How healthy is area's healthcare?

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TCRH assesses community's health needs


The Community Advisory Groups of Carroll, Grayson and Galax held a joint meeting at Twin County Regional Hospital on Jan. 9 to discuss topics for a community health needs assessment.
This assessment is Twin County Regional Healthcare’s newest project, which has been taken on in an effort to pinpoint health concerns in the community. Over the next three years, the hospital will partner with research group Stratasan to collect data and form a plan.
“We are pleased to announce tonight that  — with the help of Duke LifePoint, who guided us to Stratasan  — we will begin the first of many steps in the process of really hearing from the community what you feel are the biggest healthcare needs,” said Twin County Regional Healthcare CEO Jon Applebaum in an opening address at the meeting.  
Applebaum introduced the group to Lee Ann Lambdin, vice president of strategy at Stratasan, who led the group into a 90-minute discussion about the current healthcare status of the Twin County community.
“This is a focus group, so I’m not going to do a lot of talking. I will ask you questions about what you perceive the health issues are in our community,” Lambdin told the group. “Try not to think about just the hospital, but other issues such as socioeconomic issues, mental health issues, etc.”
She added that the information gathered at the meeting would be included in a community health summit that will take place in two weeks.
Lambdin prompted the group to define the overall health of the community.
“I’d say below average,” said Galax Mayor C.M. Mitchell, who also works as a pharmacist for the hospital.
He highlighted two of what he perceived as the two primary health issues that local families deal with: diabetes and cancer.
“I think that obesity is also an issue, which impacts diabetes,” agreed Sam Terry.
“Disability is another issue... it has become the new welfare for folks who can’t hold or keep a job.”
“There are a lot of folks who are put on disability and just stay there,” added Dr. Robert Pryor.
Others disagreed with the negative comments, saying that people are more active than ever, taking advantage of local trails and parks.
Applebaum also added that there are examples of employers supporting and encouraging healthy behavior. “At the hospital, we have a vitality program that encourages our employees to be healthy. We have health assessments for employees, and opportunities for employees to earn rewards.”
“If you could think of two or three main issues that impact people’s health the most in your community, what would those be?” asked Lambdin.
Unemployment and insurance costs were quick responses from the group, and they collectively agreed that finances were a big reason for patients skipping doctor visits.
Dr. Carlos Blattner mentioned illegal drug use as another issue. “We have issues with meth, alcohol...”
“Marijuana, prescription drug abuse...” someone else added.
Grayson County Commonwealth’s Attorney Doug Vaught — also chairman of the hospital’s board of directors — explained that, while he has seen a number of prosecutions involving drug use in Grayson County, a carefully hidden network is responsible for the continued problem. “There is such an intricate underground network, and we have limited law enforcement capability to [find them all],” he said.
“I’ve noted that this area has a high graduation rate, but not a lot of post-secondary education. Is that effecting the overall health here?” asked Lambdin.
“That goes back to the economic situation, and a somewhat lack of availability of higher education — though we are working on that,” Mitchell said. “Part of it is that we export a lot of our kids. We educate them well and some other community reaps the benefit because of employment opportunities.”
“What about primary or basic health care needs — where do people usually go for that kind of care?” Lambdin asked.
After a second or two, she prompted, “Emergency room?”
Mava Vass nodded. “There just aren’t enough primary providers in the area.”
Blattner agreed. “There is a tremendous lack of primary care here, which contributes a lot to the exodus of patients that go to Mount Airy [N.C.] or Radford. They don’t stay in our hospital. I think we’re moving in the right direction to hire more primary care doctors, but that issue is still a must.”
Applebaum noted that in the next two weeks, the hospital will launch a new program called “Wellness Works,” which will help to address local healthcare needs and possibly help to solve the problem of primary care.
Primary care doctors are also targeting larger cities for work, due to the lack of insurance coverage in smaller areas like the Twin Counties, Blattner added.
