Key Findings from the 2022 Community Health Survey

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Key Findings from the 2022 Community Health Survey

Download the 2022 Community Health Survey Key Findings

The 2022 Larimer County Community Health Survey was the tenth triennial survey conducted by the Health District of Northern Larimer County. The survey instrument contained 74 multi-part questions to collect data from adult residents of Larimer County on a variety of health conditions and behaviors, healthcare affordability and coverage, access to healthcare, and need for various services.

A total of 2,700 useable surveys were returned, resulting in a response rate of 21%. There were 1,645 surveys (61%) received from residences within the Health District boundaries and 1,055 from south Larimer County. Data was weighted by demographic information, such as age, gender, education, and more. This is a common statistical technique used to improve the accuracy of representation in the survey sample. When available, 2022 results are compared with results from previous surveys; however, not all questions were included on earlier surveys. Due to differences in household sampling methods and how the data was weighted, some caution is needed when looking at trends.

This report includes a high-level summary of both positive health indicators and areas of potential concern on the following topics:

Physical Health

In 2022, residents reported lower overall health status and more days in the past month (3 days vs 2019: 2) of poor physical health impacting the ability to do usual activities like work and recreation.

Chart 1. Overall, would you say your health is ... ?

Reports of excellent or very good health dropped from over 60% in 2010 through 2016 to 47% in 2022. 7% said fair or poor health in the first three years, but 14% did in 2022.

Chart 2. Chronic Conditions by Race/Ethnicity
At 30%, non-Hispanic white adults have the highest rate of high blood pressure, followed by non-Hispanic people of color at 23% and Hispanic or Latino adults at 20%. Hispanic or Latino adults have the highest rates of several other conditions, such as diabetes at 11%, COPD, emphysema or chronic bronchitis at 7% and asthma at 16%.

*Data masked due to less than 5 responses

Prevalence of asthma, COPD and diabetes was 2 to 3 times higher in Hispanic or Latino/a/x residents than non-Hispanic white and other people of color.

About 7% of adults have high impact pain (pain most or every day and pain that limits life or work most or every day in the last 6 months). Some groups affected disproportionately are transgender and non-binary adults (20%), residents in households ≤250% of the federal poverty level (FPL) (lower income) (17%), those 65 and older (11%), and Hispanic or Latino/a/x adults (10%).

The share of adults in Larimer County within the normal BMI range has declined slowly since 2010. The share considered overweight is consistently above 30% and many more are in the obese BMI range, above 20% for the first time (since 1995).

Chart 3. BMI by Survey Year

The share of adults with a normal BMI between 18.5 and 25.0 has dropped from 51% in 2010 to 44% in 2022. The share who are obese with a BMI of 30 or more has grown from 15% to 22% over the same time.

Chart 4. Obesity Prevalence

33% of Hispanic or Latino adults, 30% of transgender or non-binary adults and 30% of those in households with income at or below 250% fall into the obese range of BMI.
Daily servings of fruits and vegetables, considered a key component of a healthy diet, are down, with just one in three adults consuming the recommended 5 or more servings.

Mental Health

There have been declines in mental health status since 2013. In 2022, respondents reported an average of 4 1/2 days in the past month when their mental health was not good - a full day more than in 2019.

More young adults (ages 18-34), transgender and non-binary adults and those in households ≤250% FPL have days of poor mental health compared to all local adults while most of those 65 years or older claim no poor mental health days. Also, 30% of adults get too little sleep (less than 7 hours), compared to 25% in 2019.

Chart 5. Average Days in the Past Month when Mental Health was Not Good

In 2013 and 2016, adults experienced about 3 days of poor mental health, and that rose to 4 and a half days in 2022. Days of poor mental health limiting the ability to conduct daily activities increased from 1 in 2013 to about 2.

*Data not collected in 2010

Chart 6. Days in the Past Month with Poor Mental Health by Selected Characteristics

More adults shared that they have been diagnosed with a mental health disorder (2022: 37% vs 2019: 30%) and 36% have been diagnosed with depression and/or anxiety. Young adults report the most mental health challenges, including stress and considering suicide.

7 days in the past month when mental health was not good
4 days in the past month when poor mental health limited usual activities
37% with a depression diagnosis
42% with an anxiety diagnosis
51% with depression, anxiety or another mental health disorder diagnosis

More adults reported that they, or someone in their household, needed mental health counseling/treatment and got treated in the past year (2022: 24% vs 2019: 22%). However, more also said that the needed help was not received (2022: 12% vs. 2019: 8%).

Eight percent are often stressed. Some groups disproportionately claimed to deal with stress nearly all the time; among them are young adults (16%), those in households ≤250% FPL (15%) and non-Hispanic/Latino/a/x people of color (15%).

