
Health
While Colorado often ranks as one of the healthier states in the US, our residents still don’t enjoy the length and quality of life that they should or could. The reasons for this are complex and require us to look beyond a handful of morbidity (sickness) or mortality (death) metrics. We must look to a broader set of social and economic factors like housing, income, education, discrimination, the environment, and others to fully understand the drivers. As such, we encourage readers to explore other Quality of Life reports that relate to these factors such as Economy, Education, Land Use & Built Environment.

Report Summary:
Health
While Coloradans have traditionally enjoyed good health compared to residents of other states, we are developing more complex physical and mental health problems which, if not addressed, will influence the health of our community in the future. Data can better help us understand critical indicators surrounding our health and influence our trajectory. Those indicators include adult and childhood obesity, behavioral health (particularly suicide and substance use), and access to care.
Health Summary
While Coloradans have traditionally enjoyed good health compared to residents of other states, we are developing more complex physical and mental health problems which, if not addressed, will influence the health of our community in the future. Data can better help us understand critical indicators surrounding our health and influence our trajectory. Those indicators include adult and childhood obesity, behavioral health (particularly suicide and substance use), and access to care.
Understanding the Pikes Peak region’s health is a complex endeavor. Historic and current day policies and practices influences a complex interplay of factors that shape our health status and outcomes. As a result, it is difficult to make sensible generalizations about a community’s health. Instead, this complexity invites us to look more closely at the different factors influencing health to understand our region’s strengths and opportunities for improvement. This often involves analyzing health issues in a disaggregated fashion to detect health disparities among demographic groups or geographic regions, which we have reflected in the presentation of health data in this section.

Health Summary - More Details
- El Paso and Teller Counties have a significantly higher rate of premature death relative to the state overall.
- In El Paso and Teller Counties, the proportion of the adult population estimated to be obese was 28.5% in 2021, an increase from 21% in 2015.
- Data from 2020 indicates that 15% of El Paso County individuals (ages 5+) reported 14 or more days of poor mental health within the previous 30 days.
- In El Paso County, drug-related deaths jumped from 191 to 392 between 2018 and 2022.
- Colorado Springs has a higher age-adjusted suicide rate than the state overall as well as peer communities in Colorado.
- In 2019, Colorado Springs had 62.3 primary care physicians per 100,000 population or 1 for every 1,600 residents.
- 7.7% of Colorado Springs residents under age 65 lacked health coverage in 2021.
- The pandemic affected primary care utilization, resulting in a 25% drop in visits to care providers.
More than 34% of Colorado Springs MSA residents have contracted COVID-19.
Key Indicators
The World Health Organization defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”1 Good health allows us the opportunity and ability to pursue and achieve life’s delights, interests and goals. Five determinants of health that are widely accepted as influencing length and quality of life include the following:2
- Health behavior (such as nutrition, physical activity, and substance use)
- Healthcare access and quality
- Genetics
- Social and economic factors
- Physical environment
This report looks at length of life, along with health behaviors and healthcare access.
Click on an indicator to learn more about it! Be sure to use the infographics and additional resources for the full experience.
Length of Life
A key measure of community health is the rate of premature deaths–that is, the years of potential life lost before age 75.3 The fewer premature deaths experienced, the healthier the community. This measure focuses attention on preventable causes of death among people in their younger and middle years. Colorado Springs Metropolitan Statistical Area (MSA) has a significantly higher rate of premature death than the state overall. It ranks 5th of 6 peer communities.
4 National Center for Health Statistics – Mortality Files, as cited by County Health Rankings
Between 2019 and 2021, Colorado Springs fared worse than peer Colorado communities in rates of preventable deaths. Additionally, Colorado Springs’ COVID-19 death rate up to December 2023 has exceeded Boulder’s by 57% and Fort Collins’ by 42%.
5 National Center for Health Statistics – Mortality Files, as cited by County Health Rankings
6 CDPHE/Colorado State Emergency Operations Center
Vaccine availability has been extremely helpful toward protecting people from infection, serious illness, and death; however, a significant portion of the Colorado Springs community remains unvaccinated.
For more about the impact of COVID-19, read the COVID-19 supplement button below.
COVID-19
This report was updated following the May 11, 2023 expiration date for the Public Health Emergency (PHE) for COVID-19. As of December 2023, El Paso County had experienced 254,969 COVID-19 cases, 7,498 COVID-19 hospitalizations and 1,977 COVID-19 deaths.i More than 34% of Colorado Springs MSA residents have contracted COVID-19. Case rates and death rates for Colorado Springs are higher than in Colorado peer MSAs.
