Regional Report
Ozarks Health Commision region includes 33 counties across three states.
PART 1: INTRODUCTION
Purpose
Health care partners and LPHAs develop the results of these assessments into Community Health Improvement Plans (CHIPs), which organizations use to target areas of health need and disparity in communities and create actionable plans to make them better over time.
OHC collaboration
The Internal Revenue Service (IRS) requires hospital systems to conduct population-based assessments every three years to maintain nonprofit status. The Public Health Accreditation Board (PHAB) requires these assessments from LPHAs every five years. In the spirit of collaboration, OHC LPHAs join forces with regional hospital systems to conduct an assessment every three years. This practice helps to capture a more thorough and frequent snapshot of health needs across the whole region, with all the necessary health care partners at play.
Representatives from these health care partners make up the OHC Steering Committee. This group conducts planning, assessment and evaluation activities and reports on community health issues. The OHC Steering Committee is a vital piece of the CHNA puzzle, ensuring that the region is assessed and reported on in a timely, accurate way that is beneficial to the communities served.
Communities served
The scope of the OHC region includes 33 counties across three states. The 2025 effort added two new counties in Missouri—St. Clair and Cedar—to capture the entire service area of Citizens Memorial Hospital (CMH), a new partner during this cycle.
The following is the 2025 OHC Regional Health Needs Assessment. This collaborative report aims to be a valuable resource for health care partners, civic organizations and people who live, work and seek health care in the region.
PART 2: Regional health summary
Health priorities across the region
The following health priorities for the OHC region are a compilation of each community’s spotlighted data. Two categories rose to the top across the seven communities:
Behavioral health, which includes mental health and substance use
Chronic health conditions, which includes a wide range of issues, from heart health to diabetes
Behavioral health
Chronic health conditions
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Behavioral HEALTH
Identified by:
Bolivar, Branson, Lebanon, Monett, Mountain View, Springfield, Tri-State
Mental health is a continued issue in the OHC region. Individual community reports highlighted indicators such as rates of poor mental health, suicide and substance use.
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Adults with poor mental health
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Suicide mortality
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Overdose mortality
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Anxiety
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Depressive disorders
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Drug use
Public health data
MHA data
Chronic health conditions
Identified by:
Bolivar, Branson, Lebanon, Monett, Mountain View, Springfield and Tri-State
Chronic diseases are broadly defined as conditions that last one year or more. They require ongoing medical attention, limit activities of daily living or both. Individual community reports highlighted varying chronic diseases including heart disease, diabetes, cancer and lung disease.
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Heart disease mortality
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Lung disease mortality
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All cancer mortality
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Chronic obstructive pulmonary disease
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Type 2 Diabetes
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High blood pressure
Public health data
MHA data
Process, methodology and data summary
Convening
Following the conclusion of the 2022 CHNA cycle, Steering Committee members met in August 2023 to plan for the 2025 CHNA. The feedback from these early meetings resulted in large-scale changes from previous cycles, including:
Foregoing the use of an outside contractor. This led to cost savings, the ability to conduct surveys earlier in the process and more options for customization in community-level survey questions.
Contracting with the Missouri Hospital Association (MHA) to provide health care data from all participating hospitals.
Formally inviting Citizens Memorial Hospital to join the 2025 cycle.
Providing the opportunity for communities to prioritize upstream factors during the CHNA process to further inform CHIPs.
Data collection and analysis
Data collection began in November 2023 with the development of the Community Partner Survey. The Community Survey followed in summer 2024. Using the Community Partner Survey results as a guide, quantitative public health and hospital data were requested from external sources. These results were distributed to the Steering Committee in fall 2024 to facilitate key findings for each community and the region.
Qualitative data
Community Partner Survey
The Steering Committee drafted a comprehensive questionnaire to survey community partners about overall impressions of health in their communities. The responses from this survey later informed the development of a survey for all community members. Developed using resources like NACCHO MAPP 2.0, the questions included on the Community Partner Survey were wide-ranging. They asked about specific populations served, availability of resources and health care. The questionnaire was sent to more than 700 community partners. Nearly 200 partners shared their impressions, a response rate of 26%.
The Community Partner Survey responses were categorized into benefits and barriers of living in the OHC region, as well as in each individual community. These findings provided a basis for further qualitative and quantitative investigation.
Community Survey
The Steering Committee developed a brief, web-based survey to gather input from community members about general health and resources in their communities. The survey questions were developed using insights from the Community Partner Survey and included multiple choice questions with branching logic to solicit deeper insights when appropriate. Free text impressions and demographic information were also collected. Several communities within the region developed supplementary questions specific to their residents.
Paper copies were made available across the region so community members without access to a computer, tablet or smartphone would be able to participate. Both the web and paper surveys were available in English and Spanish. The Community Survey launched on May 1, 2024 and was extensively marketed. Upon closing eight weeks later, nearly 1,700 community members contributed to the CHNA through this mechanism.
Survey analysis
The Community Survey results were analyzed using Microsoft Power BI and ChatGPT. Power BI was used to process the responses for internal use by the Steering Committee. This helped visualize response results across the region and within in each community. ChatGPT was used to help prepare the full survey dataset for Power BI analysis and assess qualitative themes from some free text questions. The relevant response fields were extracted from the full Community Survey response dataset and anonymized prior to ChatGPT analysis. ChatGPT parsed and coded certain multi-select questions, which enabled quantitative analysis in Power BI. It also grouped free text responses for two survey questions into general themes. At each stage, the accuracy of ChatGPT’s analysis was manually verified.
