 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.
___
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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