More information about how COVID has affected our region is available on the websites of El Paso County Public Health and Teller County Public Health and Environment. ii
Health Conditions & Behaviors
Complicating Factor: Obesity
Being overweight or obese increases the risk of chronic disease, cancer, heart disease, stroke, diabetes, and other metabolic diseases. Body Mass Index (BMI) is used to measure this factor.8 Though Colorado Springs and the state of Colorado historically have been among the healthiest in the nation, more people in the community are becoming overweight and obese. In 2021, more than six in 10 adults in the community were in an unhealthy weight category,9 and 28.5% were estimated to be obese,10 up from 23% in 2016.11
12 CDC’s Behavioral Risk Factor System
Obesity leads to many chronic conditions. The incidence of these in Colorado Springs and peer communities can be found in the Chronic Conditions supplement button below.
Chronic Conditions
Elevated BMI and being overweight and/or obese increases the risk of chronic disease and morbidity (incidence of other diseases) and decreases life expectancy. The risk of cancers, heart disease and stroke, as well as other cardiovascular conditions such as hypertension, atherosclerosis, angina, and myocardial infarction are at an increased risk due to being overweight or obese. The rates of metabolic diseases, such as diabetes and hyperlipidemia, are increased with a BMI of 25 or more. Quality of life is also affected due to degenerative changes in the joints resulting in arthritis and pain that limit mobility and functionality.iii The graph below highlights the prevalence of four of these chronic conditions in our community and state.

It is important to recognize that the prevalence of conditions increased by elevated BMI correlate with many of the top causes of mortality and morbidity within the country, Colorado, and El Paso and Teller Counties. Being overweight and/or obese threatens quality and duration of life, but also strains the healthcare system. The seriousness of obesity has been further highlighted by COVID-19 – individuals who have elevated BMIs are at increased likelihood of hospitalization and death.v
Nutrition
Obesity can be combatted by good nutrition, including a diet that matches calories consumed with calories burned. The Dietary Guidelines for Americans promote eating foods that are nutritionally dense and low in calories such as vegetables, whole fruits, and whole grains.
Exercise
For substantial health benefits, children should have one hour of activity daily for at least five days per week, and adults should have 30 minutes or more of activity at least five days a week to maintain a healthy lifestyle and decrease the risk of cardiovascular and chronic disease.
As of 2019, only 46% of high school students in El Paso County reported being sufficiently physically active for a total of at least 60 minutes per day for five or more days within the past week.16
Next Steps
Each individual has the responsibility to eat healthy and exercise, but policy makers, local organizations, employers, and elected leaders can all help to create an environment that supports healthier lifestyles and that reduces risk factors. Steps can be taken to increase access to exercise options (trails, open space, safe neighborhoods) and affordable healthy foods (fresh fruits and vegetables in stores accessible by walking and/or public transportation), and to improve education about nutrition. Public policy should support regular physical activity, increase affordable dietary choices, promote reduction of sugar, fat, salt, and preservatives in processed and fast foods, and restrict marketing to youth of foods and beverages high in sugar, fats, and salts.
Behavioral Health
Behavioral health “refers to the promotion of mental health, resilience, and well-being; treatment of mental and substance use disorders; and support of those who experience and/or are in recovery from these conditions, along with their families and communities.”17 In short, behavioral health includes both mental health and substance use, and this section will review those topics along with suicide.
Mental Health
Self-reported health status, specifically poor mental health days, is often used as a general measure of health-related quality of life in a population.18 Data from 2021 indicate that 15.8% of Colorado Springs individuals (ages 5+) reported 14 or more days of poor mental health within the previous 30 days, which is higher than the State level of 14.6%. Among peer communities for which data was available (Albuquerque, Austin, and Boise), Colorado Springs ranked 3rd of 4.19
Substance Use Disorder
SAMHSA’s 2022 National Survey on Drug Use and Health (NSDUH) reports that approximately 25.4 million people aged 18 or older had a substance use disorder in the past year.20 In El Paso County, drug-related deaths jumped from 186 to 206 between 2020 and 2022.21 Among Colorado peer communities, Colorado Springs ranked 3rd of 3 in each of three key categories of drug-related deaths.
Alcohol
Alcohol is the most used substance nationally and in the state. In 2021, 18% of adults in the Colorado Springs MSA reported binge drinking or heavy alcohol consumption.23 That ranked 2nd best of 6 peer communities.
In 2019 the percentage of El Paso County high school students reported binge drinking in the previous 30 days was 10.6%, compared to 14.2% statewide.24 That ranked 1st of 3 Colorado peer communities for least binge drinking among high school students. For more information and local statistics, see the Substance Use Disorder Supplement button below.
