Help with Healthcare

Help with Healthcare

http://www.adirondackdailyenterprise.com/page/content.detail/id/540022/Library-will-host-healthcare-workshops.html?nav=5049

This article in the the Adirondack Daily Enterprise talks about how a local library in Tupper Lake will host healthcare workshops. The whole of United States has been struggling with the changes of the  Affordable Care Act and this does not exclude the rural county of Essex, NY. These workshops are led by Jill Rock, an education and outreach specialist and by Sandy Duquette, a health insurance administrator of the North Country Chamber of Commerce. These women have cited the confusion that people have been experiencing and how many people have reached out asking for help.

I think that rural communities will struggle more with the changes in the healthcare policy given their isolation. Therefore, I think that these workshops are a great idea and should be implemented in other small communities. Because of their physical isolation, it makes it harder for people to understand the healthcare changes and how it will affect them given their lack of communication. Furthermore, because rural counties tend to be of lower socioeconomic status and generally are more blue-collar workers, people have limited access to the internet. This will make it particularly difficult for people to access the already difficult healthcare.gov website. It is nice to see this type of community outreach and I hope that other small communities implement similar programs.

Poison Ivy!

Poison Ivy!

http://www.adirondackalmanack.com/2010/07/adirondack-outdoor-hazards-poison-ivy.html

The Adirondacks are a vacation spot for many. Home to the 46 High Peaks, tons of people travel to the "Dacks" to hike the many mountains and explore the beautiful nature. One of the greatest hazards of hiking is not the precarious terrain, or even the mountain lion lurking in the boulders, it is Toxicodenron radicans. Most of us know it as Poison Ivy and nearly everyone can tell you what it looks it. The classic 3 red leaf structure can be a misleading description. Green is the color you want to look for, accompanied by jagged edges and bilateral symmetry. The article I found in the Adirondack Almanack talks about how this notorious plant is an environmental hazard of the North Country. It is important to be aware of how to avoid the plant and the precautions you need to take. The article also provides tips for how to avoid the symptoms.  For example, the oil that causes the dreadful allergic reaction is water resistant, so you must use soap and water to clean any potentially affected areas, and quickly. 

If I were a physician working in a rural area such as the Adirondacks, it would be incredibly important that I knew about the health hazards that poison ivy causes. It is necessary to inform your patients about what to watch out for and the necessary precautions to take. Prevention is the key and it is my job as a physician to educate my patients. 

Reflections on Rural Health in Essex County

It has been a very neat experience to study the health network and delivery system in a county that I have grown to love since childhood. The Adirondacks have always been very special to me and I have always seen myself living there in the future. This project has presented many aspects of rural health in Essex County that I had never considered. It has strengthened my convictions to live there and take a part in the community so that I can improve many aspects of rural health.

One of the things that I found my shocking about Essex County was the obesity rate. I naively assumed that the people who lived in the Adirondacks were the active, "outdoorsy" type. However, this isn't necessarily the case. The County Health Department Director told me that those are the kind of people who come to visit the Adirondacks. The permanent residents who live are not vacationers, they are blue-collar residents who struggle to make a living in difficult economic times. I did not realize how strong the correlation was between lower socioeconomic status and poorer health. Not only can people of lower socioeconomic status not afford healthcare as much, they also tend to be less educated. In many instances, this population lacks the education about certain preventive practices and habits to lead a health life. This all translates into poorer health that is then only compounded when access is limited in a rural community. 

I have a great passion for physical fitness, nutrition and a healthy lifestyle. I also love to teach so I can see myself playing an educational and motivational role as a physician in a rural community. This project has opened my eyes to many aspects of health that I did not know existed. It has further motivated me to pursue a career and life in a rural community like Essex where I can help to make a difference in people's lives.

Children's Mental Health in Essex County

http://www.familiesfirstessex.org/welcome.html

The program called "Families First" of Essex County is a support network for families whose children suffer from mental health issues. I could not find whether or not mental health among children was a predominant issue in this county, however, I think it is an important medical issue among any community. Specifically, I would imagine that rural communities such as Essex County would suffer disproportionately from mental health-related issues given the fact that communication and access to resources is scarce. Indeed, this program was founded in 1992 to provide services to a growing part of the community whose needs were unmet. Families First facilitates opportunities to meet other families whose children have similar emotional or behavioral challenges. They also provide a family support specialist who meets with individual families in their homes and coaches and educates parents on how to deal and manage their children's needs. In addition, they also provide a case worker to prevent residential placement of such children.