Community Partner Survey
Quantitative data
Public health data
The Steering Committee utilized the University of Missouri’s Center for Applied Research and Engagement Systems (CARES) to collect and aggregate publicly available health data for the CHNA. The Steering Committee provided a listing of 188 indicators in several topic areas for CARES to research. To do this, the group utilized the US Census Bureau, the Centers for Disease Control and Prevention (CDC) and Centers for Medicare and Medicaid Services (CMS), among others. A final dataset of 127 indicators, aggregated by geography, was provided to the Steering Committee and sorted into the following health categories:
Population demographics
Health factors (access to care, employment, food access, housing, insurance, income, health behaviors, etc.)
Health outcomes (chronic disease, infectious disease, mental health, quality of life, etc.)
The indicators were also categorized based on the response themes garnered from the analyses of the Community Partner Survey and Community Survey. When applicable, each indicator category was defined as “Good,” “Mixed,” or, “Bad” for the region or a given community.
This dataset was color-coded to highlight county, community, and regional differences when compared to the OHC region, the state in which the county was situated (Kansas, Oklahoma or Missouri), and the United States (when available). The color coding emphasized instances in which a given locality performed worse than the state and/or the OHC region in a particular indicator. Together, these steps allowed for easy identification of alignment between the survey responses compared to quantitative public health data trends.
Mortality data
Due to a limitation within the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) program, mortality information for county, community, regional and state levels was requested from the Missouri Department of Health and Senior Services (DHSS). They provided age-adjusted rates for several specific causes of death for use in the CHNA.
Population demographics
In addition to the public health data that was collected during this assessment, the Steering Committee determined emergency department (ED) data to be essential to the CHNA process. This cycle, the Steering Committee partnered with the Hospital Industry Data Institute (HIDI) at the Missouri Hospital Association (MHA), who aggregated and provided ED discharge data from 2020-2022 on 149 identified health issues across OHC region hospital providers. The hospital systems included in the dataset:
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Citizens Memorial Hospital Bolivar
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Cox Branson
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Cox Barton County
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Cox Monett
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Cox Springfield
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Freeman Joplin
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Freeman Neosho
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Mercy Aurora
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Mercy Carthage
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Mercy Cassville
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Mercy Columbus
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Mercy Joplin
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Mercy Lebanon
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Mercy Springfield
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Mercy St. Francis
The ED dataset provided health issue prevalence rates among specific populations being treated across our region’s hospitals. The data were visualized in a Microsoft Power BI dashboard for Steering Committee use. The dashboard illustrated populations with higher health issue prevalence rates when compared to rates exhibited in other counties, communities, the entire CHNA region and the state. This approach provided the opportunity to assess potential disparities across patient groups (by location, age, gender, payer and race) and identify community-specific needs, therefore assisting in the creation of each community’s CHIP.
Report finalization
The following report is an overview of the OHC region’s health priorities on a community level. Each community decided their health priorities based on qualitative and quantitative data for their population. Together, this gives the OHC a broad snapshot of our health needs as a region.
Community Partner Survey
Service area and population overview
Almost 1.3 million people live in the seven communities within the OHC region. These communities are served by various health care systems and LPHAs.
Tri-State Community
Health care systems
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Cox Barton County
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Freeman Joplin
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Freeman Neosho
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Mercy Carthage
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Mercy Columbus
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Mercy Joplin
LPHAs
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Barton County Health Department
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City of Joplin Health Department
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Jasper County Health Department
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McDonald County Health Department
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Vernon County Health Department
Bolivar Community
Health care systems
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Citizens Memorial Hospital
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Cedar County Memorial Hospital
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Ellett Memorial Hospital
LPHAs
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Dade County Health Department
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Hickory County Health Department
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Polk County Health Center
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Cedar County Health Department
Lebanon Community
Health care systems
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Mercy Lebanon
LPHAs
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Dallas County Health Department
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Texas County Health Department
Mountain View Community
Health care systems
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Mercy Hospital St. Francis
LPHAs
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Douglas County Health Department
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Howell County Health Department
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Ozark County Health Department
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Shannon County Health Department
Springfield Community
Health care systems
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CoxHealth
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Mercy Springfield
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Burrell Behavioral Health
LPHAs
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Christian County Health Department
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Springfield-Greene County Health Department
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Webster County Health Unit
Branson Community
Health care systems
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CoxHealth Branson
LPHAs
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Stone County Health Department
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Taney County Health Department
Monett Community
Health care systems
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CoxHealth Monett
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Mercy Aurora
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Mercy Cassville
LPHAs
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Barry County Health Department
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Lawrence County Health Department
PART 3: Closing Remarks
Conclusion
While this overview of health in the OHC region is not comprehensive, it gives an important glimpse into health priorities reflected in both data and community feedback. Community reports provide a more in-depth analysis of the health conditions highlighted here. The 2025 community-level assessments will be used to inform public health and health care initiatives. These initiatives will be outlined in forthcoming Community Health Improvement Plans.
Dissemination
The OHC regional report and all community-level reports are available to the public through various channels
Websites
Ozarks Health Commission
ozarkshealthcommission.org
CoxHealth
Mercy Hospital
Printed copies
Printed copies will be available by request through health care partners and LPHAs. Please refer to organization websites or contact an organization directly
Ackowledgements
Thank you to the partners and residents that make up the OHC region for contributing to this assessment through your feedback. Your contributions provide rich context to the vast health care data compiled for this report.
Thank you to the OHC Steering Committee for your collaboration and resource sharing during every step of the CHNA process.