Substance Use Disorder
Substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home. SAMHSA’s 2022 National Survey on Drug Use and Health (NSDUH) reports that approximately 48.7 million people aged 12 or older had a substance use disorder in the past year.vi The primary types of substance use disorders include:
- Opioid Use Disorder
- Marijuana Use Disorder
- Nicotine Use Disorder
- Stimulant Use Disorder
- Sedative Use Disorder
- Hallucinogen Use Disorder
- Alcohol Use Disorder
Alcohol
In 2022, according to the NSDUH report, 49% of Americans aged 12 or older (or 137.4 million people) used alcohol in the past month (i.e., current alcohol users) and of those, 44% were classified as binge drinkers. The percentage of people who were past month binge alcohol users was highest among young adults aged 18 to 25 (29.5%) compared with 22.6% of adults aged 26 or older and 3.2% of adolescents aged 12 to 17.vii
In our region and of those self-reporting, the use of alcohol remains high. Alcohol is the most used substance nationally and in the state. In 2021, 18% of adults in the Colorado Springs MSA reported binge drinking (having five or more drinks for men and four or more drinks for women within the past 30 days) or heavy alcohol consumption (more than two drinks for males and more than one drink for females per day).viii Colorado Springs ranked 2nd of 6 peer communities for least binge drinking.
Marijuana
According to SAMHSA, “marijuana is the most commonly used illegal substance in the U.S. and its use is growing. Marijuana use among all adult age groups, both sexes, and pregnant women is going up. At the same time, the perception of how harmful marijuana use can be is declining. Increasingly, young people today do not consider marijuana use a risky behavior.” ix
It is difficult to compare Colorado marijuana use to the rest of the country because many states have not legalized marijuana; however, we do know that approximately 1 in 10 people who use marijuana will become addicted. If they begin to use marijuana before the age of 18, the rate of addiction rises to 1 in 6 people.x From 2013-2019, marijuana use increased across all demographics in El Paso County. For example, in 2013 14.7% of youth reported having used marijuana in the past 30 days. That percentage had increased to 21.5% by 2019.xi An increasing proportion of females reported usage over this time period, while there was only a slight increase in reported usage among males.xi Year-over-year data from Healthy Kids Colorado shows an upward trend in usage for all demographics, and youth identifying as LGB+ demonstrate a higher use rate overall.xii
Vaping
In 2023, according to the Healthy Kids Survey, 9% of surveyed Colorado high schoolers said they currently vape nicotine, defined as having smoked an electronic cigarette in the last 30 days.xiii That figure has dropped by nearly two-thirds since 2019. El Paso County data is not available for 2023 but local usage closely mirrored state rates in 2019 and 2021. The same survey indicated that most students try vaping by the time they are 15 years old; in 2019, 40% of students 15 years old or younger reported they had used an electronic vape, and that percentage jumped to 50% by age 17. The graph below shows that in El Paso County, almost 50% of students surveyed in 2019 had used a vaping product.

Access to vaping supplies is relatively easy. In 2019, 45% of youth under 15 years old and 80% of young adults 18 years or older were confident they could get an electronic vape. Students reported it was slightly easier to get e-vapes in 2019 than in 2017, although students 15 or younger reported it was much harder.xiv
Opioid Use and Overdoses
Opioid overdose deaths in Colorado in 2023 were 21.7 per 100,000 people (age adjusted). The rate for El Paso County was slightly lower at 20.3. According to the El Paso County Coroner,xvi drug-related deaths increased from 130 in 2019 to 227 in 2021 before dropping slightly to 216 in 2022. The table below summarizes the types of substances that were found during autopsy and the associated increase in deaths between 2019 to 2022. Forty-four percent of drug-related deaths in El Paso County were due to a combination of substances.
Recent data has shown a growing prevalence in substance use due to the extended isolation and stressors of the COVID-19 pandemic.xvi Seventeen percent of Americans now indicate they have a substance use disorder (SUD),xvii while in Colorado, the percentage is closer to 12%.xviii
This underscores the critical need for substance use disorder prevention, treatment and recovery programs in the region. This is especially true for those who are served by Colorado’s Medicaid program. Lack of a full continuum-of-care often forces residents to seek care outside of the region or state, or, worse yet, forgo treatment.
Reducing barriers to accessing help, including same-day treatment, medication-assisted treatment, and residential treatment when appropriate, can help reduce opioid and drug overdose deaths. Educating the community on Narcan and expanding safe needle exchange programs in the community are evidence-based practices that can help reduce opioid use and deaths.
Suicide
Colorado Springs MSA lost 202 people to suicide in 2023; El Paso County accounted for 196 suicide deaths and Teller County accounted for six. The 2020 El Paso County Coroner’s Report indicated that firearms were responsible for 61% of local deaths by suicide in 2022.25 Colorado Springs has a higher age-adjusted suicide rate than the state overall as well as peer communities in Colorado.26
28 CDPHE/Colorado Center for Health and Environmental Data
Youth Suicide
According to the United Health Foundation’s Health of Children and Women Report 2019, Colorado had the highest increase in the teen suicide rate in the U.S. between 2014 and 2017. xix The graph below demonstrates the year-over-year trend comparing Colorado to the nation overall.
