As director of the Moffat County Public Health department, Registered Nurse Becky Copeland fully understands, “We got our work cut out for us.”

Copeland and her three energetic staff members are counting on a strong network of partnering health agencies to help improve long-standing low ratings for health factors and outcomes in the county. The Public Health department has a part-time medical director, Dr. Kevin Fitzgerald, who also serves as public health medical director in Mesa County.

Copeland said she is “cautiously optimistic” that improvements are on the horizon.

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Five other larger partners work alongside the public health department, including Northwest Colorado Health, Memorial Regional Health, The Health Partnership, Mind Springs Health and UCHealth, all of which have an office or staff in Craig. Copeland said another key player is the Craig location of Front Range Clinic, which provides recovery and addiction treatment and recently acquired Providence Recovery Services in Craig.

“I agree we have a lot of work to do, and it’s going to take the partnership of all the entities working together to improve the health of Moffat County,” said Amanda Arnold, chief operation officer at Northwest Colorado Health. “I think that we are a hard-working community, and sometimes we don’t slow down to take care of ourselves.”

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Copeland does not prefer to use the word “hurdles,” but she and others readily acknowledge the health care challenges in Moffat County.

In the 2023 County Health Rankings released through the University of Wisconsin Population Health Institute, Moffat ranked “among the least healthy counties in Colorado” in the 0-25% category for health factors that can be modified to improve the length and quality of life.

For health outcomes such as premature death and poor mental or physical health days, Moffat ranked in the lower-middle range — or 25-50% — of Colorado counties. Those health outcomes are meant to show how healthy a county is right now in terms of length and quality of life.

This year the institute ranked Moffat County as 41st out of the 59 rated Colorado counties in health outcomes and 45th in health factors. Moffat has been ranked overall from 31st to 47th since 2013.

At the end of July, Public Health submitted its new five-year Public Health Improvement Plan to state officials. The top areas of concern in the plan include substance use disorder, behavioral health, suicide prevention and affordable housing.

“We are all working to try and increase access and to reduce the stigma of accessing behavioral health,” Arnold said. “Some people in Moffat County can be hesitant to access behavioral health because of the stigma behind it. More access to behavioral health is most definitely a priority in Northwest Colorado.”

Officials from both Northwest Colorado Health and Memorial Regional Health say they are currently recruiting and hiring for more behavioral and mental health professionals and support staff.

Sheli Steele, MRH marketing and community relations director, noted: “We recognize that access to mental health services is a challenge, and we plan to add additional behavioral health specialists to our outpatient services. Our goal is to add two to three licensed professional counselors in the next 12 months.”

MRH also has advocacy and peer support trained behavioral health technicians on call 24/7 in the Emergency Department to connect patients to community resources.

The public health staff and other health officials point to a variety of problems that impact the health of Moffat County residents, such as significant suicide ideation, lower or stagnant wages on average, increasing housing prices and cost of living, poor quality of some of the housing stock, lack of rental apartments, shortage of medical doctors, historically low numbers of mental health professionals, and a lack of in-town bus or taxi transportation.

Fitzgerald pointed out the health care system in the Yampa Valley is further strained by being “destination cities” for visitors who may also need medical care.

Examples of health challenges may be as simple as a lower-income person without a vehicle having difficulty in bringing home healthier foods like seasonal fruit or melons on sale versus a light-weight bag of chips.

“Generally, inflation has caused a rise in cost for many social determinants of health,” noted Suzi Mariano, senior director of marketing and development at Northwest Colorado Health. “We see firsthand the effects of people not being able to afford their rent, groceries and transportation and the effect it has on their physical and mental health.”

The nationwide County Health Rankings, found online at CountyHealthRankings.org, show Moffat County rates worse in many categories compared to Colorado overall, such as in teen births, percentage of uninsured residents, preventable hospital stays, flu vaccinations, children in poverty, children in single-parent households, injury deaths, premature deaths, poor physical health days, adult smoking and obesity, physical inactivity and ratio of population versus availability of primary care physicians, dentists and mental health providers.

With 13,142 residents, Moffat County has a lower population number, and it’s the second-largest county in the state. Because of its low population density, finding enough grant funding to tackle big health care topics, such as building a community health club, can seem like dreams that take a backseat to the daily work at public health ranging from COVID-19 antigen testing and building a departmental website to administering childhood immunizations.

Public Health Registered Nurse Selene Cooper explained the department’s philosophy that investing upstream in prevention rather than downstream in intervention can be wiser and more effective.

The department has a long list of health care prevention items available for community members for free such as pistol lockboxes, trigger locks for guns, harm reduction kits with Naloxone and Fentanyl test strips, take-home sexually transmitted infection testing kits, condoms, baby boxes, masks, bike helmets, pill lock boxes, smoke and carbon monoxide detectors, and first aid kits.

Copeland said public health, although experiencing growing pains after only becoming a stand-alone department in December 2019, will continue to identify the local health care gaps and provide coordination assistance with local partners.