One in five adults from lower-income households experience forms of social isolation and 53% of them have support in only one or none of these areas.

12% of all adults rarely or never have someone to confide in; 21% of those in households at or below 250% FPL rarely or never do
12% of adults rarely or never have someone to take them to the doctor; 25% of those in households at or below 250% FPL rarely or never do
12% of adults rarely or never have someone to have a good time with; 22% of those in households at or below 250% FPL rarely or never do

Substance Use

Alcohol:

Use of alcohol is down slightly (2022: 59% any regular alcohol consumption vs 2019: 62%). Not including those who abstain, the average most drinks at one time is 3 ½. However, about 1 in 5 adults still report binge drinking.

Chart 7. Alcohol Consumption

Average number of alcoholic drinks per week has been just above 6 since 2013, while average most drinks at one time has slightly fallen from 4.1 in 2010 to 3.5.

Overall, 5% of adults have been told by a healthcare provider that they have a substance use disorder. This is much higher for transgender and non-binary (14%) and Hispanic or Latino/a/x (13%) adults.

After a concerning spike in 2019, adults who report in the past month having one or more instances of driving after drinking 2 or more alcoholic beverages has returned to 4%.

Chart 8. Drinking and Driving: 2004-2022

There was a decline in drinking and driving from 8% of adults reporting the behavior in 2004 to 4% in 2016. This was followed by the jump to 9% in 2019 before falling again to 4%.

Cannabis:

One in 5 adults (22%) report using cannabis in the past month, and they are using it on more days each month. Daily users grew from 27% in 2019 to 32% in 2022 and the average number of days of use per month increased from 14 to 17 days.

Chart 9. Cannabis Use by Age

Cannabis use in the past year and month decrease with age. 45% of adults 18-34 years old have used cannabis in the past year, but 33% have in the past month. While just 11% of adults 65 and older have used it in the past year, nearly all or 9% have used it in the past month.

Chart 10. Frequency of Cannabis Use in the Past 30 Days by Age

By small margins, adults 18-34 and 35-50 mostly use cannabis 1-13 days per month. 38% of adults 51-64 use it 1-13 days and another 38% use it nearly daily. 57% of older adults 65 and over use it fewer than 14 days, but 31% use it nearly daily.

Most adults who recently used cannabis did so to reduce stress and relax or to improve sleep.

A larger share of young adults use cannabis to treat depression/anxiety or to get high/for fun than any other age group.

Chart 11. All Adults vs Young Adults Use

In descending order, 72% of all adults who used cannabis in the past month used it for stress followed by 55% to improve sleep, then to treat depression or anxiety, to get high/for fun, to reduce pain/inflammation, and then 18% to socialize. Among young adults, 88% used it for stress. Larger shares of young adults reported each reason with the exception of reducing pain/inflammation.

Tobacco:

Regular (combustible) cigarette use continues to drop (1995: 18%). Seven in 10 cigarette smokers are seriously considering quitting.

Chart 12. Cigarette Use

Daily cigarette smokers went from 7% to 4% between 2013 and 2016 and has stayed near 4% since. The size of adults who smoke at all has decreased from 10% to 6% over the same time.

E-cigarette (electronic vaping product with nicotine) users have grown (2019: 4% vs 2022: 6%). Again, most (61%) are seriously thinking of quitting. Of those who vape/use e-cigs, 42% do so to quit or reduce regular cigarette use.

Use of other tobacco products like cigars or pipes, and chew or spit tobacco remains near 3%. The majority (59%) of chew/spit users are seriously considering quitting, but just 30% of cigar/pipe smokers are.

Fourteen percent of adults use at least one form of tobacco, but use is uneven across various demographics.

Chart 13. Tobacco Users by Selected Characteristics

A. Gender
7% of women are tobacco users as are 12% of men and 22% of transgender and non-binary adults.

B. Income

9% of those in households with income above 250% FPL are tobacco users, but 25% of those in lower income households are.

C. Age

9% of adults over 50 years old are tobacco users, as are 12% of adults 35-50 and 20% of adults under 35.

Social Factors

Access to Care:

In 2022, fewer adults were very or somewhat worried about affording the care they need (40% vs 2019: 47%). Still, it was a concern for half or nearly half of some groups, such as adults other than men, under 65 years old, from lower income households, and people of color.

Chart 14. Very or Somewhat Worried They Can Afford Medical Care

40% of adults overall worry about affording medical care, but higher rates of some groups carry that worry: 42% of women, 57% of transgender and non-binary adults, 52% of 18-34 year olds, 60% of those in households at or below 250% FPL, 51% of Hispanic or Latino adults, and 50% of other people of color.