Between 2014 and 2021, teen suicide in Colorado rose from 12.9 to 21.8 deaths per 100,000 adolescents ages 15-19, according to the 2023 report. Overall, that rate put Colorado as the eighth-worst state in the country. Colorado’s 2019-2021 rate is more than double the national rate of 10.6 per 100,000 adolescents ages 15-19.xx While trend data for younger youth are not available, the suicide attempts in 2019 were higher in El Paso County and Health Statistics Region 4 (Teller, Park, Gilpin and Clear Creek Counties) than the state average according to the 2019 Healthy Kids Colorado Survey, and females considered, planned or attempted suicide more often than males. Suicide attempts and deaths are significantly higher for youth who identify as Lesbian, Gay or Bisexual and for transgender youth. The following graph presents a clear picture of variations in 2019 suicide attempts by different demographic groups.
Data in the 2023 National Survey on LGBTQ Youth Mental Health further underscores these disparities, noting that nearly 20% of transgender and non-binary youth attempted suicide; 54% of LGBTQ+ youth reported symptoms of major depressive disorder; and that 56% wanted mental health care, but didn’t get it.xxii Stress resulting from prejudice and discrimination (e.g., family rejection, bullying, violence) is a known risk factor for suicide attempts among lesbian, gay, bisexual, and transgender (LGBT) youth.xxiii
Lastly, several studies have documented the need for culturally-competent providers with specific training in addressing the behavioral health needs of LGBTQ+ persons.xxiv xxv xxvi Although the need to develop a culturally and linguistically competent workforce is ever more important, it is compounded by the ongoing challenges with shortages in most mental health provider types. Behavioral health organizations are working to rapidly build or partner with organizations that can provide unique specialized training to work toward better supporting this need.
The efficacy of suicide-prevention education and specific interventions among teens is uncertain.xxvii However, expanded access to behavioral health services is vital for improving mental health, with the goal to reduce deaths by suicide. Evidenced-based practices and programs like Mental Health First Aid and CALM – Counseling Access to Lethal Means provide community members, and other healthcare providers, with resources and tools to support upstream prevention work in an effort to decrease deaths by suicide.xxviii
Access to Health Care
Clinical medical care (access and quality) accounts for 10 to 20% of a person’s total health.29 Access to care, especially primary care, is a key resource for individuals to meet their potential.
Primary Care Access
In 2021, Colorado Springs had 62.3 primary care physicians per 100,000 population (1 for every 1,600 residents). While that measure has improved in most of the past 10 years, Colorado Springs still had fewer primary care doctors, relative to population, than the state (82.9) and nation (75.2). Colorado Springs also ranked 6th out of 6 peer communities.
Health Insurance
Health care costs may be covered through employer-sponsored insurance, individual plans purchased through the Health Insurance Exchange, other insurance and government-sponsored programs such as Medicare for adults aged 65 and over, Medicaid for low-income families, and the Children’s Health Insurance Program for young people in low-income settings.
35 U.S. Census, Small Area Health Insurance Estimates
The Colorado Health Institute has estimated coverage for all Coloradans. Between 2019 and 2023 the number of commercially insured El Paso County residents decreased by almost 6 percentage points, while Medicaid enrollment increased from 19.4% to 28.9% of the county’s population.36 El Paso County’s Medicaid enrollment rate is 4% higher than the national average.
Health Care Utilization
According to the Colorado Health Access Survey 2023, El Paso County falls in the middle of the pack for Colorado regions for accessing health services such as primary care and dental care. El Paso County ranked 3rd of 3 Colorado peer communities for proportion of the population making preventive care visits and dentist visits. However, the county ranked 1st of 3 Colorado peer communities for having a regular source of care and health advice.37
38 Colorado Health Access Survey 2023
Healthcare Workforce
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Sources
References
References
1 World Health Organization, https://www.who.int/about/governance/constitution, accessed October 7, 2024.
2 Choi, Edwin, and Sonin, Juhan. Meta-analysis of seven published studies of the relative contribution of five determinants of health categories. Nov. 15, 2018 (v. 3). https://www.goinvo.com/vision/determinants-of-health/, accessed October 7, 2024.
3 This is described as the total per 100,000 population, adjusted for the community’s age profile.
4 National Center for Health Statistics – Mortality Files, as cited by County Health Rankings. Data published in 2024 based on age-adjusted data aggregated from 2019-2021, https://www.countyhealthrankings.org/health-data/colorado/data-and-resources and https://www.countyhealthrankings.org/explore-health-rankings/rankings-data-documentation, both accessed October 7, 2024. MSA data was calculated from county data, with each county weighted proportionally based on the population or sub-population. Results rounded to nearest 100.
5 National Center for Health Statistics – Mortality Files, as cited by County Health Rankings. Rates published in 2024 based on aggregated data from various periods from 2017-2021. https://www.countyhealthrankings.org/explore-health-rankings/rankings-data-documentation, accessed October 7, 2024. MSA data was calculated from county data, with each county weighted proportionally based on population. Suicide rate includes adjustment for age profile of community.
6 CDPHE. Data at https://covid19.colorado.gov/data and https://cdphe.colorado.gov/covid-19/data, both accessed October 7, 2024.
