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3  Executive Summary

The 2025 Mid-Hudson Regional Community Health Assessment (CHA) provides a comprehensive overview of the health status, needs, and priorities across the seven Mid-Hudson counties—Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, and Westchester. This systematic process was a joint effort across the seven counties to collect, analyze, and interpret data on health outcomes, behaviors, and social determinants of health. It serves as a foundation for coordinated public health action by identifying key challenges and guiding local health departments (LHDs), hospitals, and community partners in planning evidence-based strategies.

The assessment reveals that despite the Mid-Hudson Region’s geographic, economic, and demographic diversity, the seven counties share several core health challenges that have been identified as joint regional priorities. Mental health and substance use consistently emerged as the top concerns across every county. Rates of anxiety, depression, and suicide have continued to rise, particularly among youth and working-age adults, while substance use, especially related to opioids, alcohol, and emerging synthetic drugs, remains a major public health threat. Limited access to behavioral health services, provider shortages, and stigma around seeking care further exacerbate these issues.

Chronic disease prevention and management represent another shared regional priority. Conditions such as cardiovascular disease, obesity, diabetes, and cancer contribute significantly to morbidity and mortality in all seven counties. Contributing factors include limited access to affordable, healthy foods, physical inactivity, and poor nutrition. Preventive care and early screening rates vary across the region, with rural areas and low-income populations facing additional barriers to care.

Access to healthcare and social services remains a foundational concern throughout the Mid-Hudson Region. Residents report difficulty obtaining timely appointments, navigating complex insurance systems, or affording medical care. Shortages of primary care, dental, and mental health providers, especially in rural counties such as Sullivan and Ulster, limit the availability of preventive and specialty services. Transportation barriers and limited health literacy also contribute to disparities in access and outcomes.

The CHA also highlights the widespread influence of social determinants of health, including housing instability, economic insecurity, food access, and transportation. These factors directly affect residents’ ability to maintain good health. High housing costs and limited affordable options are major challenges in Dutchess, Orange, and Westchester counties, while poverty and underemployment are more prevalent in Sullivan and Ulster counties. Across the region, food insecurity remains a persistent concern, especially for families with children and older adults.

Collectively, these findings illustrate that the seven Mid-Hudson counties face interrelated challenges rooted in both medical and social factors. By focusing on shared priorities such as mental health and substance use, chronic disease prevention, access to healthcare, and the social determinants of health, the region can align efforts, share resources, and strengthen partnerships to create sustainable improvements. The 2025 CHA provides the evidence base for coordinated regional action through the Community Health Improvement Plan (CHIP), ensuring that public health interventions are data-driven, equitable, and responsive to the needs of all Mid-Hudson residents.