Monday, April 12, 2010
 
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Committee focuses in on top health needs in county

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[April 12, 2010]  Friday afternoon, the Logan County Health Department's 2010 Community Health Committee wrapped up its share of the work on what will eventually be Logan County's contribution to the state's IPLAN for the year 2010.

The IPLAN, the Illinois Project for Local Assessment of Needs, is a community health assessment and planning process conducted every five years.

The completion of the IPLAN fulfills most of the requirements for the county's health department recertification that is awarded by the Illinois Department of Public Health.

The process began with invitations going out from the health department to 58 individuals representing 47 local government offices, social service organizations, civic groups and clubs, health care and elder care professionals, education professionals, and members of the media.

Of those invitations, 25 organizations were represented by a total of 31 people, all of whom attended at least one of the three planning meetings.

Facilitating all three meetings was Kristi Melton, a Logan County native currently studying for her master's in public health at the University of Illinois Springfield.

Melton's role in the meetings was to provide information from the current IPLAN and recent health surveys, offer guidance to the group as they conducted a new health needs assessment, then correlate all the information gathered, and create a new top five priority list for Logan County. In the end, she will define Logan County's IPLAN and submit it to the state Board of Health.

At the first meeting, on Feb. 26, the committee reviewed the information that was available to them and discussed the process for building the IPLAN.

At the second meeting, held on March 19, the real work began.

Melton began with a definition of a health problem, saying, "It is a situation or condition of the people which is considered undesirable, is likely to exist in the future, and is measured as death, disease or disability."

She also said that in the health assessment conducted in 2005, access to health care, lack of preventive health care and teen pregnancy were top priorities in Logan County. In addition, physical activity or lack thereof, immunization programs, tobacco use and substance abuse were also of great concern.

Armed with several pages of statistical information, Melton drew attention to the mortality rate in Logan County. The county currently ranks 20th out of 101 counties included in the IPLAN in premature deaths per capita. Not surprisingly, going along with this statistic, the county ranks 89th as one with a population that consistently practices healthy lifestyles and behaviors.

She also presented her own research of deaths in Logan County in 2007. Her results from going through Logan County death certificates for that year showed that 152 citizens died of diseases of the heart, and she ranked that as the No. 1 cause of premature death in the county.

In addition she offered the following statistics from her research: death by malignant neoplasm, 144; accidents (other than vehicular), 126; coronary heart disease, 76; motor vehicle accidents, 75; perinatal conditions, 64; cerebrovascular disease, 62; colorectal cancer, 41; lung cancer, 29; and, rounding out the top 20 causes of premature death in Logan County, chronic lower respiratory diseases, with 21 deaths in 2007.

Additional information Melton presented included the 2008 Youth Survey for Logan County. In the survey children in grades six, eight, 10 and 12 were asked about their use of alcohol, tobacco and marijuana.

Of the eighth-graders surveyed, 19 percent said that they consumed alcohol, 9 percent used tobacco and 5 percent admitted to using marijuana.

Of the 10th-graders surveyed that year, percentages jumped to 43, 23 and 17 percent, respectively, while the same substance abuse percentages fell in the 12th-graders of 2008 to 41, 22 and 15 percent, respectively.

The survey also showed that as children grew older, they felt their parents were less likely to disapprove of their use of these products. For example, among sixth-graders 95 percent said their parents would disapprove of their alcohol usage, and 100 percent said parents would disapprove of the use of tobacco and or marijuana. In eighth-graders those ratings dropped to 92 percent for alcohol, 96 percent for tobacco and 98 percent for marijuana. By 10th grade the disapproval ratings dropped to 84, 92 and 96; and for 12th-graders 69, 75 and 91 percent, respectively.

Melton also drew attention to other high-risk factors that are prevalent in the community, such as adult obesity and teen pregnancy.

Melton said that even though statistics support the fact that there are some definite health threats in the county, there are also several obstacles to addressing the problems. Included among these obstacles, she noted public resistance to change, a conflict between actual data and the community's perception of the problem, organization problems, and pressure from special interest groups.

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Before dividing the room into work groups, Melton invited anyone who wished to make comments about the current health conditions of the county to share those thoughts with the group.

When the needs assessment was done in 2005, the lack of dental services to children of low-income families was a top priority. Comments were made in the group that services to these families have indeed improved, but they are still not near what they could or should be. Preliminary dental exams are now offered by the Logan County HOPE Mobile, but there is a severe shortage of dentists who will take Medicaid payments, so many children are still going without proper dental care.

The comments were expanded upon as others said that the Medicaid problem is not exclusive to children nor is it exclusive to dentists.

As a result, medical and dental care is being prohibited to many Medicaid recipients regardless of their age.

Another comment was made about the lack of general practitioners in Logan County, as it was cited that there are doctors leaving the area with no one coming in to replace them.

This is not the first time these issues have been discussed. At the September 2009 Economic Summit, Dolan Dalpoas of Abraham Lincoln Memorial Hospital commented in a roundtable discussion that Logan County could support more doctors than they have. At the January meeting, Dr. Kristen Green-Morrow spoke about the need for more doctors who are willing to take Medicaid.

The group also listened to comments about mental illness as a disability. This situation seems to exist largely in adults age 18 to 59 and seems to be concentrated in the age groups between 18 and 35.

Comments were made that it appears that there are those who go through the process, seeking a label of mentally disabled, or who are experiencing debilitating health conditions at a premature age, thus becoming dependent on Social Security.

Later, during the roundtable discussions, it was brought up that a portion of this could be the result of stressful economic times, with the loss of jobs and increasing financial instability.

When these kinds of stress enter into the family dynamic, adults may reach a point where that they are not functioning at full capacity and the family suffers. It was also pointed out that this could be playing a role in substance abuse as well as other unhealthy behaviors.

As the topic of substance abuse came up, it became a broad category that included not just illegal drugs and alcohol, but also tobacco use. Later, at the third meeting, the group working on this issue would also discuss abuse of prescription medications.

And finally another concern that was addressed in the open forum part of the meeting was teenage pregnancy.

It was noted that from 1993 to 2007, teenage pregnancy numbers in Logan County have been in general on the decline. However, they are still well above the state averages for that same time period, and there has been a spike since 2006.

When the discussions were concluded, Mark Hilliard, administrator of the Logan County Health Department, divided the room into groups of four to five.

Each group was given a worksheet and asked to establish and rate what they thought the top 10 health issues were in Logan County.

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This concludes part one of this article. Part two will deal with the results of the worksheets and the follow-up work the committee did at the third and final meeting.

[By NILA SMITH]

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