7 Choi, Edwin, and Sonin, Juhan. Meta-analysis of seven published studies of relative contributions of determinants of health. Nov. 15, 2018 (v. 3). https://www.goinvo.com/vision/determinants-of-health, accessed October 7, 2024. More on health determinants can be found at CDPHE’s Health Disparities and Community Grant program, https://cdphe.colorado.gov/hdcgp, and in the University of Wisconsin Population Health Institute’s County Health Rankings, https://www.countyhealthrankings.org/explore-health-rankings/measures-data-sources/county-health-rankings-model, both accessed October 7, 2024.
8 BMI is calculated by comparing weight measured in kilograms to height measured in meters squared (kg/m²). The World Health Organization considers adults with a BMI of 25 or greater to be overweight; it considers those with a BMI of 30 or greater as obese. Children under the age of two are considered overweight if their BMI is at least two standard deviations above WHO Child Growth Standard Medians; they are considered obese if they are three standard deviations above. Children ages 5-19 are considered overweight if they are one standard deviation above the median and obese if two standard deviations above.
9 CDC’s Youth Risk Behavior Surveillance System, 2021 data, https://nccd.cdc.gov/BRFSSPrevalence/rdPage.aspx?rdReport=DPH_BRFSS.ExploreByLocation, query selections: MMSAs, Location – Colorado Springs, CO Metropolitan Area, Class – Overweight and Obesity; Topic – BMI Categories, Year – 2021; see also https://epc-assets.elpasoco.com/wp-content/uploads/sites/18/2024/06/Community-Health-Assessment-20.pdf, p. 28, both accessed Oct. 9, 2024.
10 Ibid.
11 CDC’s Behavioral Risk Factor Surveillance System, 2021 & 2016 data, https://nccd.cdc.gov/BRFSSPrevalence/rdPage.aspx?rdReport=DPH_BRFSS.ExploreByLocation, query selections: MMSAs, Location – Colorado Springs, CO Metropolitan Area, Class – Overweight and Obesity; Topic – BMI Categories, Years – 2021, 2016; see also https://epc-assets.elpasoco.com/wp-content/uploads/sites/18/2024/06/Community-Health-Assessment-20.pdf, El Paso County Health Indicators 2017 Report, https://epc-assets.elpasoco.com/wp-content/uploads/sites/18/2024/02/CHA-Report-2017_0-1.pdf, p. 25, accessed Oct. 9, 2024.
12 CDC’s Behavioral Risk Factor Surveillance System, 2015-2021 data, https://nccd.cdc.gov/BRFSSPrevalence/rdPage.aspx?rdReport=DPH_BRFSS.ExploreByLocation, query selections: MMSAs, Location – Colorado Springs, CO Metropolitan Area, Class – Overweight and Obesity; Topic – BMI Categories, Years – 2015-2021; see also https://epc-assets.elpasoco.com/wp-content/uploads/sites/18/2024/06/Community-Health-Assessment-20.pdf, p. 28, both accessed Oct. 9, 2024.
13 Dietary Guidelines for Americans, https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf, accessed Oct. 9, 2024.
14 CDC’s Behavioral Risk Factor Surveillance System (BRFSS), https://nccd.cdc.gov/BRFSSPrevalence/rdPage.aspx?rdReport=DPH_BRFSS.ExploreByLocation, accessed June 29, 2024. Query selections: MMSAs; Location: Colorado Springs MSA; Class: Fruits and Vegetables; Topic: Vegetable Consumption; age-adjusted prevalence Year: 2021.
15 CDC’s Behavioral Risk Factor Surveillance System (BRFSS), https://nccd.cdc.gov/BRFSSPrevalence/rdPage.aspx?rdReport=DPH_BRFSS.ExploreByTopic, accessed June 28, 2024. Query selections: Class: Fruits and Vegetables; Topic: Vegetable Consumption; Year: 2021; View by: Household Income; Response: One or more times per day.
16 Healthy Kids Colorado Survey 2019, https://cdphe.colorado.gov/healthy-kids-colorado-survey-dashboard, accessed June 28, 2024. Query selections: Reset Filters; Region 4 (El Paso County); Year: 2019; Health Topic: Physical Activity; Health Measure: Percentage of Students who were physically active for a total of at least 60 minutes per day on five or more days in the past week. Results noted for El Paso County only because Teller County is combined with other counties in another region.
17 Substance Abuse and Mental Health Services Administration (SAMHSA), https://www.samhsa.gov/sites/default/files/samhsa-behavioral-health-integration.pdf, accessed Oct. 9, 2024.
