Download the Top 11 Themes

 

The 2022 Community Health Survey included one open-ended question at the end of the survey:

What do you feel are the greatest local concerns or issues impacting the health of the people of Larimer County?

In total, 1,850 respondents in Larimer County answered this question with their concerns about local health issues. After applying thematic codes and tabulating frequency of mentions, eleven themes emerged as the top concerns for the residents of Larimer County. In order of most frequently mentioned, the main concerns expressed by survey participants were:

1. Health Care
2. Mental Health
3. Wildfire
4. Housing
5. Homelessness
6. Climate Change
7. Water
8. Pollution
9. COVID-19
10. Traffic
11. Food

Health Care (283 mentions)

Health Care was the major topic that came up in comments regarding affordability and quality and accessibility of services, particularly for specific demographics. Frustration over long wait times to see providers was also voiced. Several commented on the increased cost of health insurance.

Selected comments about health care:

• “I would love to see affordable, quality health care for all with adequate access to medical, dental, and mental health services.”
• “There is a lack of access to women’s health care.”
• “The cost of health services is difficult to find in advance. Health insurance prices have risen and there are far more out-of-pocket expenses. This combination makes it less likely that people will seek medical care.”
• “Marginalized groups lacking representation in health care services.”
• “Access to all resources in one place – including free health care.”
• “Access to affordable preventative health care in an environment where all people are respected and well received.”
• “A lack of medical services and transportation for people in rural areas.”
• “We need better access to affordable medications.”
• “I think the lack of good quality health care is an extremely serious issue in Larimer County. More of the same is NOT going to fix it!
• “Availability of doctors accepting new patients. It now takes as much as six months to get a doctor’s appointment to receive care.”
• “Ability to afford health care through retirement.”
• “People die due to the lack of being able to afford medicine! I had a heart episode but could not afford a doctor, so it has gone untreated.”

 

Mental health (282 mentions)

Mental Health was mentioned second most frequently regarding a lack of access to services due to cost and a shortage of providers in Larimer County. Stress, anxiety, and depression exacerbated by the COVID pandemic brought the need for more mental health resources into sharper focus, particularly services for youth. Several respondents were concerned about burn out of mental health providers.

Selected comments about mental health:

• “Connecting people with appropriate mental health care is important and there are not enough providers to handle the county’s needs. Also we should better support the mental health professionals we do have so they avoid burnout.”
• “All parts of Larimer County need to be equipped to handle suicide risks.”
• “We need more mental health help for the homeless population. The increased presence of the homeless in my neighborhood increases my own stress and anxiety regarding personal and property safety.”
• “Mental health for teenagers. Schools need to provide a regular mental health program, and a safe space for students to go in and out of school.”
•  “Mental health care including quality addiction recovery programs.”
•  “If people get help for addiction or depression, everyone would see a change for the good.”
• “Mental health, illness, and gun control all goes hand in hand. We do not have enough resources. What if your child is the next one to be killed in a school shooting?"

 

Wildfire/Fire (239 mentions)

Poor air quality from wildfire smoke drifting over our skies, and the need for better fire mitigation and emergency preparedness were mentioned. Commenters noted how climate change is increasing the number and duration of wildfires.

Selected comments about wildfire:

• “Wildfires are affecting our water, land sources, and air quality.”
• “I’m increasingly concerned about air pollution from unhealthy levels of ozone and wildfire smoke.”
• “Wildfire control and education.”
• “Poor air as a result of wildfires and air pollution traveling in from larger metro areas within and outside of Colorado (ex. California).”
• “Climate change impacts such as wildfires, smoke, and rising temperatures are a health problem.”
• “The threat of wildfire due to an unhealthy level of fuel in our forests combined with uneducated tourists not practicing fire safety when visiting.”
• “When there is smoke from wildfires and bad air days we need better instructions other than ‘stay indoors.’ What kind of mask—if any—would help? Why live here if one has to stay indoors?”

