The 2016 Tuolumne County Community Health Needs Assessment presents measurements that allow for a course to be set to improve the public’s health. Tuolumne County Public Health and Sonora Regional Medical Center (SRMC) teamed up to work with a large and diverse committee representing Tuolumne County agencies and businesses to build on the 2013 Community Health Assessment. Both documents reflect the content of the Let’s Get Healthy California Task Force’s guidelines.
The California Department of Public Health released the Let’s Get Healthy Task Force Final Report on December 19, 2012. In the document, the governor’s Task Force sought to prepare “a ten-year plan for improving the health of Californians, controlling health care costs, promoting personal responsibility for individual health, and advancing health equity.” The Task Force Final Report identified indicators to measure and targets achieve. This document provides an opportunity for local health jurisdictions throughout the state to follow suit by reviewing the applicability of these indicators to their own communities and to apply their own selected indicators to an assessment of local health status.
The Tuolumne County Public Health Officer, Dr. Liza M. Ortiz, and the Sonora Regional Medical Center Regional Director of Business Development, Bruce Chan, co-chaired the process. The process was facilitated by Patricia Jones of Patricia Jones Consulting.
An initial meeting of the Tuolumne County Community Health Assessment (TCCHA) Steering Committee was convened in February 2016 to review the 2013 document and discuss what worked with this edition and what could be improved. They also recommended topic-specific committee composition, timelines, content and format. The Steering Committee consisted of local community leaders including business owners, non-profit executive directors, seniors, county and state social service directors, health care providers and community members. The committee members dedicated their time, knowledge, expertise and resources throughout the process.
The Steering Committee confirmed the goals of the Let’s Get Healthy California Task Force Final Report as an initial structure for selecting indicators with which to measure the status of health in Tuolumne County.
- Healthy Beginnings: Laying the Foundation for a Healthy Life
- Living Well: Preventing and Managing Chronic Disease
- End of Life: Maintaining Dignity and Independence
- Redesigning the Health System: Efficient, Safe and Patient-Centered Care
- Creating Healthy Communities: Enabling Healthy Living
The topic-specific committee members were asked to review the list of indicators found in the 2013 Health Assessment and modify the content and presentation according to the needs of our county.
The process of data collection was guided by the consultant and Public Health Director, and shared by each of the committees, with data analysis conducted and reviewed by the full Steering Committee and in some cases by other members of the community. Multiple meetings were conducted over a period of six months with in- kind contributions of time and resources from the community members. The data was edited by all committee members to arrive at this final document.
Tuolumne County is in the central eastern section of California. It covers 2,221 square miles and ranges in elevation from about 300 feet in the Sierra Nevada foothills to almost 13,000 feet in the eastern regions. Federal, state, and local governments own approximately 77% of the land in Tuolumne County.
Bordered by rivers to the north and south, by the Sierra Nevada to the east and the San Joaquin valley to the west, Tuolumne County represents a portion of the southern reach of the historic Mother Lode Gold Country. With portions of Yosemite National Park in the southern sectors, tourism drives a significant percentage of the local economy.
The government is the major employer in Tuolumne County, followed by health and social assistance, and retail trade.
In July, 2016, the labor force included 22,270 residents, of which 20,820 were employed.
Half of the population has a household income of less than $50,000; the California median income (2010 to 2014) was $64,189.
- In the last five years, the county’s population has decreased from 55,185 to 53,709.3
- The prison population of approximately 4,300 inmates is included in the total population number.
- From 2008 to 2013, the prison population decreased by 1,187 to 2,915 inmates. However, in the ensuing years, the inmate population regained that loss; so the decrease in county population cannot be attributed to decrease in incarcerated individuals.
- Tuolumne County’s 2.8% population decrease in the last 15 years is in contrast to neighboring counties as well as the state in general.
- The county population is older than the state, with 12% of the state being over 65 years old compared to 22% of Tuolumne County being that age.
- Females make up 55% of Tuolumne County residents over 64 years old.
Racial and Ethnic Diversity ^
- Tuolumne County is predominantly of a single ethnicity with 91.1% of its population being White
- California is 62% White
The beneficiaries of this Community Health Needs Assessment are the residents of Tuolumne County. Some of the insights gained by this project will inspire further study and analysis, some will reassure, and some will reveal gaps in the community infrastructure that demand remediation. This reflection process will be formalized through a Community Health Improvement Plan task force overseen by Sonora Regional Medical Center and the Tuolumne County Health Department. The task force will prioritize areas for improvement, dig deeper into the causative factors and trends, recommend the means to address the top issues, and report back to the community on the evaluation of progress towards meeting goals to augment the health of the community. The overall objective of the work is to guide the development of a community health plan to address the disparities and build on the identified strengths.
A cover page for each of the chapters summarizes the findings. In general, at least one of the criteria is met by Tuolumne County for the indicator to be placed in a category.
Trends are positive. National or State targets are met or exceeded Tuolumne County does better than other like counties or the state.
The trends and/or achieving targets are not evident. Tuolumne County does not fare as well as similar counties or the state.
Trends are not consistently good or bad. Comparisons to others and/or targets are not available or inconsistent.