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Tuesday October 21st 2014

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Escambia, Santa Rosa Continue Negative Trend
By Jeremy Morrison

We die more often of strokes, pneumonia and diabetes. We have a higher rate of underweight newborns and obese mothers. A lot of us smoke. A lot of us turn to the emergency room for medical care.

These are the findings of the Partnership for a Healthy Community’s 2012 health assessment for Escambia and Santa Rosa counties. The recently released assessment reveals a community with serious health concerns.

This isn’t a big surprise. The study has returned similar results three other times since the Partnership first assessed the counties’ health in 1995.

“It is a little disheartening to think we haven’t moved the dial at all in 18 years,” said Nora Bailey, a member of the Partnership.

Bailey was among those with the Partnership who presented the group’s findings recently during a panel discussion at Sacred Heart Hospital. The 2012 assessment—a bleak account—was relayed to members of the health care and social services community, with some attention given to ways the community might better improve its outlook.

“It’s a change in thinking,” explained Partnership President David Sjoberg, afterward.

The Diagnosis The Partnership’s 2012 assessment used county-specific data—including health, crime and sociological statistics—to assess the region. Each county was compared to three ‘peer,’ or similar, counties and also held up to the state as a whole.

“The results do not compare favorably,” Sjoberg told the crowd at Sacred Heart.

Some highlights from this year’s assessment: Escambia has high rates of chlamydia, gonorrhea, infectious syphilis and all sexually-transmitted diseases; Santa Rosa struggles with diabetes; both counties have a lot of people who cope with asthma; Santa Rosa has a high death rate for Alzheimer’s Disease and Escambia has a high death rate for that and seven other conditions.

The report also notes that Escambia has a low number of dentists, but a high rate of repeat births to teen mothers. And Santa Rosa needs more nursing home beds. Both counties show a lower rate of several kinds of cancer—including bladder, prostate and melanoma—but a higher rate of breast cancer.

The assessment also looked at societal factors in considering the region’s overall health outlook. While Santa Rosa had a higher rate of unintentional non-motor vehicle injury deaths, Escambia saw a lower rate in that category, but a higher rate in such areas as aggravated assault, alcohol-related injuries, burglary, forcible fondling, sodomy and motor vehicle crashes.

“It’s easy to get lost in the numbers, but these numbers represent real people, these numbers are our neighbors,” said Lee Turner, of Sacred Heart Health System, and a Partnership board member.

Our neighbors, it appears, are still not doing well. They are less healthy overall than the populations of similar counties or the state of Florida. Noting that Florida ranks poorly—in the bottom third—nationally, the Partnership assessment concluded that Escambia’s and Santa Rosa’s unfavorable landscape “must be cause for public concern.”

Prescription The Escambia and Santa Rosa region has shown consistently poor health assessments through the years. Our problems seem to be societal and cultural—everything from diet to education to economic disparities.

When discussing possible ways to better the area’s health outlook, people inevitably arrive at the same word: “holistic.”  They talk about addressing the whole person—physically, mentally—in an attempt to address the problem from the inside out, to enable people to make healthier decisions and, hopefully, reverse a regional trend.

“We have to put our heads together as a community-minded venture,” said George Smith, chief medical officer at Escambia Community Clinic.

Smith blames the region’s consistently poor health assessments on factors such as economic disparity and lifestyle choices. He stresses the need for the community to pool its resources in an effort to better reach the population and improve its outlook.

“Because,” Smith said, “we are, I think, a resource-rich community insofar as health-care related resources.”

Turner had made the same point at the Partnership’s Sacred Heart event.

“We have extraordinary resources,” he said. “We need to look at why these resources have not been able to significantly change what’s happening in the community.”

Smith, also on the Partnership panel during the Q&A session, told to the Sacred Heart audience that he was both “disappointed” and “encouraged” and suggested the recent assessment be viewed as an “opportunity.”

“It is an opportunity for us to really work together and think outside the box,” he told them.

That’s the direction Mark Dufva, executive director of Catholic Charities of Northwest Florida, would like to see the community take.

“It really is about coming together,” he said.

Dufva was encouraged to hear health care professionals talking about a holistic approach. He believes bigger-picture issues—such as poverty, education and racial disparities—will need to be addressed before the area’s health outlook improves.

“To look at individuals beyond just treating the moment,” Dufva explained.

The holistic approach doesn’t jive effortlessly with the dominating philosophy of western medicine. It’s a shift in mentality.

“It is, it is,” said Sjoberg, after the Sacred Heart event. “You’ve got to think about the way we think about things in this country.”

Sjoberg, who is also a vice president at Baptist Health Care, explained that the country’s health care system is built with incentives for the medical community to treat a person only when they are experiencing a medical need. He points out that most people receive the majority of their health care services during the last six months of their lives, instead of nurturing that individual throughout in hopes of setting them on a healthier path.

“That just hasn’t been part of our mentality,” Sjoberg said.

The Partnership president paints a picture of a patient consulting a doctor about their problem with diabetes. He explained that the patient could have benefited much earlier from an education about proper diet and the health effects of certain lifestyle choices.

“If I’ve got diabetes,” he said, “I’ve got a host of other issues.”

In addition to a shift in mentality, Sjoberg said local government also needs to be more plugged in to the equation. He stressed the importance of its involvement, both financially and culturally.

“It’s ok to focus on growth and development,” he said, “but we also need to realize we need to take every opportunity to improve our health.”

Sjoberg noted that out of 67 counties in Florida, Escambia ranks 63rd in its investment toward health care in the community.

“This is a very sensitive issue,” he said.

Following the Partnership’s 2000 health assessment, the Northwest Florida Legislative Delegation appointed the Escambia Health Care Task Force. After 18 months of evaluation, the task force’s report led to the formation of AccessEscambia, an advocacy organization that recommended developing a community-based benefit plan for the uninsured and underinsured.

AccessEscambia advocated for a half-cent sales tax to fund the effort. Voters rejected that in both 2004 and 2006.

“People see a half-cent sales tax and say, ‘I don’t want to pay anymore taxes,’” Sjoberg said. “People have to realize, we’re already paying for this. We really are.”

Sjoberg said bettering the region’s health outlook hinges on better coordination of resources and a cultural and mental shift on how we deal with the issue of health.

“That’s kind of where the ship needs to go,” he said.

The Partnership is aiming for a regional health care summit sometime in the spring. It will be an opportunity for area players to map out a path forward, to hopefully figure out how to better address an ailing community.

“That’s the $64 million question right there,” said Dufva. “You can issue statements and reports all you want. Where are the resources to act on the report, to do something about it? Where’s the leadership?”