Some commenters describe direct and indirect impacts of previous fires and increasing concern with fire risk being unbound to a season. A variety of causes were noted and areas where solutions can be applied.

• “Wildfire threat year-round.”
• “The ever increasing risk of fire with the dryness and wind. I live on the far west side of town and I worry about a Marshall Fire like event, or the wildfires that happen in the mountains getting close to town.”
• “Cigarette butts thrown out car windows causing fires.”
• “Wildfires in the mountains and now in town (considering what happened near Boulder).”
• “Wildfire. We already lost our cabin to Cameron Peak fire, and feel like we are very vulnerable even in rural area. Need better wildfire response with aircraft.”

 

Housing (235 mentions)

Responses included concerns about the overall high cost of housing and a lack of affordable housing for residents with middle and low incomes. The burden of restrictions like U+2 in Fort Collins and investors buying up properties and raising the cost to rent or lease were mentioned. Several people made the connection between a lack of affordable housing and rising homelessness.

Selected comments regarding housing:

• “Affordable housing is nonexistent”
• “Cost of living inequities; lack of affordable housing for middle-class working families (non-subsidized options). Fort Collins is starting to lose the solid middle and young families – and if those groups can't afford to build lives here, that can't possibly be beneficial to the community as a whole.”
• “Affordable housing and the growing homeless population.”
• “Lack of housing and rent costs.”
•  “Affordable housing is the single biggest threat facing Larimer County. Regressive policies such as ‘U+2’ and a chronic lack of zoning reform has left poorer families unable to find homes they can rent or own affordably. This must change.”
• “If there is not adequate housing, this is a health problem.”
• “A lack of stable and safe housing that all families and individuals can afford. I believe that with safe and stable housing, the other areas of one’s life (employment, food, education, child care, health quality) have a better chance of being successfully addressed.”

 

Homelessness (220 mentions)

Responses regarding the unhoused population ran the gamut from support for providing additional resources to help end homelessness to concerns about unsanitary living conditions and fear of violence from unhoused individuals. Homelessness was mentioned often in connection to mental health needs, substance use, and a lack of affordable housing.

Selected comments about homelessness:

• “Increased presence of homeless increases stress and anxiety felt regarding personal and property safety. The relentless screaming of mentally-challenged homeless people radically effects peace of mind and quality of life…”
•  “Fear, worry, stress, and anxiety about daily presence of homeless in the neighborhood effects my mental and physical health… The police do not seem to have viable options to handle complaints about the homeless. Last summer one officer told me my only option was to have them arrested! He seemed frustrated himself on how to get them the mental health services they needed.”
• “Homeless population increasing – need to get jobs instead of begging on street corners.”
• “A lack of affordable housing, and, relatedly, increasing homelessness.”
• “The homeless population is setting up encampments all over town and in the public parks. We have found glass, drug paraphernalia, human and dog feces in children’s playgrounds…It’s getting out of control. We don’t feel safe going to some parks anymore.”
• “Need to help people get into homes and off of the streets.”
• “The transient population coming from big cities (like Chicago) are violent and aggressive…Fort Collins is not nearly as safe as it used to be because of this issue.”
• “There are almost more dispensaries than liquor stores. Alcohol and drug addiction, including cannabis, are at the heart of most of our mental illness and homelessness.”
• “Addressing/caring for the unhoused population.”
• “Mental health and substance abuse treatment and education in conjunction with assistance and attention to solving and/or supporting the homeless.”

 

Climate Change (188 mentions)

Concerns over climate change came up frequently including the health impacts of global warming, regional wildfires, and increasingly hotter local temperatures. Multiple respondents mentioned fears about extreme weather events in the coming years.

