2024 Tuba City service area Community Health Assessment now available

TUBA CITY, Ariz. —In a concerted effort to understand and address the public health needs of the Tuba City service area, the 2024 Community Health Assessment and Needs Survey (CHA) has been completed, which yields significant data that will shape future health initiatives and programs. Tuba City Regional Health Care Corporation (TCRHCC) publishes the CHA every three years, utilizing data on Service Area residents from a variety of sources. The last CHA was published in 2021.

The assessment provides comprehensive data on the health status, needs, and priorities of the Navajo, Hopi and San Juan Southern Paiute communities within the Tuba City Service Area. It also serves as a foundation for developing the Community Health Improvement Plans (CHIP). The assessment provides population health data that allows each Chapter community to develop its own improvement plan.

Annie Edleman, Public Health Director; Dr. Jamie Wilson, Epidemiologist/Evaluator; and Stacy Claw, Health Communications Specialist, led the team in developing the CHA. Edleman emphasized the importance of grassroots involvement in the survey design. “We met with people at the grassroots level to get their input and feedback on survey questions and what data from other sources they wanted to see. It was important to include data that community members and leaders wanted to know about.” said Edleman. The survey reached people in various settings, including stores, chapters, flea markets, and laundromats, aiming for a good representation of the community. All participants were 18 years old or older. The survey, which was finalized in February and rolled out to the community from late February through the first week of May, gathered 1,150 responses—representing roughly 5% of the adult population of each of the nine chapters and Moencopi.

The assessment process also highlighted challenges, particularly in relation to the 2020 Census data. Due to the COVID-19 pandemic, political factors, and operational challenges, the census faced significant shortcomings, with AIAN populations being among the most undercounted groups. “In addition to those challenges, new privacy methods introduced changed the way data could be reported for rural communities,” said  Edleman. She said that for these reasons, 2020 Census data sets are more limited and less accurate for tribal nations than they were in prior Census years. For some communities, 2010 Census data was used and in other communities 2020 Census data was used, which may not be entirely accurate Edleman said. For example, the published Census population for Tonalea in 2010 was 2,595 and in 2020 was 451.

Despite these challenges, the assessment provides a wealth of information that will be invaluable for community leaders and organizations. The 104-page document not only compiled data from the survey but also integrated other relevant data sources. The findings will support grant applications, direct Chapter Health Improvement Plans (CHIP), and meet regulatory requirements mandated by the Centers for Medicare and Medicaid Services (CMS). “The information in the CHA can be used by community programs and community leaders to improve the community’s health and meet community members’ needs however they see fit.” Edleman said.

The CHA covers a broad spectrum of health-related topics, including specific health conditions and social determinants of health such as access to water, electricity, and internet. “This time around, we also asked about heating and cooling, trash disposal, and childcare access—issues that are really unique to our community,” Edleman explained. One particularly revealing question asked whether an ambulance could reach a respondent’s house under all seasonal and road conditions, providing critical data that is unique to this community. Across the Service Area, 18% reported that an emergency vehicle could not reach their home in all seasons and road conditions, but this varied by community, from 6% in Lechee to 52% in Dinnebito.

One surprising outcome of the survey was the openness of respondents, even on socially sensitive topics. “We were surprised that people were answering openly and honestly, even when the question is socially frowned upon. For example, in one of the questions about trash disposal, 10% of respondents admitted to dumping trash,” said Edleman. The CHA also included data on long COVID, STIs, childhood vaccination, and substance use, reflecting current health concerns.

The most common community health problem identified by survey respondents was substance use (39%), followed by diabetes (14%), other chronic disease (11%), public/highway safety (7%), and mental health & suicide (6%). Family violence, elder health, and animal control, among others, were also often identified.

The CHA was published in December 2024 and is being presented in Tuba City service area communities.

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