December 20, 2018

Coalitions in Action— Coalition to Eliminate the Abuse of Substances (CEASe) Gives Youth a Seat at the Table


Tell me about your community and the communities that your coalition serves – its population and unique features. When was the coalition formed?
On the border of the Knobstone Trail, Indiana’s longest hiking trail, sits picturesque Scott County. A rural community with a population of nearly 24,000 people located 30 miles north of Louisville, Kentucky, it is a relatively small county geographically with 190.4 square miles of land area and a population density of 127 persons/sq. mile. In the early to mid 20th century, three canning factories were a major economic driver, with active recruitment from eastern Kentucky. Many families and individuals from Appalachia came to call Scott County home.

In the late 1990’s and early 2000’s, Scott County residents pursued a path to improve educational outcomes in our community. From 2000-2008, high school graduation rates increased from just under 50% to 70%.  As of 2017, the graduation rates have increased to 86.6%. And in 2010, after we first learned of our dismal county health ranking of 92/92, Scott County pulled together once again and worked to address our disparaging health outcomes on a variety of fronts. With a broad cross-section of community stakeholders, including concerned citizens and service providers, we worked in tandem to address issues, such as: after-school programming for students, mentor-based programming to empower people in poverty, and a comprehensive program (Connections) that provided supports to young pregnant women with tangible outcomes.

What unique issues is your coalition facing?

Scott County struggles with many challenges. Low educational outcomes and a historically high poverty rate are both causes and symptoms of the county’s substance misuse problems. A percentage of the population is mired in a “culture of generational poverty” and has strong links to the Appalachian communities of eastern Kentucky. Non-medical use of prescription medications has led to an epidemic of overdose deaths and an unprecedented HIV epidemic. Amidst the beauty of Scott County, there is devastating poverty, premature deaths, high rates of abuse and neglect, and substance misuse. This has a negative effect on the health and well-being of our citizens and our economy. Scott County’s premature death rate is higher than the rest of the state and citizens report a higher incidence of ill health, as documented in the 2010-17 county health rankings, conducted by the Robert Wood Johnson Foundation.

In February 2015, health officials became alarmed about 26 confirmed and four preliminary positive HIV cases in an area that previously saw only a handful. The cases were linked to needles used to inject painkillers. The number of cases more than doubled the first month. By mid-May 2015, they’d risen to 153. Dr. Tom Frieden, former director of the U.S. Centers for Disease Control and Prevention, said that gave Austin, with a population of around 4,200, a higher incidence of HIV than “any country in sub-Saharan Africa,” and “more people infected with HIV through injection drug use than in all of New York City last year.” He estimated that treating those infected would cost $100 million. And his agency issued a nationwide health advisory to be on the lookout for clusters of HIV and hepatitis C among intravenous drug users and to take steps to prevent them. 

What activity or program is your coalition most proud of and/or what activity would you like us to spotlight?

The EMPOWER Youth Coalition was formed in March 2018 and started with 3 members. As part of the Scott County Drug Free Communities (DFC) Support Program initiative, some Scott County youth from both school districts started a youth driven and youth managed coalition this past spring called EMPOWER. 

“Youth-adult partnerships are one of the most effective ways to engage both parties in meaningful activities, which is why we have worked to include Scott County youth as equal partners in all health coalition efforts,” said Coalition Coordinator Lori Croasdell. “Our EMPOWER youth coalition colleagues are involved in positive, meaningful, respectful relationships with adult collaborators. This practice not only helps us to increase our local youth leadership capacity, it has also built collaborative skills of our adult members as well. Scott County youth-adult partnerships take place as we work together to plan and learn, with both groups sharing equally in the decision-making process. This dynamic is very different from many or our past relationships, in which adults took leadership roles and youth were assigned inferior roles, or when our youth made all the decisions while adults sat back and watched. Instead, our partnerships build on the strengths of each group, and our outcomes have been stronger.” 

How did you get there, and what are your outcomes?  (Be as specific as possible in terms of strategies that you used)  

“We know that the longer a youth delays using substances, the less likely they are to develop substance use disorder,” said Croasdell. “Through a collaboration with community partners, evidence-based substance abuse prevention curricula is provided in both county middle schools with an instructor going into the schools and teaching LifeSkills for 6-7th grades and All Stars for the 8th grades. After six years our trending data shows the use of substances by our youth is dropping dramatically. For example, when asked about their past month’s marijuana usage, 22.5% of 12th graders reported using in 2011. In 2014 it was 12.7%, but in 2018 it was down to 8.9%. Similar decreases in self-reported using were also seen in tobacco and alcohol usage as well.”

“By inspiring young people to think about their passions and the effect they are having on their community by pursuing those passions, we can redirect their focus and help promote a lifestyle that will reduce abuse risk factors,” said Croasdell. 

What are you looking forward to the most at National Leadership Forum/what do you hope to learn?

“We are looking forward to learning more about how to improve and enhance our youth-adult partnerships, as well as expanding recruitment opportunities and ideas for the youth coalition,” said Croasdell.

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