low population affects grant eligibility; Waite said population adjustments are considered in many grant formulas and rural funding streams increasingly account for rural needs. The county will continue working regionally on HPV vaccine uptake and lead testing for young children.
Waite closed by asking for committee feedback on the priorities and said the department will present proposed interventions next month ahead of the December state submission.
