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a kayaker at Horsetooth Reservoir in Larimer County
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2023 CHAS: Larimer and Weld Counties

Northern Colorado Data Highlight Key Differences Between Counties, Calling for Localized Solutions.  

December 18, 2024

Northern Colorado, which includes the neighboring counties of Larimer and Weld, is a microcosm of some of Colorado’s greatest health challenges. Regional data from the 2023 Colorado Health Access Survey shed light on some of these issues — the mental health crisis, housing instability, and transportation issues. Each county’s approach to these issues reflects the distinct needs of its demographic populations. At the same time, they have banded together to create shared solutions for this interdependent region.   

Within this region, nearly 40% of the northern Colorado population crosses county borders between Larimer and Weld for work, school, recreation, and child care on any given day. As a result, policies or programs implemented in one county impact the other. In fact, major systems, like the Regional Accountable Entities (RAEs), organizations responsible for administering Colorado’s Medicaid program within a specific geographic region, and the Behavioral Health Administrative Service Organizations (BHASOs), regional organizations supporting the state’s Behavioral Health Administration, have shifted to align services in Larimer and Weld counties. 

At the same time, these two counties have distinct demographics that require unique approaches to best serve their communities. For example, Larimer and Weld County differed in terms of racial and ethnic composition and by education levels. 

These differences highlight the need for local approaches that address specific needs, such as language access, cultural considerations, and other community-specific factors. Three areas that demonstrate the need for both shared strategies and customized solutions include behavioral health care, housing, and transportation. 

Northern Coloradans communities have pursued innovative ways to address the behavioral health crisis. 

Overall, 28.6% of residents in Weld County and 27.6% in Larimer County reported poor mental health (defined by the Colorado Health Access Survey as eight or more days of poor mental health in the past month). The number of people reporting poor mental health in the region has trended upward over the past decade.  

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The sun glows red as smoke from the Cameron Peak fire blankets Fort Collins

Climate and Mental Health in Larimer County 

While the causes of mental health issues are complex, CHAS data suggest that in Larimer County, climate anxiety may be contributing to these challenges. Nearly half (48.1%) of Larimer County residents who reported that climate affected their health said climate change was impacting their mental health, compared with 32.9% statewide. Many Larimer County residents might recall the destruction and disruption caused by recent wildfires, like the 2020 Cameron Peak Fire, which profoundly affected the northern Colorado community.

Cost remains a significant barrier to accessing needed mental health care for Weld County residents, and appointment availability is an added challenge. Addressing cost and appointment availability for mental health care remains a challenge across the state with behavioral health workforce shortages and financial instability of community mental health centers. 

With so many community members reporting poor mental health outcomes, Larimer and Weld counties have been responsive over the last decade to creatively increase access to mental health care.  

Northern Colorado communities have sought to address the increased demand for mental health services in other ways. In 2018, Larimer County passed a local ballot measure to fund a taxpayer-supported behavioral health facility. The new Acute Care Facility at Longview Campus opened in 2023, filling a critical gap in crisis care services for the Larimer County community. CHI supported the County’s Behavioral Health Services in developing its five-year Community Master Plan to continue addressing these issues at a local level.   

Larimer and Weld community partners have also come together through the Colorado Opioid Synergy — Larimer and Weld, a program of the North Colorado Health Alliance (NCHA) Addiction Response Team. This initiative created a network of clinics that offer medication assisted treatment and peer support teams in response to the opioid epidemic. NCHA, which serves all of Weld and portions of Larimer County, also operates several additional programs to meet community-specific needs for mental health and substance use disorders. 

Northern Colorado residents were housing stressed, with renters more likely to report poor mental health.  

Housing plays an important role in health. Nearly half (49.5%) of Larimer renters reported experiencing eight or more days of poor mental health in the previous month, compared with only 15.7% of Larimer homeowners. In Weld County, 40.0% of renters reported poor mental health, compared with 23.2% of Weld homeowners.  

Nearly a fifth (19.9%) of Weld County residents and 14.5% of Larimer residents reported trouble paying their rent or mortgage in the last year. Housing insecurity disproportionately affected people of color in Weld County, with 30.0% reporting difficulty paying rent or a mortgage, more than twice that of non-Hispanic, white residents (14.3%). 

As the region continues to grow, and as the number of people experiencing homelessness increases, the need for affordable housing options has become more pressing. This is especially true for those struggling to afford market-rate rentals.  

To address the social and health impacts of this issue, housing can benefit from both regional and local solutions. Regionally, the Northern Colorado Continuum of Care (NoCO CoC) is the newest Continuum of Care (CoC) in Colorado, established in 2020. CoCs are responsible for creating community plans to provide emergency shelter, permanent housing, and other supports for people experiencing homelessness. The NoCO CoC supports a coordinated, community-wide system with the goal to make homelessness “rare, short-lived, and non-recurring” across both Larimer and Weld counties. In 2023, the NoCO CoC helped 353 individuals or families access housing.  

In Larimer County, organizations like Housing Catalyst are leading the way in developing affordable housing units and trauma-informed permanent supportive housing. Across the county line in Weld County, the Housing Navigation Center in Greeley works to connect people to housing opportunities, whether they are at risk of homelessness or are already experiencing homelessness. 


 


 

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Transportation challenges strained Northern Coloradans differently, impacting access to health care.  

With more people and cars moving to the region, CHAS data show that transportation is a pain point for many Northern Colorado residents.  

According to the CHAS, nearly half of Weld County residents reported a lack of public transportation (44.8%) and gas being too expensive (43.2%) as transportation barriers, higher than the percentage of Larimer County residents and the statewide average who reported similar concerns. Nearly a third of Weld County residents (32.5%) also cited too much traffic and poor road conditions as barriers. The CHAS also estimates that approximately 4,295 Weld County residents went without health care in 2023 because they did not have a way to get to a doctor’s office. 

While nearly half of Larimer County residents (47.1%) cited too many cars and too much traffic as an issue, only 16.6% of Larimer County residents reported a lack of public transportation as a barrier, possibly suggesting that public transportation is not considered a solution for high traffic.  

For Northern Colorado, addressing the distinct transportation challenges in each community would benefit public health by offering increased access to health care, reducing traffic and collisions, and mitigating environmental effects that impact the well-being of residents. 

Groups like the North Front Range Metropolitan Planning Organization and the Colorado Department of Transportation work on initiatives to keep these two counties connected to each other and to metro Denver while reducing cars on the road. Examples include the Poudre Express, connecting Greeley to Fort Collins, and the Bustang, which takes riders from Fort Collins and Loveland or Greeley to Denver. But many challenges still exist when it comes to safe, affordable, and accessible transportation within communities. Local municipalities are doing what they can to find options that connect not just the population centers within Northern Colorado, but the many small communities that are an essential part of its fabric.  

Conclusion 

Northern Colorado faces a complex array of challenges, from mental health issues and housing insecurity to transportation barriers. However, the region's strong sense of community and understanding of its unique local needs have led to important strides in addressing these issues. The data highlight disparities within the region, yet Northern Colorado shows a growing commitment to creating tailored solutions that meet the diverse needs of residents. From the development of behavioral health services and affordable housing to initiatives aimed at improving transportation, local governments, organizations, and community members are working together to foster a more connected, equitable, and thriving Northern Colorado. While there is still much work to be done, the passion and collaboration seen across the region provide hope for a future where these challenges are addressed and residents are supported in achieving better health, stability, and quality of life.