Selected comments about climate change:

• “Climate change that disrupts food security, ecology, and extreme weather events.”
• “Increasing risk of natural disasters due to climate change.”
• “Climate change affecting drought and the occurrence of wildfires.”
• “Climate change impacts such as wildfires, smoke, and rising temperatures are a health problem.”
• “Heating of the earth and higher temperatures and less precipitation, especially snow.”
• “An inordinate amount of people drive large trucks around town and they are clearly not using them for work or carpooling, which is very inefficient…these trucks are smog-producers and contribute to man-made climate change.”
• “Climate change = more fires, hotter weather, and less water.”
• “Climate change and the associated increase in pollution, wildfires, and flooding.”
• “Climate change and the resulting wildfires led to very poor air quality and extreme heat. The last couple summers have been miserable because, besides the direct impacts of the fires and heat, they often preclude outdoor activities.”

 

Water (150 mentions)

Water was a major concern mentioned in relation to population growth and the impacts of climate change. Participants often commented on water scarcity due to drought and more users, which drives up the cost and leads to usage restrictions. Some mentioned fears of ground water pollution from fracking, fertilizers, and pesticides.

Selected comments regarding water:

• “Concern for water availability.”
• “Ground water depletion & underground water contamination due to fracking & fertilizer/pesticide usage.”
• “Current poor understanding to use and conserve scarce potable water resource/supply in community.”
• “Unwise use of water.”
• “Water usage and long term availability.”
• “Too much growth for the water available along with the needed infrastructure.”
• “Need higher costs for water taps to inhibit growth.”
• “Scarcity of water in the coming years due to drought exacerbated by population increases.”

 

Pollution (145 mentions)

Many participants expressed concerns about various forms of pollution, including air, noise, and light. The ozone levels impacted by personal vehicles and landscaping machine emissions was noted several times. The connection was made between increased and longer burning wildfires and polluted air.

Selected comments regarding pollution:

• “Sound pollution. I live 1 block from trains and sirens at all times of the day (and night).”
• “Extreme noise pollution from train horns impacts hearing, disrupts sleep patterns, and increases stress. What happened to Quiet Zones or Times?”
• “Increasingly concerned about air pollution from ozone and wildfire smoke.”
• “Creosote at the sugar factory/railroad ties dusting our neighborhood daily—causing health problems to all of us!”
• “Extremely high level of methane pollution, coming from industrial-scale animal farms—the urine and dung smell.”
• “The combination of industry, vehicle and agricultural emissions, and wildfire smoke have created dangerous air quality for the northern Front Range.”
• “Need to lower the decibels (dBA) of train horn. Horns are excessively loud and disturbing. Need quiet zone through all of Fort Collins.”
• “Air pollution, dust created by cement plans + gravel pits; light pollution; and noise pollution.”
• “Larimer County does not enforce or make people aware of anti-idling laws.”
• “Having the bus go down Lemay Avenue would help us seniors and mean less cars and pollution as a result.”

 

COVID-19 (141 mentions)

Comments about COVID mainly focused on masking and vaccination, with a mixture of support and opposition for each. Differing perceptions emerged for how mandates and rules around protocols kept us physically safe, and how mental health was impacted during the height of the pandemic.

Selected comments regarding COVID-19:

• “COVID – everyone needs to follow the recommendations of science.”
•  “100 percent lack of COVID current awareness, absent mask/distancing mandates (or suggested).”
• “Anti-vaccination and unvaccinated, refusing mask wearing when requested/required.”
• “Being forced to wear masks and pressured to get vaccinated.”
• “Compliance with mask mandates during COVID outbreaks.”
• “Continued guidance on the pandemic.”
• “The pandemic impacted business hours and has left night shift workers having to sacrifice sleep to accomplish anything.”
• “Mental health concerns related to the pandemic.”
• “People that don’t believe in scientific facts regarding vaccines.”
• “Mental health issues are a major concern here and everywhere, exacerbated by COVID.”

 

Traffic (141 mentions)

Issues around traffic that were mentioned frequently included congestion and speeding, followed by distracted driving and driving under the influence of alcohol and/or other drugs. Many respondents suggested expanding public transportation and bicycle infrastructure and government encouraging carpooling and alternate forms of transportation to ease anxiety on the roadways and improve air quality.

