2022 Community Health Needs Assessment (CHNA) Overview
Cottage Health, representing Goleta Valley Cottage Hospital, Santa Barbara Cottage Hospital, and Santa Ynez Valley Cottage Hospital, and Santa Barbara County Public Health Department (SBCPHD) partnered with community organizations and agencies to conduct a comprehensive 2022 Community Health Needs Assessment (CHNA). Assessing the most pressing health needs, this report describes the well-being of Santa Barbara County’s residents and selected social determinants of their health, with comparisons to California’s health profile as a whole. It also connects selected health indicators for Santa Barbara County to the goals or targets in Healthy People 2030 (HP 2030), data-driven national objectives set every ten years by the U.S. Department of Health and Human Services.
Data Sources
The 2022 CHNA includes primary data collected through a random web-based survey with approximately 1,600 community members, a Listening Tour with more than 200 individuals who represent the broad interests of the community, including medically underserved, low-income, and vulnerable populations, and Subpopulation Assessments for two smaller geographies within the county. Secondary data were also obtained from existing online sources. This approach is consistent with the methodology established in the 2016 and 2019 Cottage Health CHNAs, which also serve as benchmarks for the 2022 data.
Santa Barbara Countywide Survey
Santa Barbara Countywide Survey
Cottage Health contracted with the Population Survey Facility (PSF) at the University of Pittsburgh, an academic research unit with extensive experience in survey methodology, analysis, and reporting. The PSF used two data sources for the CHNA: a multi-mode survey designed specifically for this effort and existing health and demographic data (such as U.S. Census data) already collected for the county and California. The multimode survey consisting of mail, email, SMS text, and telephone recruitment and was conducted from August through October 2022 to obtain data from Santa Barbara County adults ages 18 years of age and older. Initial mailings and reminder postcards were sent to Santa Barbara County residents, which invited them to take a self-administered, web-based survey. Additional recruitment attempts were made via SMS text messages for a sample of households with cell phone numbers. Likewise, non-responders were recruited via email if an email was on file, and if no response was received via mail, text message or email, a group of trained interviewers attempted to contact residents via telephone to either conduct the interview over the phone or to send them an email or text message if they preferred to do the survey at a more convenient time.
The majority of survey questions were based on the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey instrument, created by the Centers for Disease Control and Prevention (CDC). The data collected from the survey were weighted to make sure that survey results were representative of county demographics, such as age, race/ethnicity, and gender, and then compared to the 2016 and 2019 Santa Barbara County CHNA results, the 2021 California BRFSS, and Healthy People Leading Health Indicators.
Community Perspectives: Listening Tour
Community Perspectives: Listening Tour
The 2022 CHNA included a Listening Tour with more than 200 individuals who represent the broad interests of the community, including medically underserved, low-income, and vulnerable populations. Secondary data were also obtained and incorporated from Behavioral Health Asset Mapping interviews conducted by Santa Barbara Alliance for Community Transformation (SB ACT).
The Listening Tour solicited input from a wide array of community members and leaders, including public health officials, health providers, nonprofit workers, Cottage Health employees, and government leaders. Fifty in-person and virtual focus groups and interviews were conducted from July through September 2022 around three topic areas: 1) youth behavioral health, 2) maternal health equity, and 3) COVID-19 pandemic impacts.
Subpopulation Assessments
Subpopulation Assessments
The CHNA included two Subpopulation Assessments designed to better understand the health and well-being needs of subareas of Santa Barbara County. Designed to provide a more in-depth understanding of specific communities and improve representation of marginalized community members, these Subpopulation Assessments were set-up to be replicated in other areas of the county, allowing for expanded data collection that will be comparable to data at the county level.
Westside Needs Assessment
The Westside Needs Assessment collected data door-to-door in the primary census tracts on the Westside of Santa Barbara in July through August 2022. The process used a stratified random sample methodology with an option to complete the survey in-person or online. The procedures used in this effort were based on the Centers for Disease Control and Prevention’s (CDC) Community Assessment for Public Health Emergency Response (CASPER) method. University of California, Santa Barbara (UCSB) was contracted for this assessment. Findings will help inform programs and initiatives to support the needs of those living on the Westside and the development of a Westside community resource center.
