Mental Health is the Community's Biggest Health Concern
That's according to the 2025 Community Health Assessment, released this week by the Rappahannock Area Health District and Mary Washington Healthcare.
By Adele Uphaus
MANAGING EDITOR AND CORRESPONDENT
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Mental health is by far the Fredericksburg region’s biggest health concern, according to the 2025 Community Health Assessment (CHA), which was released this week by the Rappahannock Health District and Mary Washington Healthcare.
Almost 56% of community members who responded to a survey distributed this fall as part of the CHA process rated mental health, including depression and anxiety, as one of their top three health concerns.
Mental health is the only health issue that a majority of respondents pointed to as being a top concern. About a third of respondents said chronic conditions such as cancer and diabetes are a top concern and 30% said aging-related issues, such as dementia or falls, are a top concern.
Mary Washington Healthcare (MWHC) and the Rappahannock Health District—which serves Fredericksburg City and the counties of Stafford, Spotsylvania, Caroline, and King George—complete a community health assessment every three years.
The Affordable Care Act requires nonprofit hospital systems such as MWHC to conduct such an assessment—and adopt a plan for meeting the healthcare needs identified in the assessment—every three years to maintain nonprofit status.
The healthcare system first partnered with the local health district to conduct the CHA in 2021. To prepare this year’s report, the two organizations gathered qualitative data from focus groups and guided conversations with 135 community members; survey responses from 1,308 community members; secondary data from the Virginia Department of Health and the Centers for Disease Control; screening data from MWHC’s adult inpatient population; and survey responses from 37 community organizations.
Behavioral health—including mental health and substance abuse—is one of five “key issues” identified in this year’s CHA, along with aging-related concerns; healthcare utilization and access; physical activity and healthy eating; and social determinants of health.
This last issue incorporates the non-medical factors that influence a person’s health and well-being, such as housing and food insecurity and the availability of childcare.
More than 500 survey respondents pointed to affordable housing as the issue that would most improve the community’s health—followed by mental health services, better access to healthcare, affordable healthy food, and affordable childcare.
“When considering factors that could most improve health, affordability emerged as a recurring theme,” the CHA states.
The top five behaviors that respondents said need to be addressed were lack of exercise, eating unhealthy foods, bullying (including online), isolation and loneliness, and driving while drunk or high.
The survey respondents did not represent a statistical sample of the communities served by the Rappahannock Health District, the report states, but “aligned closely with the actual population” in terms of racial and ethnic demographics. There was a higher response rate from older adults and women.
Secondary health data collected in the CHA shows that most localities served by the local health district have higher hospitalization rates across conditions than the Virginia average, except for Stafford.
All localities except Stafford also have worse maternal and child health metrics than Virginia. Spotsylvania’s infant mortality rate per 1,000 live births is 9.30, compared to the state rate of 6.20. Caroline’s is 8.70, Fredericksburg’s is 8.00, King George’s is 7.20, and Stafford’s is 5.40.
And all localities “performed worse than Virginia and the U.S. averages when it comes to adults with poor mental health and adults with frequent mental distress,” the CHA states.
The health district has above state average rates of many chronic conditions, especially high blood pressure, and above average rates of depression.
“Data now shows that all localities saw an increase in depression rates from 2019 to 2022, with the largest jump occurring from 2020 to 2021,” the report states. “The largest increase was seen in King George, with an increase of 27.5% over this four-year period.”
The CHA identified behaviors in the community that “may elevate risks of mental health,” such “long commute times, large numbers of adults with no physical activity and too little sleep” and stressors such as housing and food insecurity reported by adult patients as part of the hospital’s social determinants of health screening.
With the health assessment complete, MWHC and the health district will now work on developing a community health improvement plan to address the identified health needs.
The public is invited to the first meeting to develop the plan, which will will take place on Thursday, April 10, from 11 a.m. to 12:30 p.m. at the John F. Fick III Conference Center, located at 1301 Sam Perry Boulevard in Fredericksburg.
Register to attend the meeting here.
The report notes that secondary data lags by two to three years, so the impact of the 2022 community health improvement plan “may not be reflected yet in this data.”
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