As a "local medical expert" I would love to get involved in this program that Essex County has established. I think that the support system is a great way for parents to network with other families and family support specialists. As a physician, I would do my best to screen for emotional and behavioral issues among my younger patients and would strongly advocate this program. I think it is a great preventive program that targets the issue in its infancy, instead of addressing more severe circumstances down the road. While mental health issues are not necessarily preventable, I think that they can be managed in a such a way as to prevent the issues from becoming debilitating. In addition, this program would have a great impact on the community as it would raise awareness about children's mental health and promote greater compassion and support.

EAHCN: Exemplary Patient-Centered Health Care

http://www.plattsburgh.edu/offices/centers/cisp/eahcn/index.php

I found an organization called the Eastern Adirondack Health Care Network that focuses on patient-centered initiatives. EAHCN is a coalition of health care providers that span Essex, Franklin and Clinton Counties. This network strives to achieve many unique goals that include improving the financial viability of rural health care providers and enhancing partnerships with neighboring communities to share services in rural areas. One of the projects undertaken by this network includes a healthy youth development program that works within local communities to prevent substance abuse, teen pregnancy, delinquency, violence and school dropouts. Other projects include geriatric mental health and arthritis management.

The EAHCN exemplifies many aspects of the patient-centered medical home initiative. It focuses on better communication between the patient population and health-care providers. It revolves around getting patients more involved in the healthcare process. I would love to be a part of this network as a rural healthcare practitioner. I think it is important to reach out to the community and increase patient involvement.  I could see myself getting involved in some sort of health living initiative that would include outreach programs that that teach nutrition, fitness, mental wellness and other healthy lifestyle behaviors. This is my personal passion and I would love to launch an initiative in the local community that I live and work in.

 Medical Reserve Corps of Essex County

http://www.co.essex.ny.us/EssexCountyPublicHealth/index_files/Page447.htm

The formation of the Medical Reserve Corps of Essex County was precipitated by the events of September 11, 2001. This catastrophic event turned into a public health emergency that could not be met adequately enough by the support system in place. The system was overwhelmed by a lack of coordination and organization of resources. The Office of the US Surgeon General has since launched a Medical Reserve Corp program initiative in order to effectively train volunteers as a team.

The Essex County MRC is composed of volunteer medical and non-medical support personnel who respond to natural disasters, terrorist attacks, disease outbreaks or any other public health emergency.  The Essex County Public Health Department called on its MRC during the 2009-2010 Pandemic Flu to assist with mass vaccinations.

I think that this is not only a great national initiative, but an even better one for rural counties nation-wide. Given the isolated nature and limited access to healthcare in rural communities, it is even more important to have safety mechanisms in place should a public health emergency arise.  I would love to volunteer in such a program as a rural physician. Physicians are needed to oversee the medical care and emergency services provided, as well as to train volunteers with limited or no medical skill. The average community volunteer plays an integral role in providing widespread help and it is important to get as many committed people involved as possible. As a rural physician, I could use my position within the community to recruit volunteers and to network with other neighboring communities. Given the rural physician’s connections and place within the community, the physician’s networking skills would be just as valuable as their medical skills. 

Health Indicators of Essex County

Relatively speaking, Essex County fares similarly to the rest of the state and the nation in the indicators of Morbidity and Mortality. However, they have a slightly higher mortality rate than the rest of the state and the nation, in addition to having more poor or fair health as compared to the rest of the nation. The social and economic indicators show some more variation. The high school graduation rate of Essex is higher than the rest of New York, but the college attendance rates are lower. In addition, the unemployment rate is significantly higher than the state and the rest of the nation's. The violent crime rate is significantly lower than the rest of the state's, however, it is higher than the national average.

One health behavior indicator that stands out to me is the adult obesity rate of Essex. This rate is higher than the rest of the state and the nation. This strikes me as anomalous because I would have thought that being in the Adirondacks would promote a healthier lifestyle. I always assumed that it attracted a certain demographic of people that value physical activity, the outdoors, nature and nutrition. However, Essex county does encompass a broad range of New York state that does areas other than the Adirondacks. In addition, since Essex county is a rural county, it makes since that the adult obesity rate is higher on average. Rural counties tend to have less health networks and providers. In addition, more blue-collar people live in rural counties and this demographic tends to be less educated, as evidenced by the low college attendance rate.

The incredibly high ratio of primary care physicians per Essex County resident is evidence of the fact that rural communities have less health care providers. In fact, this ratio is nearly three times that of the state and national average. This statistic alone highlights the great need for more primary care physicians in Essex County. If this issue were to be addressed, I believe that many of the other health indicators would be improved as well.