Public Health in the Rockies 2026

Background

Falls are the leading cause of injury among older adults in Colorado, costing the state $739 million/year. Evidence-based fall prevention programs exist, but they’re underutilized and not systematically implemented statewide. The multi-year Scaling Trusted Evidence-based Fall Prevention (STEP) initiative scales evidence-based fall-prevention programs across Colorado and evaluates their real-world impact. We aimed to identify 10 fall-prevention program delivery sites across Colorado using a data-driven approach.

Methods

We mapped Colorado evidence-based fall prevention programs, then calculated county-level, age-specific, fall-associated ED visit incidence rates. Using 2019-2023 Census population estimates, SVI (Social Vulnerability Index), and CO Department of Public Health and Environment injury dashboard data, we created a series of choropleth maps showing Colorado counties with the highest density of older adults, highest frequency and rates of falls-associated ED visits, and highest SVI. Input from the STEP advisory board and the Colorado Falls Coalition informed the mapping tool and guided identification of high-priority regions for delivery site implementation. After candidates were identified, we conducted outreach to assess interest and distributed surveys to evaluate suitability.

Results

Areas (counties) identified as high-priority included the Denver Metro area (Adams, Jefferson, Arapahoe, and Denver), Front Range outside the Denver Metro area (Pueblo, El Paso, Weld, and Larimer), Western Slope (Mesa, La Plata, Montezuma, and Montrose), Central Mountains (Fremont, Summit), San Luis Valley, and Eastern Plains (Morgan, Las Animas). Thus far, we have identified 48 potential delivery sites. Final delivery site information will be finalized and available at time of conference.

Implications

Utilizing publicly available data sources can be a powerful way to aid public health program site exploration or research design. It allowed us to identify and target Colorado areas experiencing the highest need for fall prevention programs based on health care utilization data and falls risk factors.

Background: Rural populations experience a wide range of health disparities, including higher rates of cancer and heart disease death. Persistent inequities in the social determinants of health, such as lower access to quality public services, underlie many rural health disparities. Yet, rural contexts vary both across and within states, and the particular needs and resilience capacity of Colorado’s rural populations have been insufficiently characterized. This research showcase will report on a two-year project led by the Colorado Department of Public Health and Environment to assess rural health equity statewide and inform policy responses.

Methods: The presentation will compare rural, rural resort, and urban geographies on 40 health and social determinant indicators, drawing on a novel dataset that combines vital statistics and survey data for all 64 counties in Colorado. The presentation will also report on a qualitative analysis of interviews and focus groups and a review of Colorado public policy.

Results: Rural populations fared worse than urban populations on 75% of health indicators, including premature mortality and deaths from chronic disease. Rural areas also fared worse on 55% of social determinant indicators tested, such as uninsured rates and food insecurity, but fared better on 30%, including the violent crime rate. Rural resort populations, by contrast, actually fared better than urban ones on 87% of health indicators. They also fared better on 50% of social determinant indicators, while faring worse on just 20%. Social connections are core strengths of both rural and rural resort communities, with participants routinely reporting a strong sense of belonging and interdependence.

Implications: Colorado’s rural populations face interlocking disadvantages across most health and social determinant indicators, but they also hold strengths that can be reinforced through strategic investments and expanded support. The presentation concludes with a discussion of promising approaches and lessons for advancing rural health equity.

The Colorado Alcohol Impacts Coalition (CAIC) is a newly formed statewide coalition dedicated to fostering a more healthful environment around alcohol use in Colorado. Excessive alcohol consumption remains a significant and often under-addressed public health concern, contributing to chronic disease, injury, mental health challenges, and health inequities across our state. CAIC brings together public health professionals, community organizations, researchers, and advocates to address these harms through a unified, evidence-based approach.

This presentation will introduce CAIC's founding mission, coalition structure, and strategic framework — centered on education, data, and policy — and outline priority areas for collective action in the months and years ahead. Attendees will learn how to engage with and contribute to this growing coalition as we shift Colorado's alcohol landscape toward one that better supports health and well-being for all.

We request 60 minutes because our presentation covers a wide variety of topics, from founding to current activities to funding. We hope this session will grow our coalition to include early public health professionals, rural stakeholders, and people affected by alcohol use. Therefore, we will include audience participation, coalition sign-ups, and material on funding for a new, advocacy-focused nonprofit. Audience members will be encouraged to share stories about alcohol impacts in their community to help us understand how the Coalition can better serve them.

