Drawing on a national ranking of health-related data from every county in the nation, the Franklin Regional Council of Governments is simultaneously creating a network of partners as it works to build up the region’s health.
The County Health Rankings, released by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, show that good health results from many factors beyond medical care — including housing, education, jobs, access to healthy foods, said Phoebe Walker, the COG’s community services director. She helped bring together more than 50 people from across disciplines on Friday — including an array of planners, human-service agencies, court officials and others, like Greenfield’s Just Roots Farm, Baystate Franklin Health Center and the Restorative Justice program — to help announce the ranking and map out 22 Community Health Improvement Plan strategies for improving outcomes over the next three years.
Franklin County ranked 10th of 14 Massachusetts counties in “health outcomes” factors, or what Walker described as a measure of “today’s health” — the result of behaviors (30 percent) such as tobacco use, diet and exercise and alcohol and drug use, as well as access to clinical care (20 percent) for prevention as well as treatment, plus social and economic factors (20 percent) like education, employment, income, family and social support and community safety. The physical environment, such as air and water quality and housing and transit, accounted for another 10 percent.
Part of the reason for the relatively low ranking, Walker said, was that rural areas are show a rise in the percentage of “preventable deaths” by drug overdose, which the data shows as being a more dramatic increase in rural areas.
Hidden in the mountains of data are what Walker called “sobering” statistics, such as the fact that Franklin County has one primary-care physician per 1,290 residents, versus the 1:950 ratio statewide, or that there is one dentist per 1,600 residents, compared to one per 1,050 residents statewide.
All told, it’s “a wake-up call” for trying to change the picture.
And yet, it’s hardly the case that all the results were bad. Franklin County ranked fifth of the 14 counties for “social and economic factors” influencing health — especially “the way we build community,” said Ann Darling of Community Action.
“We provide support to each other as a community,” she said, pointing to 12.1 community-gathering organizations per 10,000 people, compared to 9.4 statewide.
In another measure, which Walker described as “practices and laws in place that affect “tomorrow’s health,” the county was ranked sixth of the 14 counties.
Rather than a competition to see which counties did better than others, Walker said, the rankings help guide health planners on what areas to address and how the county compares with similar regions around the country, Walker said.
Planning toolMost importantly, Walker said, the national rankings provide “a tool for planning, a good way to help us narrow our focus onto kinds of the issues that really make a difference in health outcomes.”
And while people’s access to decent housing, transportation, employment aren’t normally considered as having health effects, she said, “getting public health planners to think about that and work together with transportation planners, housing authorities, across these really broad disciplines, on ways to improve health.”
The COG, together with the United Way of Franklin County, Baystate Franklin Medical Center, North Quabbin Community Coalition, Community Health Center of Franklin County, Community Action, the Franklin County Opioid Task Force and six other organizations used the data, along needs assessments done by the hospital, Community Action, the Communities that Care teen survey and a United Way survey to develop 22 strategies to improve overall health.
“We tried to narrow down to pick, what are the 22 things, that if we did them for the next three years, could really move the needle. They ran the gamut, because we all want to be working off same sheet moving toward better health.”
Included among the strategies — some of which are already in the works, and others of which might be areas to involve additional players, like the schools, include health behaviors, like expanding a diabetes prevention program, creating new bicycle paths, encouraging better nutrition and getting insurers to provide more incentives for exercise.
There are also clinical-care strategies, like offering more programs in self-management of chronic diseases, and social and economic strategies, including “mental health first aid” training among police, health-care providers, as well as passage of a “Fair Share” state constitutional amendment to provide more money for education and transportation.
Rep. Paul Mark, D-Greenfield, was a guest speaker at Friday’s event, describing not only the amendment process to allow a graduated income tax, but also health improvement plan-endorsed legislation like hands-free phoning by drivers and expanding the paid family leave.
Other recommended strategies pertain to “physical environment,” such as increasing public transportation, including on-demand transportation.
To work together on what COG Community Health Program Manager Rachel Stoller called “social determinants of health,” as well as things in the physical environment that can “influence people’s ability to make healthy choices,” she said, “We’ve brought together different partners who aren’t necessarily used to working together.”
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