Summit’s focus on Scotland’s overall health

June 26--LAURINBURG -- Taking a first step toward addressing deficiencies in general health and wellness in the community, on Wednesday a group of 30 Scotland County health care providers, local officials and residents considered the most prevalent issues confronting the county's population.

Spurred by the county's low statewide ranking in the most recent county health rankings performed by the Robert Wood Johnson Foundation, the Scotland County Board of Health and health department gathered community insights regarding the various unmet needs contributing to that ranking. Out of 100 counties, Scotland ranked 98th in terms of health outcomes and 95th in overall quality of life.

"It just brings to light a lot of the data that lets us ask questions to try to make a determination of what criteria has changed, why it's changed, and what we can do to impact some of this to make a difference," said David Jenkins, the county's health director.

"This type of effort is not going to be something that we can say is going to happen overnight; it may be years in the process before we actually see any tangible changes in the community, but we need to get started."

The group attending Wednesday's health summit was asked to identify two critical health priorities on which to focus its future efforts, with both small work groups highlighting obesity as a risk factor for generally poor health as well as other specific health priorities.

"We felt that if we worked on obesity, the indirect results would be improvement in diabetes health, improvement in high blood pressure and also improvement in heart disease and in cancer," said Becca Hughes, a local insurance agent.

"I see obesity where we were with smoking 30 years ago. It took a long time, through education and laws, to link smoking with the bad outcomes from smoking. There's a disconnect."

Convincing patients to take change of their own health and realize the correlations between their behaviors -- such as eating habits and substance use -- and their health outcomes also provided food for thought.

"I don't think that what is up here for us as the definition of health is what our patients' definition is," said health board member and registered nurse Jamie Bromley-Turner. "So we have got to somehow find a middle ground so that we can figure out what their definition is, what our definition is, fuse them together, and then maybe we can move forward."

According to Scotland Health Care System CEO Greg Wood, as reimbursement to health care providers from insurance and Medicare moves away from itemized payment to a general charge to provide care to a given population, increased accountability on the part of both providers and patients will be crucial to the health of the hospital as a business.

"In the long run, keeping people healthy and getting them to the right place and teaching them how to live healthier lives and getting them their screenings is going to make business sense," Wood said.

"We're tracking how well we're doing managing diabetes and hypertension and heart disease; we're beginning to be able to track that data. We're beginning to be able to, just like your veterinarian does, send people notices and say you haven't been in in a while and you've got blood pressure issues."

In addition to obesity and correlating behaviors like physical inactivity and poor nutrition, the summit highlighted the county's shortage of mental health resources as a concern deserving attention. Noran Sanford, a clinical social worker, said that as much as a third of the county's population may have a diagnosable mental ailment.

"It depends on how you define it," he said. "If you're talking about mental health as the mechanism through which we all lose weight or improve our lifestyle, it touches everybody."

According to Scotland Physician's Network clinical coordinator Jennifer Jones, it is not uncommon for the Scotland Memorial Hospital emergency room to be the first place that the mentally ill access care.

"It's not unusual for you to go to our ER at any given time and there may be four or five our more patients taking up space and you have to have somebody there with them for direct observation and they sit there until we can figure out where we can take those patients for care," she said. "And it may be days or weeks."

"It affects their physical health because they don't take their medications -- they don't believe they need the medicine for their mental health issues or their physical health issues," added Laurinburg Housing Authority representative Juliette McMillan.

The summit is expected to meet again by early fall to discuss plans of action in contending with the issues prioritized on Wednesday.

"When we saw these numbers, as a board we were flabbergasted," said Bromley-Turner. "If we pick two and work hard, we can see some increase and next year when they roll out we can go on to something different."

Mary Katherine Murphy can be reached at 910-276-2311, ext. 17. Follow her on Twitter @emkaylbg.

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