Santa Maria Needs Assessment
Santa Barbara County Public Health Department collaborated with Cottage Health, Dignity Health, California Department of Public Health (CDPH), and community-based organizations to conduct a rapid needs assessment of Santa Maria in October 2022. Using the CASPER methodology, the Santa Maria Needs Assessment (SMNA) quickly captured information about the health needs and assets of community through a random, door-to-door sample of households. The SMNA aimed to collect data that can be generalizable and will help inform the future allocation of resources to support the needs of those living in Santa Maria.
Results
Based on results from the 2022, 2019, and 2016 CHNA telephone and web surveys, secondary data analysis, and Listening Tour findings, nineteen health indicators from the Santa Barbara County Random Survey were identified for in-depth analysis and prioritization. These indicators were selected using the Leading Health Indicators and Core Objectives from Healthy People 2030. Table 1 summarizes these indicators and shows the seven indicators for which Santa Barbara has exceeded or met HP targets and the four below the targets. Eight of the nineteen indicators do not have a comparable HP target, but these were included in analysis because of their overall prominence and importance to the community and guidance from CHNA partner organizations.
Many differences were found within demographic groups, such as economic status, race/ethnicity, and educational attainment. When viewing population-level data, demographic differences provide a deeper understanding of the health outcomes of various groups. These data were further analyzed based on demographic differences, which will be forthcoming on the Cottage Center for Population Health’s website and Cottage Data2Go
Table 1. Health Indicator Profiles for Santa Barbara County, Compared to California and the HP 2030 Target
| Health Indicator |
2022 Santa Barbara County % |
California+ % |
Healthy People 2030 Target % |
| Exceeds HP 2030 Target |
|
|
|
| Alcohol use (binge drinking, past 30 days) |
21.1 |
15.0 |
25.4 |
| Current smoking (cigarettes) |
4.7 |
8.8 |
6.1 |
| Insurance status (insured) |
93.8 |
89.7 |
92.4* |
| Obesity |
27.6 |
27.6 |
36.0** |
| Oral health (dentist in past year) |
72.1 |
64.6 |
45.0* |
| Overall good health |
84.2 |
83.8 |
79.8^ |
| Physical inactivity |
16.1 |
20.0 |
21.8 |
| Below HP 2030 Target |
|
|
|
| Depression |
26.0 |
15.2 |
5.8 |
| Diabetes |
10.0 |
11.6 |
6.0^^ |
| Food insecurity |
25.5 |
NA |
83.9 |
| Primary care provider (have usual PCP) |
79.2 |
82.0 |
84.0 |
| HP 2030 Target Not Available |
|
|
|
| Below or At State Benchmark |
|
|
|
| Cost as a barrier to care |
17.2 |
9.1 |
NA |
| Current vaping |
5.1 |
5.2 |
NA |
| Mental health days (poor days >=14) |
20.8 |
14.4 |
NA |
| No HP 2030 Target and No State Benchmark |
|
|
|
| Adverse Childhood Experiences (ACEs) Score >=4 |
20.6 |
NA |
NA |
| Anxiety and other mental health disorders |
26.7 |
NA |
NA |
| Housing insecurity |
11.4 |
NA |
NA |
| Resilience |
24.0 |
NA |
NA |
| Serious mental illness |
12.9 |
NA |
NA |
Chart Legend
+ 2021 Behavioral Risk Factor Surveillance System data unless otherwise noted
* Includes children and adolescents
** Age 20 and over
^ The Healthy People 2020 target was used here as a reference, as there is not a comparable Healthy People 2030
benchmark.
^^The HP 2030 target includes children and adults aged ≥ 2 years and is based on responses to three questions about food availability. For Santa Barbara County, the measure of food insecurity includes two questions.
Conclusions
The results show that on many health indicators, Santa Barbara County is performing slightly better or the same as California and has already met seven Healthy People 2030 targets. The benefits of good health and well-being do not extend to all groups in the county, with Hispanic/Latino residents, people with low incomes, and those with less education suffering the most from health disparities. Overall, six areas emerged as priority health areas in Santa Barbara County (alpha order):
- Access to Care
- Behavioral Health
- Chronic Conditions
- Maternal Health
- Resiliency
- Social Needs
Efforts to address these areas could lead to population health improvements in the county. Cottage Health and Santa Barbara County Public Health Department are committed to taking action based on the findings in this report and leading the community in implementing evidence-based population health programs and policies.
