Community Context and Challenges

  • The county ranks 82nd out of Iowa’s 99 counties for overall health outcomes and 92nd for key social and economic determinants of health, such as unemployment, children living in poverty, and children living in single-family homes.

  • Outdoor space and opportunities for physical activities are scarce, leading to high levels of physical inactivity in Monona County compared with the state (27% versus 24%,) as well as a high obesity rate (29%).

  • Heart disease affects nearly one-third of the population and is the leading cause of death.

  • One in five adults (20%) report drinking excessively, significantly higher than the U.S. average (16%). Alcohol factors into 23% driving deaths in Iowa, nearly twice the national rate of 14%.

  • Children are at high risk for abuse and neglect, and county residents have limited access to the supports that help prevent child maltreatment, e.g., health and mental health services, school social workers, food stamps, employment services, and quality housing.

Community Actions: A First Look

Across Monona County, organizations and residents have been coming together across sectors to implement focused initiatives and outreach efforts.

Since a 2010 community health improvement plan, the county health department and partners have targeted specific risk behaviors that influence residents’ health, such as alcohol abuse and physical inactivity. Input is currently being sought on the 2016 health assessment conducted by Monona County Public Health, from which the county aims to chart a five-year plan for action.


These baseline reports, created in 2016, reflect our initial observations on select community programs and initiatives to gauge ongoing, as well as newer, efforts to improve community health. Future reports will provide more in-depth insights and analysis into this community's activities.

Going Forward: Questions for Consideration

Monona County’s population is contracting because of a long-term shift from its traditional farming economy to service-sector jobs and the aging of many lifelong residents. New residents are more likely to be born into single-parent households and to mothers with less than a high school education, compared to state levels. These factors present significant future challenges for the health and well-being of Monona County residents. Additional surveillance, data and information gathering, analysis, and reporting will examine how cross-sector partners can sustain or expand current initiatives and the impact of current programs on improved child, adolescent, and adult health outcomes.

The following questions provide opportunities for further exploration:

  • Which priorities have residents and other stakeholders of Monona County identified as a result of the health department’s 2016 health assessment? How was their input sought?

  • Heart disease is the leading cause of death in Monona County, and its incidence exceeds state and national averages. Have Monona County health officials and local and regional health providers taken steps to address this disparity? What types of resources are needed to implement interventions?

  • To what extent has the collaboration between MCCA and ERASE resulted in reductions in alcohol abuse among young people? Have outcomes such as arrests for drunken driving or other indicators declined?

  • To what extent have the collaborative initiatives of Early Childhood Iowa and Monona County to promote early childhood learning had an impact on measures such as school success and other indicators of positive child development?

  • Have other communities in Monona County pursued the ambitious goals of Mapleton to promote walkability and enhance quality of life? What is their progress?

  • In what specific ways did the farm crisis of the 1980s alter Monona County’s demographics? To what extent do current health issues and initiatives reflect that legacy?