After months of study, four main areas of concern — access to health care, housing, depression and suicide, and interpersonal abuse — have emerged as the foci for an emerging community health improvement plan, Island County’s public health department told the Council of Governments last month.

The Health Department last year began a community health assessment, evaluating county residents on 145 health indicators, such as the violent-crime rate per 1,000 people and the number of 10th-grade students who feel safe at school.

It also received 1,100 survey responses and held eight focus groups.

The items of greatest concern were gradually refined to eight broad topics at a workshop in February and further refined to four topics at a workshop earlier this month.

Now comes the next step: formulating a community health improvement plan, said Laura Luginbill, assessment and healthy communities director for Island County Public Health.

That is the province not of the Health Department but of the community as a whole, explained Keith Higman, Health Services director.

“We are not the movers, we are not the shakers on this plan,” he said. “We don’t have the ability to affect the things that emerged as most important. The community does, through policy development or individual behavior change.”

Creating such a plan — part of repeating five-year cycle of community health planning — is an element of getting accredited as a health department, Higman said. Accreditation is not mandated, but the health department envisions that in the future, access to state and federal money may require accreditation, he said.

Detailing the four main areas of concern to be addressed in the community health improvement plan, the most recent draft workshop objectives state that:

Island County residents need to better understand how to get health care and need to learn about alternatives to using the emergency room for non-emergency uses. Urgent-care services should be made more available, as should primary care on weekends and evenings.

The county’s homeless population is rising, and the community should be made more aware of it. Emergency housing and permanent supportive housing should be created, more and better-paying jobs should be created, regulations limiting the development of affordable housing should be revised and incentives should be created to develop such housing.

To address serious consideration of suicide among youths, school and Whidbey General mental health services should be increased, the cost of mental health treatment should be mitigated, domestic violence should be cut, and education and training should be provided to youth, parents and adults working with youth.

To minimize violence and abuse against youth, parents should be trained in healthy relationships, parent support groups should be created, more positive role models should be made available to youth, and the fear of repercussions from reporting abuse should be decreased.