2025 Children's of Alabmama Community Health Needs Assessment

FOCUS GROUPS

Focus groups were conducted to explore community perspectives on child and family health, behavioral health, education, and safety. Four sessions—held in Pickens County, Birmingham City Schools, the William A. Daniel, Jr. Adolescent Clinic’s Youth Advisory Board, and Birmingham’s West End—captured the experiences of caregivers, youth, educators, and local professionals.

Despite different contexts, consistent themes emerged:

• Barriers to healthcare persist due to limited local services, transportation gaps, and financial hardship. • Mental and behavioral health challenges—especially among youth—are rising amid stigma and scarce counseling options. • Family instability and kinship care complicate medical and educational decision-making. • Youth risk behaviors , including vaping, sexual activity, and social media exposure, are increasing without adequate supervision or education. • Community assets —schools, clinics, churches, and libraries—remain trusted but under-resourced centers for support.

Collectively, participants described a need for sustained local investment in behavioral health, transportation, parental education, and youth development programs.

PICKENS COUNTY: RURAL SERVICE PROVIDERS’ PERSPECTIVES

The Pickens County focus group (September 2, 2025) included six local professionals: a school-based therapist, Head Start coordinator, community action leader, two school health clinic staff, and the county sheriff.

KEY THEMES

Healthcare Access and Distance Participants reported that most local clinics operate only during business hours, forcing families to travel to Tuscaloosa or Birmingham for after-hours or specialized care.

“Most of our kids are on Medicaid, but if they can’t get to the provider, that’s a problem, and we don’t have public transportation.”

Transportation and Financial Barriers With no public transit and widespread poverty, even modest costs deter access to care. Families depend on aging cars or informal rides.

“At the end of the month, $5 is a lot if you’re on a fixed income.”

Behavioral Health and Kinship Care Children are often raised by grandparents or relatives without formal guardianship, limiting access to healthcare and counseling. Behavioral issues—including anger and defiance—are prevalent. Stigma remains a barrier to treatment.

“Parents will talk about a child’s physical health but not admit something might be wrong mentally.”

Education and Safety Participants cited lack of sex education and parental supervision. Early exposure to explicit content and sexting among middle-schoolers were noted concerns. One participant noted, “We need sex ed. I had a 16-year-old who thought you could get pregnant through your belly button.” Another echoed the concern, stating, “We can test them for STDs and we can give them a pregnancy test, but we can’t tell them how not to get those things.”

SUMMARY OF NEEDS

• Expand mobile or telehealth services. • Improve rural transportation options.

• Provide caregiver education and legal guidance for kinship families. • Reintroduce structured behavioral health and sex education programs.

Children’s of Alabama, 2025 CHNA

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