To address local data needs, the Weld County Department of Public Health and Environment (WCDPHE) conducts a household-based Community Health Survey (CHS) using scientific random sampling to obtain population-level metrics for Weld County adults every three years. This survey's robust sample size along with weighting the results allow for disaggregation to highlight disparities.

In 2023 the then US Surgeon General released an advisory describing loneliness and social isolation as an epidemic. Between this report and coalition activities focused on reducing loneliness, many external and internal partners expressed a need to understand the impact of social isolation and loneliness in Weld residents.

While creating the 2025 Weld CHS, the WCDPHE data team added two new validated questions about social isolation and loneliness to meet partners’ data needs. The survey was sent out to around 20,000 randomly selected households in Weld County. A total of 2,802 residents completed the survey. The data was then weighted using Weld census data so that the results are representative of the county’s adult population.

Over 1 in 4 Weld residents reported being lonely, and over 1 in 10 never or rarely get the social and emotional support they need. Disparities in social isolation and loneliness were found when breaking the data down by income, gender, and race/ethnicity. Additionally, both loneliness and social isolation were much higher in residents with indicators of poor physical and mental health.

These results show how social connection can be quantitatively measured through survey data in large populations to produce useful metrics to guide and improve programs. Incorporating these metrics into Weld’s Community Health Assessment enables the county to better address the physical and mental health needs of residents through improved and targeted programming.

The rising cost of living, housing, and healthcare costs were the top three challenges facing the state, identified by residents in the 2025 Colorado PULSE poll. Weld County’s triennial Community Health Survey (CHS) captures several metrics relating residents’ affordability concerns to factors influencing their health. This presentation will share findings on food insecurity, rising housing cost burden, and cost as a barrier to healthcare from a random sample, mail-based survey sent to 20,000 Weld County households in 2025. Weighted results offer a representative picture of how these issues affect county residents.

The 2025 Weld CHS revealed that roughly 4 in 10 residents are worried or stressed about affording medical care, health insurance, and healthy meals. Additionally, cost remains the most frequently cited barrier to accessing healthcare, behavioral healthcare, and insurance. The percent of residents who are housing cost burdened (spending 30% or more of household income on rent or mortgage and utilities) rose significantly from the previous survey cycle in 2022 (43% versus 33%, respectively). While affordability concerns affect a broad swath of Weld’s population, young adults and those living in low-income households bear a disproportionate burden.

These findings support Weld County’s efforts to expand access to care and adequate nutrition, addressing cost barriers through free health screenings, a public health mobile unit, and free, high-quality chronic disease prevention/nutrition programming. The impact of the Weld CHS does not end with the health department; these findings are disseminated to a multitude of community partners leading to continued improvements to service delivery addressing financial barriers to health care, behavioral healthcare, housing, and food access. Continued inclusion of affordability measures as part of the CHS strengthens this collaborative effort across a broad coalition of community organizations and healthcare partners.

Background: Roadway safety remains a critical public health challenge across Colorado, where factors such as population density and roadway type vary significantly in different regions of the state. Effective prevention strategies rely on the timely identification of high-risk locations and a nuanced understanding of contributing factors to motor vehicle crashes. Existing tools for crash data analysis are currently aggregated to the county level, but there is limited information available statewide about the factors of individual crashes. The purpose of this presentation will be to describe the development of a new Crash Map Dashboard, and provide a demonstration of the map.

Methods: The Crash Map Dashboard was developed to address input of stakeholders from local public health agencies, the Colorado Department of Transportation (CDOT), and injury and built environment specialists at the Colorado Department of Public Health and Environment. Geocoded crash data collected by the Department of Revenue and managed by CDOT were obtained for 2024. The data were cleaned and locations were validated against a street network database to map precise locations of crashes. The maps were integrated into an online interactive ArcGIS Dashboard.

Results: Preliminary results from beta testing indicate that the Crash Map Dashboard can provide key insights into contributing factors for individual crashes. Crash-level data are now accessible for all 64 counties in Colorado. Some of the functionality requested by partners that has been incorporated into the dashboard include selection tools for identifying crashes that occur near schools and symbology for differentiating crashes that involve vulnerable road users.

Implications: The Crash Map Dashboard offers an accessible and user-friendly tool that allows public health professionals to access data that can be incorporated into injury prevention programs. The next phase of the project seeks to provide additional levels of analysis and years of data to improve upon the dashboard.