Community Health Needs Assessment

CCHHS: Many area residents struggle to meet basic needs

Carson City Health and Human Services

Carson City Health and Human Services

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Some of the statistics and comments from a recent health needs assessment are difficult to process. A Douglas County participant mentions six senior suicides in June of last year. Nearly 36 percent of Carson City residents surveyed say they have few people, if anyone, to love or make them feel wanted. A participant from Lyon County said opioid use is on the rise.

The information was presented to the Carson City Board of Supervisors, convened as the Board of Health, on March 2.

Between August and December 2022, Carson City Health and Human Services worked with Carson Tahoe Health and several local and regional partners to form what’s called a Community Health Needs Assessment. The assessment is part of CCHHS’ reaccreditation process every five years, though CCHHS officials would like to do it every three years to better capture health trends. The recent assessment followed the COVID-19 pandemic, which exacerbated health issues across the quad county region that includes Carson City, Douglas, Lyon and Storey counties.

From more than 1,500 community surveys, stakeholder interviews and focus groups conducted during the assessment, four priority needs surfaced: access to basic needs like primary healthcare and housing; mental and emotional health; access to healthcare for specific populations; and substance use prevention, treatment and recovery.

CCHHS Director Nicki Aaker and Deputy Director Jeanne Freeman presented the findings. According to the assessment, many residents in the quad county area are struggling to meet basic needs. Access to primary healthcare for low-income and underinsured individuals is a challenge as wait times can be one to four months. Specific populations can be more at-risk, including seniors, Spanish speakers, LGBTQ residents and those with chronic health problems.

The assessment reveals the way social and medical issues intertwine. For example, one top need identified is safe, affordable housing. A survey participant from Storey County warned the housing stock is old and “unsafe for many seniors.” A focus group participant from an unidentified county said $2,000 rents in some areas are forcing those living on $900 a month into motels.

These social realities can affect mental and emotional health — another priority identified in the assessment. Survey results show people across the post-pandemic quad counties are suffering from loneliness, emotional isolation and a lack of human connection. Approximately 35.9 percent of those surveyed in Carson City noted a lack of someone to love and make them feel wanted. That percentage was even higher in Lyon and Storey counties: 36.3 percent and 38.6 percent, respectively.

“It’s difficult to look at,” Freeman said of the results. “These are inherent humanistic aspects of our society. If we don’t have these, then it does impact other areas. It impacts our workforce again. It impacts our social dynamics. It impacts the way our youth interact with one another at school.”

Mental and emotional challenges can also lead to substance abuse. The assessment identified the need for more treatment services, including for those in recovery, and the need for more coordination between schools and prevention agencies and early intervention programs.

“Between 2019 and 2020, the opioid-related overdose death rate increased in three out of four service area counties, with Carson City alone reporting a decrease. Douglas County experienced the most severe increase from 5.1 deaths to 18.1 deaths per 100,000 population,” reads an executive summary of the assessment.

The next step for CCHHS and the Board of Health is to create a Community Health Improvement Plan that addresses needs. The plan is expected to be completed in the next six to nine months. The goal is to bring diverse partners together, including the public, and assess service gaps and barriers while developing new strategies and programs.

“It is that continual process for us to evaluate what’s going on, to look how we can impact it," said Freeman, “to implement programs and implement different ideas and to make changes so that maybe at the next community health assessment in three years, we will see the pendulum move.”

Funding remains a challenge. According to Aaker, Nevada lags behind the nation in public health spending, about $72 a person versus the national median of $119 a person. Aaker pointed to Senate Bill 118 that would boost public health spending by $5 a person by allocating $30 million statewide over the next two years. The funding would be non-categorical and community-specific, Aaker said.

“Meaning it will let us take care of the priorities we have,” she said.

The bill was recently moved out of committee and awaits a vote in the Nevada Senate.

An executive summary of the Community Health Needs Assessment and the full report are available online at

Members of the public interested in participating in the Community Health Improvement Plan can email Aaker at with the subject line “CHIP.”


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