18 Centers for Disease Control, https://www.cdc.gov/cdi/indicator-definitions/mental-health.html, accessed Oct. 9, 2024.
19 CDC’s Behavioral Risk Factor Surveillance System https://nccd.cdc.gov/BRFSSPrevalence/rdPage.aspx?rdReport=DPH_BRFSS.ExploreByLocation&rdProcessAction=&SaveFileGenerated=1&irbLocationType=MSMAs, Query settings: MMSAs; Location: Colorado Springs; Class: Days of Poor Health; Topic: Healthy Days; Year: 2021; Data Type: Age-adjusted Prevalence. Accessed July 2, 2024. Comparison community data is available for Albuquerque, Austin and Boise, but not for Boulder or Fort Collins. County-level information from BRFSS is also tracked via dashboard at http://thrivingcolorado.com.
20 Substance Abuse & Mental Health Service Administration, 2022 NSDUH table 5.1A, https://www.samhsa.gov/data/report/2022-nsduh-detailed-tables, accessed July 1, 2024.
21 El Paso County Coroner’s Office, 2022 Annual Report, p. 11 & 2020 Annual Report, p. 9, https://epc-assets.elpasoco.com/wp-content/uploads/sites/6/2022-Annual-Coronerss-Report.pdf, accessed July 1, 2024, and https://www.elpasocountyhealth.org/about-public-health/community-health-improvement-plan-chip/, accessed Oct. 10, 2024.
22 Colorado Health Information Dataset (CoHID), 2020 data, age-adjusted, with Colorado Springs MSA figures calculated as a weighted average of county statistics based on 2023 population proportions (El Paso County 96.80%; Teller County 3.20%). https://cohealthviz.dphe.state.co.us/t/HealthInformaticsPublic/views/COHIDFullDeathQuery_StateDemographyPopEstimates/MortalityStatistics, accessed Oct. 10, 2024.
23 Binge drinking is defined as having five or more drinks for men and four or more drinks for women within the past 30 days, Heavy consumption is defined as more than two drinks for males and more than one drink for females per day.
24 Healthy Kids Colorado Survey 2019; data reported for El Paso County only because Teller County was included in a separate region with Park, Gilpin and Clear Creek counties. https://cohealthviz.dphe.state.co.us/t/HSEBPublic/views/13_19HKCSHS_Tableau_05_21sizetest/Story1, accessed Oct. 10, 2024.
25 El Paso County Coroner’s Office, 2022 Annual Report, p. 14 (97 of 178 suicides). https://epc-assets.elpasoco.com/wp-content/uploads/sites/6/2022-Annual-Coronerss-Report.pdf, accessed June 26, 2024.
26 Colorado Department of Public Health & Environment, https://cohealthviz.dphe.state.co.us/t/HealthInformaticsPublic/views/COVDRSSuicideDashboardAllYearsExcludesRace/Story1, from https://cdphe.colorado.gov/colorado-suicide-statistics, both accessed Oct. 10, 2024.
27 United Health Foundation, Health of Women and Children Report 2019, 45. https://assets.americashealthrankings.org/app/uploads/2019-health-of-women-and-children-report.pdf, accessed Oct. 10, 2024.
28 Colorado Department of Public Health & Environment, https://cohealthviz.dphe.state.co.us/t/HealthInformaticsPublic/views/COVDRSSuicideDashboardAllYearsExcludesRace/Story1, from https://cdphe.colorado.gov/colorado-suicide-statistics, both accessed Oct. 10, 2024.
29 GoInvo meta-analysis of seven estimates of contribution of determinants of health. https://www.goinvo.com/vision/determinants-of-health/#methodology, accessed Oct. 10, 2024. Among the top-end estimates (20%) is that of the University of Wisconsin Population Health Institute’s County Health Rankings, which excludes genetics. https://www.countyhealthrankings.org/explore-health-rankings/measures-data-sources/county-health-rankings-model, accessed Oct. 10, 2024.
30 Health Resources & Services Administration https://data.hrsa.gov/data/download, Area Health Resources Files, County Data 2022-2023, field phys_nf_prim_care_pc_exc_rsdt_21. MSA-level data created by weighting county level data by population estimates in file, field popn_est_21 (figures differ slightly from Census estimates), accessed Oct. 11, 2024
31 Colorado Health Institute, Colorado’s Primary Care Workforce: A Study of Regional Disparities. Feb. 12, 2014, 8. https://coloradohealthinstitute.org/sites/default/files/file_attachments/Colorados_Primary_Care_Workforce1.pdf, accessed Oct. 10, 2024.
32 U.S. Centers for Medicare & Medicaid Services, National Provider Identification Standard (NPI), as reported the University of Wisconsin Population Health Institute’s by County Health Rankings & Roadmaps, 2024 County Health Release National Data, downloaded from https://www.countyhealthrankings.org/health-data/methodology-and-sources/data-documentation, accessed Oct. 11, 2024.
33 U.S. Census, Small Area Health Insurance Estimates, Downloaded from https://www.census.gov/data-tools/demo/sahie/#/, accessed Oct. 11, 2024. Estimates are provided at the county level for total population under age 65. MSA figures are calculated from component county estimates of uninsured persons and population. Additional perspective can be found in Colorado Health Access Survey data, which considers the percent uninsured in the total population. See https://www.coloradohealthinstitute.org/research/colorado-health-access-survey-2023, accessed Oct. 11, 2024.