Michael Jennings offered information from Carroll County as an example of the number of welfare recipients in the area. A this time, 20 percent of Carroll County residents are eligible for food stamps and nearly 17 percent are eligible for Medicaid.
Financial issues also interfere with families’ ability to buy healthier foods, which tend to be more expensive, someone else said.
“What about places to exercise? I mean... look where you are!” said Lambdin.
Mitchell nodded. “We have the second most-visited state park in the state park system with the New River Trail State Park.”
“We also have a nice Wellness Center in Hillsville,” added Terry.
“Does the community have all that it needs to manage a healthy lifestyle?” Lambdin asked.
Jim Wooddell, administrator of Waddell Nursing and Rehab Center in Galax, suggested self motivation as a key factor. “We talk about these rec centers and parks, but we don’t have anybody there. A lot of people just don’t get up and do to take care of their healthcare needs.”
Someone else mentioned education as a need for making healthier decisions. “Go to restaurants and fast food stores. If you get food there, you will get something that diabetics shouldn’t be eating, and the media and advertising pushes these items,” said Terry.
“I think Sam is right,” said Mitchell. “It’s a cultural thing... my quip is that I can’t believe my mom taught me to eat stuff that’s not good for me. But there’s a cultural aspect to that and an economic aspect as well. A lot of times, folks have $2, which will buy you a cheeseburger. There’s a lot of things that work against people doing what they ought to be doing.”
Another group participant added that, since technology has become more predominant in today’s society, a lack of exercise has developed in younger generations, as well.
Bringing the subject around to youth, Lambdin asked if there were any other factors that could impact children’s health in the community.
“I think that some problems involve home environments,” said Julie Rippey. “We have a Backpack Buddy program that allows children to have meals on the weekends. And sometimes, they get their best meals during school hours. At home, they are eating whatever their parents choose for them, and some aren’t making the best decisions.”
“What percent of your local students receive free or reduced lunches?” asked Lambdin.
“We have  62 percent who are eligible,” answered Galax Schools Assistant Superintendent Rebecca Cardwell. “Extreme poverty in these homes makes a huge difference. There are homes with no pots and pans to cook with, no working appliances. Some of these students get a candy bar for breakfast, because it’s all that they have access to.”
“At the health summit, we will be exploring ideas for taking care of these health issues, but it’s going to take a lot of collaboration. In what ways does the community already collaborate?” Lambdin prompted.
Almost everyone was in agreement that collaboration within and among the Galax, Carroll and Grayson localities is strong. “From my standpoint, we all work well together,” said Mitchell.
“I’ve been retired 22 years, so I’m out of the loop, but I work at Carroll County School, and there we organized a joint LPN program with Grayson, Galax and Carroll County, with the hospital here and with Wytheville Community College,” said Terry. “I agree that everyone works together.”
Lambdin inquired about the organizations that help create a healthy community.
The first answer was that individuals are responsible for their own health. But further probing identified several “nudgers” that help them along, such as employers, hospitals, faith-based nursing programs, insurance companies, churches, the school system, and local and national governments.
Lambdin’s final question was whether there had been enough health-related organizations or factors in the community identified for the summit, or if any subjects were not covered during the rest of the discussion.
“We have a large [drug and alcohol] rehab center here, which I have to believe has an effect on our health,” someone added.
“There is also a strong community collaboration with the Free Clinic of the Twin Counties,” said Pryor.
“Have we talked at all about mental health?” asked Marla Phillips. Lambdin replied that they had not.
“We don’t have enough mental health services to take care of the need,” Phillips continued.
“I’ve noticed that we have a particularly strong need for child and adolescent psychiatry, as well,” said Applebaum.
To conclude the meeting, Lambdin invited the group to participate in the summit for further discussions and brainstorming. “We will have a summary of what we discussed at this meeting, and surveys from the staff and employees at the hospital,” she said. “We will talk to each other and identify the biggest health issues, and come up with goals relative to those topics.”
The half-day health summit is set for Jan. 23 in Galax.