Some comments regarding traffic:

• “Driving too fast. No bike lanes from mid-Prospect Road to near Prospect/I-25 bridge.”
• “Very lengthy traffic delays on I-25 and poor road prep during construction.”
• “Speeding causing anxiety and fear… Get $$$ and have cops patrol & set up speed traps.”
• “Repeat offenders—crime/drunk driving—kept off street—incarcerated.”
• “Traffic is terrible with increased growth in area.”
• “Traffic congestion (trains contribute).”
• “Discourteous, dangerous driving. Inconsistent traffic lights, turn signals (cause rear ending, et al. accidents).”
• “Cellphone use while driving (texting) and drunk driving.”
• “Reducing traffic congestion, urban sprawl. Connecting bike routes to grocery stores and community centers.”
• “Congestion. Need county-wide, or northern Colorado-wide mass transit, and safe or dedicated bike lanes with promotion of bike riding.”
• “Traffic jams and lack of infrastructure upkeep. Lack of parking in Old Town.”
• “Increasing traffic congestion creates problems with air quality and stress levels.”
• “Cell phone use. I normally see people driving while looking down at their phones. In fact, I saw someone the other day who was Facetiming someone while driving. It seems quite easy for someone driving distracted like this to hit a pedestrian or cause a car crash.”

 

Food (135 mentions)

Respondents had concerns about the high cost of food, and access to healthy food options for residents of all ages, income levels, and neighborhoods. A lack of nutritious food for youth in particular was included in several comments. The need for more education around healthy diet was also repeated.

Selected comments regarding food:

• “I'm worried about the creation of food deserts as housing expands without public transportation services to support low income populations.”
• “Access to local food is unaffordable but very important. I don't want to buy factory farmed meat and produce that is shipped all over the world and wrapped in plastic. But grocery stores don't carry local food, the farmers markets and CSAs are so expensive, and access with food stamps is clunky or nonexistent.”
• “Limit unhealthy food at PSD breakfast and lunches”
• “Learning and using skills to replace unhealthy habits with healthy ones—like eating and exercise.”
•  “Need to address food insecurity. It’s a big issue for some elderly.”
• “Healthy nutritious meals—the Meals on Wheels meals that are served here in FOCO are nasty looking and taste as bad as they look.”
• “Obesity, lack of knowledge from a young child age all the way through adulthood about how to eat healthy, exercise, avoid substances, etc.”
• “People have to work multiple jobs just to feed their families & find housing. They don't have the time to search for healthier food or recreational activities.”
• “Junk food, few healthy restaurants, not enough access to affordable healthy organic food.”
• “Because I worry each month about rent (and student loans), I buy cheap food like I’m still in undergrad…”
• “The high cost of living, limited affordable housing, low wages, high cost of childcare, prevent a lot of people from eating healthy… and, as a result, their general mental health is affected, which affects their health in a negative way. This has a profound effect on family life—especially for children in their formative years.”

 

Some other common topics mentioned in the open-ended responses (in no particular order):

• Health insurance: concerns over rising costs, lack of accessibility to plans, lack of affordable options for those with pre-existing conditions.
• Guns: worry over easy access to firearms and the threat of injury or death from shootings. Support for Red Flag laws and universal background checks. Some concern that government will take away gun rights from law-abiding citizens.
• Transportation: lack of reliable and available public transit, particularly in Northeast Fort Collins and rural areas of the county. Limited bus schedules make it harder for people without cars to make it to medical and dental appointments. Need for more bike lanes and comprehensive bicycle infrastructure. Lack of regional rapid transit to Denver/DIA.
• Drug and alcohol use: fears that addiction is being fueled by cannabis dispensaries, breweries and distilleries, easy availability of liquor and marijuana. Worry about the Influx of fentanyl and methamphetamines in the community; support for drug overdose prevention and more treatment for addiction. Comments on restricting vaping and cigarette smoking in public (pro and con).
• Childcare: High cost, lack of licensed providers, and inequities in access to childcare were all mentioned. Lack of options for safe adult daycare.

 

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