A year of public health goals and outcomes, by George Sedlacek

A year of public health goals and outcomes
As we close out yet another year, people tend to take stock (sorry I used that word) of their goals and how close they came to accomplishing them. In the public health world, we do a similar assessment. Part of the responsibility of a health department is to conduct community health assessments.
It’s a pretty common-sense approach. We review available health statistics, and then ask the community to rank preferences to improving community health on perception of the data as well as personal experiences. Then we work on initiatives that will improve community health. Many of these health issues take decades to improve and involve many agencies and people. They are mammoth issues that no one person or agency can even hope to address alone.
The Centers for Disease Control (CDC) provides health statistics. Recently, they ranked Burlington (Vermont) as the nation’s healthiest city with ninety-two percent of their residents reporting good or better health. Huntington WV had the worst with only seventy-five percent reporting good or better health. Marquette County rates near Burlington, with eight-eight percent reporting good health. There are other health measures to look at to help prioritize issues to work on.
Since 1995, there have been four primary health initiatives in Marquette County: improve access to health care, reduce preventable chronic disease, improve child health and substance abuse prevention. Again, they are issues almost impossible to address, and yet people and agencies in our community are willing to try the impossible…and meet with some success.
First on most people’s list is the issue of access to health care. One survey indicates that nearly nineteen percent of Marquette County residents do not have health insurance. Marquette County has done a great job assisting many of our residents who do not have health insurance for medical or dental care, and do not qualify for any state or federal assistance. The Medical Care Access Coalition implemented a program, beginning in 2001, that coordinates access to volunteered and donated health care services. MCAC works with health care providers (and both local hospitals) who donate their time and services (most physicians in our county participate) so that clients can access an array of services including primary care, specialty care, pharmacy at no or low cost. According to Mac Miller, enrollment and volunteer coordinator, the program has been an overwhelming success with more than 500 clients seen monthly. Call 226-4400 for details.
The health department saw a need to provide dental care to low income children in the county and established the Marquette County Dental Clinic. Before the program was initiated in the 1990s, it was common to see children missing many teeth by the time they graduated high school. More than 2,500 children and 20,000 dental services are provided annually. This effort was and still is led by a local dentist, Dr. Jim Hayward. The clinic sees kids, as well as adults, who qualify for services. The Marquette County Health Department recently turned over “ownership” to Michigan Community Dental Clinics, a private nonprofit agency. For details, call 226-9992.
Chronic disease prevention is a huge issue. It’s estimated that up to thirty percent of all these diseases could be prevented by people taking better care of themselves. While we have the top health care in the world, our people rank lower on the longevity list at No. 41 and dropping.
Heart disease remains the top killer of our people today, followed by cancer, strokes, chronic lung disease and accidents. Diabetes and Alzheimer’s unfortunately are climbing up the list rapidly. Smoking in our county has been reduced, which should improve the top four causes of death. Another important preventive measure is good nutrition and regular, if not daily, physical activity.
Many organizations in the county are working on helping with this, including the Noqemenon Trail Network, Iron Ore Heritage Trail Recreation Authority, MSU Cooperative Extension’s Project Senior Fresh, a wealth of farmer’s markets, as well as numerous fitness facilities, including the YMCA in Marquette and Negaunee, and the W in South Marquette County. Both of our local hospitals provide their resources to promote prevention activities in the community. There is no need to be a couch potato in Marquette County, but many are, with forty-four percent not getting adequate exercise.
The Upper Peninsula Diabetes Outreach Network (228-9203) and the Alzheimer’s Association (228-3910) are working to slow the growth of their respective issues, a seemingly impossible task with our kids likely not to outlive their parents due to a lack of overall fitness.
The last priority area also can seem like an impossible task—reducing substance abuse in our community. Alcohol abuse remains the top issue for both youth and adults. Whether it’s drinking and driving crashes, domestic violence or even educational failure, alcohol intoxication remains a problem.
There are signs of success. The Marquette County Coalition and Substance Abuse Prevention (MC2) has documented both a lowering of adult and youth substance abuse use. Judy Watson Olson, director of the Great Lakes Center for Youth Development states that youth surveys over the past decade have shown a reduction of youth binge drinking and tobacco use. This is great news, as our drinking and driving fatalities also have had a similar drop and our lung cancer rate has stopped its annual increase.
Kids have the unfounded perception that all their peers drink and many use drugs. As with the chronic disease issue, many groups are working to improve the data. Larry Boburka, guidance counselor at Westwood High School, said it’s very important for youth to be involved personally with health issues that affect their lives.
“Our student leaders have been involved by action,” he said. “They have been giving presentations, both in and out of school. They have been making radio and television prevention commercials. They are currently busy planning activities for—not only this school year—but also years to come.”
The other community initiative that is working to reduce alcohol abuse is the 0-0-1-3 program. According to Merrilee Keller from the Coordinating Agency at Northcare Network and an MC2 member, it is important that we publicize the need to use alcohol in a healthy responsible manner—that means no drinking by anyone under age twenty-one, no use by pregnant women, no drinking and driving, and for people to drink less—no more than three drinks a day and to drink slower, no more than one drink per hour.
“If we can convince people to do this, we won’t have nearly the numbers of violence, liver disease and accidents in our community,” she said. “Last year, we saw eleven fatal accidents in the U.P. with alcohol involvement. While this is still too many, we have been seeing a continual drop over the past decade.”
This is what health assessment is all about: seeing a problem and then doing something about it. Marquette County is blessed with many agencies and individuals meeting the challenge of improving health. It’s one reason we are closer to Burlington (Vermont) than Huntington (West Virginia).
—George Sedlacek

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