New report takes pulse on community health needs

  • Baystate Franklin Medical Center unveiled a report on community health care, seeking to focus on the various causes of problems.  RECORDER STAFF/PAUL FRANZ

Staff Writer
Published: 6/26/2019 8:42:54 PM

GREENFIELD — It comes as no surprise that Franklin County is grappling with a complex web of public health issues.

Not only is the county the poorest in the state, it has fewer primary care doctors than the state average and the least number of dentists, as well as a shortage of specialists like psychiatrists. And while 97 percent of its residents have health insurance, many providers do not accept MassHealth, so they have to deal with expensive bills, long wait times and prohibitive paperwork.

But many reasons residents are in poor health lie beneath the surface, relating to their identity and their experiences.

A new “community health needs” report unveiled at Baystate Franklin County Medical Center Wednesday looked at the state of regional health care from this angle.

Report authors drew from multiple sources of data to come to various conclusions: the census, state Department of Public Health records, Department of Elementary and Secondary Education reports, Baystate Franklin Medical Center records, county health rankings, the state healthy aging report, as well as “local assessments and reports.” The authors also surveyed about 150 people in focus groups and interviews at community health centers, food pantries, homeless shelters and other advocacy organizations in the region.

The report, authored every three years by a coalition of seven non-profit hospitals and one insurer in central and western Massachusetts, including Baystate, focused on tracing community health issues back to their roots — listing a number of reasons that contribute to a person’s access to health care: social and built environments, education, as well as any violence and trauma they may have experienced.

“You have to take into consideration where people’s starting point is, and what barriers they have experienced in their life,” said Kim Gilhuly, research and population health manager for the Public Health Institute of western Mass.

Getting to the root of a problem is a relatively new way of thinking for health care providers and advocates, Kara McLaughlin noted. She is the project director at Gill-Montague Regional School District and the co-chair of the Opioid Task Force Prevention and Education Committee.

“It feels like we’re moving in that right direction by focusing on equity and health, instead of on individual behavior,” McLaughlin said.

While area residents are generally worse off than much of the state, the situation is far bleaker for minorities. The region’s black residents, who comprise only 1 percent of the population, fall far behind their counterparts in matters of both income and health.

According to the report, black residents are 2 ½ times more likely than white residents to rent a home and five times as likely to live below the poverty line. They are also more likely to be hospitalized for cardiovascular disease and visit an emergency department for asthma.

The report also found that individuals who have been incarcerated have barriers to health care, as they often find it difficult to secure housing and employment, and form a connection to the community. As a result, many formerly incarcerated people find it more difficult to access care for mental health and substance use disorders.

Mental health was also discussed, with report authors saying cases have risen in recent years due to a mixture of awareness and pressures such as social media. Minorities are at a particularly significant risk of experiencing mental health issues.

For example, LGBTQ youth face significant mental health issues, with the report finding that 38 percent had “seriously considered suicide” compared to 9 percent of heterosexual young people. In addition, 59 percent of LGBTQ youth had “experienced signs of depression,” while 21 percent of heterosexual youth had reported the same.

The report found that children who have been in foster care are at a greater risk for trauma — 59 percent of those who have been in foster care say they have experienced depression, compared to 26 percent for other children. Finally, nearly double the children who have lived in foster care have used prescription drugs: 14 percent compared to 8 percent of the generation population.

Finally, elderly people were also cited as a group at risk of poor health, with many reporting they feel isolated and socially excluded. The population is expected to rise exponentially in Franklin County, with the proportion of people 65 and older projected to increase from less than 20 percent to 35 percent by 2035.

It’s not all bad news, though. The report found that in the past 15 years, from 2003 to 2018, alcohol use fell from 47 percent to 25 percent, marijuana use dropped from 29 percent to 21 percent, cigarette use has fallen 19 percent to 6 percent, and prescription drug use has declined from 9 percent to 3 percent. (There has been a spike in e-cigarette use among youth, though, with 22 percent of young people in 2018 saying they had “vaped” in the past 30 days).

And in other (relatively) good news, the county’s prenatal care was slightly better than the state average — though more women in the region smoked during their pregnancies: 12 percent to the state’s 5 percent.

Also, Franklin County was below the state average in cardiovascular disease in 2012 to 2015, with 1,060 deaths per 100,000 people. The state average is 1,248. In the same period, the county was just below average for diabetes, seeing 136 deaths to this disease compared to 138 in the state.

The main reason for this report, a number of health care advocates said at the meeting, is for organizations to use in their grant applications. However, Dr. Kinan Hreib, Chief Medical Officer of Baystate Franklin Medical Center, said that while grants are nice, they are also time-consuming and unsustainable.

“We can’t depend on grants,” Hreib said. “These are spikes that help us. But how do we do it in the long term?”

Reach Grace Bird at
gbird@recorder.com or
413-772-0261, ext. 280.




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