Of adults who may have needed to see a doctor or a specialist in the past two years, 20% did not because they felt it was unaffordable.

Chart 15. Access to Care When Needed by Age Group

68% of adults feel their access to care is excellent or very good and larger shares of adults over 35 years old do, but only 54% of 18-34 year olds do. 21% of young adults feel their access is fair or poor, compared to 11% overall.

1 in 4 from lower income households have fair or poor access to care
2 in 5 are very or somewhat worried that they won’t be able to afford the medical care they need
1 in 10 have been contacted in the past year for medical debt collection
1 in 5 Hispanic or Latino/a/x adults were contacted about medical debt

Environment:

Walking is easy to do, but more adults claim public transit can get them where they need to go compared to walking.

Chart 16. Transportation by Age

83% of adults say walking and bicycling are easy, but only 56% of young adults and 42% of older adults feel public transit is easy. Overall, 65% see bicycling as an effective form of alternative transportation, that is 79% of young adults and just 43% of older adults. Fewer see walking and public transit as effective, but young adults are more favorable.

3 in 5 Hispanic or Latino/a/x adults feel they can get to places using public transit

Following large fires in 2020 and 2021, not only do more adults call climate change and wildfires problems, but

66% say polluted outdoor air is a local problem; 6 percentage points over 2019
31% say unclean indoor air is a local problem; no change from 2019
36% say pollution from industry is a local problem; no change from 2019
60% say mosquitos are a local problem; 8 percentage points over 2019
74% say changing climate conditions are a local problem; 14 percentage points over 2019
84% say wildfires are a local problem; 25 percentage points over 2019
44% say floods are a local problem; 1 percentage point below 2019

Fifty percent believe a wildfire disaster could impact their households in the future. Nearly 40% see extreme heat events as a threat.

Several mass shootings occurred across the country before and during the survey period. Nearly 1 in 5 expressed concern over terrorism, with some specifying domestic terrorism and gun violence as a problem.

There is a knowledge gap in emergency preparedness.

14% are unsure how to make a household emergency plan
30% are unsure how to sign up for Larimer County alerts

Food & Housing

Nearly 1 in 3 adults have worried about affording nutritious meals sometimes or more often in the past year and 1 in 10 used food assistance services. Young adults, Hispanic or Latino/a/x residents, and lower income households most needed food assistance.

Chart 17. Food or Meal Assistance Access

Groups who disproportionately used food and meal assistance above the 10% countywide are 13% women, 14% young adults, 26% Hispanic or Latino adults, and 33% of households at or below 250% FPL. The greatest unmet need are among 8% of Hispanic or Latino adults, 9% of young adults and 13% of those at or below 250% FPL.

More adults worried about paying rent or mortgage (2019: 17% vs 2022: 25%), although many fewer (6%) were unable to pay rent/mortgage at some time in the past 3 months. If they had to move out of their current home permanently, 7% "would not have anywhere to go.”

Chart 18. Financial Stress of Rent/Mortgage

2% of homeowners were unable to pay all or part of their housing in the past 3 months, but 13% of renters struggled. 4% of owners and 20% of renters worried about mortgage or rent in the past year.

How Characteristics are Reported

Gender:

Survey participants selected any combination of "Woman," "Man," "Transgender," or a written in gender. While people of many genders participated, low representation of transgender and non-binary residents restricts interpretive accuracy in some analyses.

Age:

Participants provided their age at the time of the survey. For this report, age groups of 18-34, 35-50, 51-64, and 65 years or older were used most often.

Race and Ethnicity:

Race and ethnicity were self-reported. Response options from previous surveys were continued, including space to write unlisted responses. Ethnicity was added among race options in one question where participants selected all that applied. Due to few responses from residents who are not White only or Hispanic or Latino/a/x of any race, "Other People of Color" may be used to regroup the remaining participants. Understanding and interpretation within this group are limited.

*Language of race and ethnicity presents many challenges. The Health District has ongoing discussions to improve language and understanding, and is open to constructive, inclusive conversations.

Income:

Participants selected household income for 2021 from ranges up to $125,000 or more. A calculation of income and the number of people who reportedly depended on that income was used to estimate the household's percentage of the Federal Poverty Level (FPL).

Acknowledgements:

The Health District of Northern Larimer County thanks the City of Loveland and the North Colorado Health Alliance for their financial support of the survey.

Thank you also to the survey respondents who took the time to share their thoughts and perceptions about health and well-being in Larimer County.

For more information and deeper analyses into particular topics, visit

http://h8o.tccestates.com/community-health-assessment

We welcome questions and comments. Please contact the Research & Evaluation team for more information about the Community Health Assessment.
Email: survey@tccestates.com
Phone: 970-224-5209

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Health District of Northern Larimer County