Many people start the new year with resolutions to eat better or exercise more, but some local leaders are trying to get all of Shawnee County to start working on improving its health.
Shawnee County was ranked as the 70th-healthiest in the state, out of 102 counties examined by the University of Wisconsin, in spite of having one of the best clinical care environments in the state. Johnson County was the healthiest, and Woodson County was the worst.
Shawnee County ranked eighth in clinical care statewide, largely because the area has more doctors and dentists per capita than the state as a whole, and older residents are more likely to receive regular screenings for conditions such as high blood sugar and breast cancer than they are in other areas.
Still, despite having access to two hospital systems in Topeka and having roughly the same rate of uninsured people as the rest of the state, Shawnee County residents were more likely to die prematurely than other Kansans.
Misty Kruger, spokeswoman for Shawnee County Health Agency, said a coalition called Heartland Healthy Neighborhoods will begin meeting this year to address 14 health-related needs with help from multiple agencies. Those needs will be broken down into three groups with a big-picture goal: healthy eating and exercise; infant health; and increasing access to care and knowledge of available health services.
“We actually know down to the neighborhood where those efforts need to be focused,” she said.
One goal is to involve a wide swath of people, because health care professionals can’t make a community healthy on their own, Kruger said.
“It’s not a health agency issue. It’s not a hospital issue. It’s really a community issue,” she said.
Gianfranco Pezzino, strategy team leader at the Kansas Health Institute, said it isn’t unusual for counties to have good health care available and still not rank highly on health outcomes. Socioeconomic factors, health behaviors and the physical environment surrounding a community all are important factors, and clinical care accounts for only 20 percent of a county’s final score in University of Wisconsin’s model, he said.
Unhealthy behaviors are a major factor in health outcomes, Pezzino said, but in the last few decades public health has begun looking at how issues such as neighborhood safety, urban planning and high school graduation rates affect a person’s behaviors and health. That means bringing together groups that weren’t traditionally involved with health, he said.
“We have two top-notch hospitals in Shawnee County,” he said. “But that itself is not enough.”
Eric Voth, vice president of primary care services for Stormont-Vail Regional Health Center, said even though the area has fewer residents per physician than more rural counties, access to primary care is a challenge. Some people don’t have insurance or are underinsured and seek care at emergency rooms, he said, and there aren’t enough primary care doctors to go around because relatively few physicians in training choose that speciality.
Longer-term solutions include steering medical students toward primary care and introducing them to different parts of the state that are in need of doctors, Voth said, but in the short term Stormont-Vail is having to use its human resources as efficiently as possible. The health care system is using the “lean” processes developed by Toyota to break down each process and make it as efficient as possible, freeing up time to serve more patients, he said.
“We’re starting from the absolute bottom and working our way up,” he said.
Stormont-Vail and its affiliates also are hiring more advanced practice clinicians, more commonly known as nurse practitioners or physician assistants, Voth said. They also are adding navigators, a relatively new medical job that involves helping patients with conditions like diabetes and heart failure to work with the medical system and hopefully improve their health. Navigators can check up with patients more regularly than doctors can to make sure they are taking their medication and going to any needed appointments, he said.
“The hope is, the more direct involvement will help them commit to better management of their diseases,” he said.
Ben Bauman, spokesman for St. Francis Health, said they also are focusing on expanding access by expanding their clinic network into areas of Topeka that don’t have easy access to care. Lifestyle issues and educating people also are difficult issues, he said, but they hope convenience will encourage people to seek medical care.
“People look for access in their local neighborhoods as much as possible,” he said.
Pezzino cautioned against putting too much emphasis on rankings. A county may improve its health but not rise in the rankings if others improve more, he said, so the best thing to do is to use the rankings to spark a conversation about improving specific areas that have been identified as problems.
“This is a ranking, so somebody has to be at the bottom,” he said.
0 comments:
Post a Comment