34 Colorado Health Institute,+ “Percentage of People Without Health Insurance Coverage in Colorado Hits an All-Time Low,” Nov. 17, 2023, https://www.coloradohealthinstitute.org/news/percentage-people-without-health-insurance-coverage-colorado-hits-all-time-low, accessed June 28, 2024.Ibid.
35 U.S. Census, Small Area Health Insurance Estimates, Downloaded from https://www.census.gov/data-tools/demo/sahie/#/, accessed Oct. 11, 2024. Estimates are provided at the county level for total population under age 65. MSA figures are calculated from component county estimates of uninsured persons and population.
36 Colorado Health Access Survey 2023 regional data, downloaded via https://www.coloradohealthinstitute.org/research/colorado-health-access-survey-2023, accessed Oct. 11, 2024. See also https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/index.html.
37 Colorado Health Access Survey 2023 regional data, downloaded via https://www.coloradohealthinstitute.org/research/colorado-health-access-survey-2023, accessed June 28, 2024. El Paso County data used because Teller County is included in a separate region with Park and Gilpin counties. For comparisons, Boulder includes combined Boulder and Broomfield counties.
38 Ibid.
39 Colorado Health Institute, analysis of Colorado Health Observation Regional Data, https://www.coloradohealthinstitute.org/news/pandemic-led-25-drop-health-care-visits-new-analysis-data-colorado-health-providers, accessed Oct. 10, 2024.
40 Colorado Health Institute, “More than 300,000 Coloradans hit with Long COVID,“ Feb. 15, 2024, https://www.coloradohealthinstitute.org/news/more-300000-coloradans-hit-long-covid, accessed June 28, 2024.
i CDPHE. Data at https://covid19.colorado.gov/data and https://cdphe.colorado.gov/covid-19/data, both accessed October 7, 2024.
ii El Paso County COVID resources: https://www.elpasocountyhealth.org/infectious-diseases-public-health-response/infectious-diseases-2/covid-19/ ; Teller County COVID resources: https://www.tellercounty.gov/Communicable-Diseases, both accessed Oct. 12, 2024.
iii CDC, https://www.cdc.gov/obesity/index.html accessed Oct. 12, 2024.
iv CDC Behavioral Risk Factor Surveillance System, https://nccd.cdc.gov/BRFSSPrevalence/rdPage.aspx?rdReport=DPH_BRFSS.ExploreByLocation, accessed Oct. 12, 2024.
v Kompaniyets L, Goodman AB, Belay B, et al. Body Mass Index and Risk for COVID-19–Related Hospitalization, Intensive Care Unit Admission, Invasive Mechanical Ventilation, and Death — United States, March–December 2020. MMWR Morb Mortal Wkly Rep 2021; 70:355–361. DOI: http://dx.doi.org/10.15585/mmwr.mm7010e4, accessed Oct. 12, 2024.
vi Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health, https://www.samhsa.gov/data/sites/default/files/reports/rpt42730/2022-nsduh-infographic-report.pdf, accessed July 1, 2024.
vii 2022 National Survey on Drug Use and Health, Table 2.1B, https://www.samhsa.gov/data/sites/default/files/reports/rpt42728/NSDUHDetailedTabs2022/NSDUHDetailedTabs2022/2022-nsduh-detailed-tables.zip , from page https://www.samhsa.gov/data/report/2022-nsduh-detailed-tables, accessed July 1, 2024.
viii County Health Rankings, https://www.countyhealthrankings.org/app/colorado/2021/measure/factors/49/data, accessed Oct. 12, 2024.
ix Substance Abuse and Mental Health Services Administration, https://www.samhsa.gov/marijuana, accessed Oct. 12, 2024.
x Substance Abuse and Mental Health Services Administration, https://www.samhsa.gov/marijuana, accessed Oct. 14, 2024.
xi CDPHE, Healthy Kids Colorado Survey, https://cdphe.colorado.gov/healthy-kids-colorado-survey-dashboard, accessed June 28, 2024.
xii CDPHE, Healthy Kids Colorado Survey, https://marijuanahealthinfo.colorado.gov/health-data/healthy-kids-colorado-survey-hkcs-data, accessed Oct. 12, 2024.
xiii CDPHE, Healthy Kids Colorado Survey, https://cdphe.colorado.gov/healthy-kids-colorado-survey-dashboard, accessed Oct. 12, 2024.
xiv Ibid.
xv El Paso County Coroner’s Office, https://coroner.elpasoco.com/annual-coroners-report/, accessed July 1, 2024.
xvi Mental Health America, https://mhanational.org/mha-state-county-data, accessed Oct. 14, 2024.
xvii Substance Abuse and Mental Health Services Administration,, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2022, Table 5.1B, https://www.samhsa.gov/data/report/2022-nsduh-detailed-tables, accessed Oct. 14, 2024.
