People of Natrona County say access to care, substance abuse issues and health care costs are some of the most pressing concerns for residents' health, according to a survey conducted by the Wyoming Medical Center and other health care organizations in the county.

Though only 191 people returned surveys out of the 800 surveys sent out in the county, the Minnesota company commissioned to do the study said a 25 percent response rate has a 95 percent confidence interval.

"We can be 95 percent confident that these results are scientific," said Kami Norland, of the Rural Resource Health Center in Duluth, Minn. "And so I gave a gold star to this community."

For surveys like this, a 30 percent response rate is optimum, Norland told a group of about 30 community members Thursday night at the hospital.

The hospital received $44,500, plus the price of commissioning the Rural Health Center, from the governor's office to complete the survey. The hospital partnered with the Community Health Center of Central Wyoming and the Casper-Natrona County Health Department.

The three organizations hope to receive another grant to take the information they learned and implement programs.

Pam Evert, planning specialist at the hospital, said she thought response was low. She said people do not take the time to fill out surveys even if it is about their own health.

However, she said the information will be valuable in helping them identify one or two issues to address as a group.

"It's given us an awareness of all the facilities working together," Evert said. "Let's compliment each other instead of compete."

More than 150 of the respondents felt access to care was one of their top health concerns and people in a focus group said wait times to see a primary care physician were long.

Some suggestions the survey and focus group pointed to were creating a mobile clinic to travel to outlying communities and increasing behavioral health services. Community members also suggested creating a health information hot line.

More than 120 people surveyed listed substance abuse in their top five health problems in the community, which Norland said is different from most of the communities the center has surveyed.

The Rural Health Center has been conducting these types of surveys for 25 years, Norland said.

Crystal Mueller, who attended the meeting, said demographics of the survey might not be representative of the community.

Two-thirds of the respondents were women and two-thirds were over the age of 45.

Norland said this is typical of health care surveys, because women typically make the health care decisions in the home.

"It's representative in the fact that it is statistically valid," Norland said. "But maybe it is not representative of the community's demographics."

Mueller, executive director of human resources with the Natrona County School District, said she attended the meeting because employee health is important for the district, which is the largest employer in the city.

This survey offers the district additional data and an opportunity for the district to work with different health care organizations, she said.

"We get caught in our silos," Mueller said. "Maybe, we can get more collaboration."

Contact health reporter Allison Rupp at (307) 266-0534 or allison.rupp@trib.com.