Medical officials target Somerset County’s poor health rankings

Posted June 04, 2011, at 5:20 a.m.
Last modified June 05, 2011, at 5:21 p.m.

PALMYRA, Maine — Somerset County ranks near the top among Maine counties in a lot of ways, but some of the county’s numbers in the medical and health realm are of rather dubious distinction.

With the county tied for having the most overweight residents of any county and dead last for some preventative health care activities such as mammograms, prostate exams and colonoscopies, local health officials are searching for ways to pull county residents in for more routine medical appointments.

To that end, representatives from local hospitals gathered Friday in Palmyra to review the findings of a recent survey on community health needs and brainstorm ways to reverse some of the troubling numbers.

“Maine is a very large state and it has large needs. Unfortunately it has limited resources,” said Jerry Whalen, vice president of business development for Eastern Maine Healthcare Systems, which commissioned the study with the Maine Health and MaineGeneral medical systems. EMHS is the parent organization for numerous hospitals, nursing homes and home care agencies across Maine, including Sebasticook Valley Hospital in Pittsfield.  The study was done by the University of Southern Maine’s Muskie School and University of New England’s Center for Health Planning and Policy Research.

Jean Mellett, director of planning for EMHS, said many of the negative health trends in Somerset County and other areas of Maine are linked to economic hardship.

“A lot of our regions in EMHS are a little less economically advantaged than other areas of the state,” she said.

Somerset County had a higher rate than the state average of people over 65, who in general use more health services than younger people. The county also had worse-than-average numbers for income, unemployment and people with no high school diplomas at age 25. Fifteen percent of the county’s people have three or more chronic medical conditions, compared with the state average of 13 percent. The county also had the highest percentage of people who told surveyors that they had “lost” at least 11 of the past 30 days because they didn’t feel well.

Somerset County did better than the state average on health insurance coverage, with only 15 percent of people saying they have none. Even with the healthy insurance numbers, however, the county’s residents go to the emergency room for common maladies as opposed to their doctor’s office at a rate more than twice as high as the rest of Maine.

The participants in a panel discussion during Friday’s conference in Palmyra brainstormed on some of the reasons for the poor health numbers, and a few solutions. Dr. Stephen Badeen, a physician at Sebasticook Valley Hospital, said too many of his patients don’t manage their health vigorously enough.

“They come into the office and seem to have a lack of responsibility or desire to take responsibility for their own health,” said Badeen. “It would be helpful from a practical standpoint if people would take responsibility for their own care.”

Karen Hawkes, director of community education for Sebasticook Valley Health, said she suspects that many people in the county just don’t know about all the services available to them — ranging from a network of doctors’ offices to a walk-in medical clinic at the Palmyra Walmart — that could keep them out of emergency rooms for routine care.

“We’ve got to be thinking about what can we do that would change that decision,” said Hawkes.

Badeen suggested that emergency room visits are high because people don’t realize how much more expensive they are. Gloria Dean, a home health nurse from Bangor who was in the audience, said there are other factors at work, such as doctors who won’t take action based on a nurse’s advice from the field, even with well-known patients.

“Ninety-nine percent of the time we’re told to send them to the emergency room,” said Dean. “Doctors won’t follow up on nurses’ recommendations.”

Ellen LaCrosse, a public health nurse with the Maine Center for Disease Control and Prevention, agreed. “Patients are almost always told to go to the emergency room,” she said.

In brainstorming about how to improve health in the region, ideas ranged from education programs to data technology investments to working closer with patients to help them manage their own health. But as Sebasticook Valley Hospital CEO Victoria Alexander-Lane put it, the overarching problem is more about money than medicine.

“If we had economic health and a strong economic program in this state, then we could afford to fund some of these programs,” she said. “Poverty is taking a huge bite out of Maine.”

The results of the statewide survey can be found at www.chna.emh.org/.

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