xviii Colorado Health Institute, https://www.coloradohealthinstitute.org/sites/default/files/file_attachments/2019%20CHAS%20Substance%20Use%20Brief_1.pdf, accessed Oct. 14, 2024.
xix United Health Foundation, Health of Women and Children Report 2019, 45. https://assets.americashealthrankings.org/app/uploads/2019-health-of-women-and-children-report.pdf, accessed Oct. 14, 2024.
xx America’s Health Rankings analysis of CDC WONDER, Multiple Cause of Death Files, United Health Foundation, https://www.americashealthrankings.org/explore/measures/teen_suicide/CO, accessed July 1, 2024.
xxi Healthy Kids Colorado Survey, 2019 https://cohealthviz.dphe.state.co.us/t/HSEBPublic/views/13_19HKCSHS_Tableau_05_21sizetest/Story1?%3Aembed=y&%3AisGuestRedirectFromVizportal=y, accessed Oct. 14, 2024.
xxii The Trevor Project 2023 National Survey on LGBTQ Youth Mental Health, https://www.thetrevorproject.org/survey-2023/assets/static/05_TREVOR05_2023survey.pdf, accessed July 2, 2024.
xxiii CDC, https://www.cdc.gov/suicide/risk-factors/?CDC_AAref_Val=https://www.cdc.gov/suicide/factors/index.html, accessed Oct. 14, 2024.
xxiv Bettergarcia, Jay & Matsuno, Em & Conover, Kristin. (2021). Training mental health providers in queer-affirming care: A systematic review. Psychology of Sexual Orientation and Gender Diversity. 8. 365-377. 10.1037/sgd0000514.
xxv Kirstin R. Painter, Maria Scannapieco, Gary Blau, Amy Andre & Kris Kohn (2018) Improving the Mental Health Outcomes of LGBTQ Youth and Young Adults: A Longitudinal Study, Journal of Social Service Research, 44:2, 223-235, DOI: 10.1080/01488376.2018.1441097
xxvi Bochicchio, Lauren & Reeder, Kelsey & Ivanoff, Andre & Pope, Hunter & Stefancic, Ana. (2020). Psychotherapeutic interventions for LGBTQ + youth: a systematic review. Journal of LGBT Youth. 10.1080/19361653.2020.1766393.
xxvii Bertolote, José M. “Suicide prevention: at what level does it work?” World psychiatry: official journal of the World Psychiatric Association (WPA) vol. 3,3 (2004): 147-51. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414695/; Lewitzka, U., Sauer, C., Bauer, M. et al. Are national suicide prevention programs effective? A comparison of 4 verum and 4 control countries over 30 years. BMC Psychiatry 19, 158 (2019). https://doi.org/10.1186/s12888-019-2147-y, both accessed Oct. 13, 2024.
xxviii The Larry A. Green Center/Primary Care Collaborative, Quick COVID-19 Primary Care Survey, Series 31, 2021. https://static1.squarespace.com/static/5d7ff8184cf0e01e4566cb02/t/6171a03c49caaa47a3532dfe/1634836542339/C19_Series_31_National_Executive_Summary_vF.pdf, accessed Oct. 13, 2024.
xxix Colorado Dept. of Labor & Employment, Quarterly Census of Employment and Wages (QCEW), as cited by Data-driven Economic Strategies June 2024 newsletter, https://www.ddestrategies.org/wp-content/uploads/2024/06/El-Paso-County-EPR-June-2024.pdf, accessed July 3, 2024.
xxx Colorado Department of Labor & Employment projections, https://www.colmigateway.com/vosnet/analyzer/DataDownload.aspx?enc=qWUdbohKqg4Dwy8kHviiflqWWqwIJaBPueOj/Bx1mhkFNRLF6lK2KdIJ52EjNHcc, accessed July 3, 2024.
xxxi The Colorado Springs Business Journal, https://www.csbj.com/premier/pandemic-boosts-health-care-employment-trends/article_75f5cf4a-ca22-11eb-bffd-3785354dc86f.html, accessed July 10, 2022. Link no longer active at of Oct. 12, 2024.
xxxii Mercer LLC, Future of the U.S. Healthcare Industry: Labor Market Projections by 2028, pp. 6-12. Estimated shortages based on American Association of Medical Colleges and other public sources. https://www.mercer.com/assets/us/en_us/shared-assets/local/attachments/pdf-us-2024-future-of-us-healthcare-industry-labor-market-projections-by-2028.pdf, accessed Oct. 14, 2024.
xxxiii Center for Improving Value in Healthcare, Telehealth Service Analysis, https://www.civhc.org/covid-19/telehealth-services-analysis/, accessed Oct. 14, 2024.
xxxiv Substance Abuse and Mental Health Services Administration (SAMHSA), https://www.samhsa.gov/brss-tacs/recovery-support-tools/peers, accessed Oct. 14, 2024.
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