Community Input Drives Health Programming

Concerns about chronic disease and mental health still top concerns

Hospital and county health departments in New York State are in the process of completing their triennial Community Health Needs Assessments and the subsequent plans for implementation of programs and interventions that will meet the needs uncovered in those assessments. It’s part of the state health department’s Prevention Agenda initiative and its quest to become the healthiest state in the nation.

The current three-year cycle includes the pandemic years. As such, hospital leaders and public health experts expected to see concerns related to infectious diseases rise to the top. But chronic disease and mental health and substance misuse are community members’ leading concerns – again. These issues surfaced to the top in the previous assessment cycle for the two counties on Long Island – Nassau and Suffolk – and the seven counties in the Hudson Valley – Westchester, Putnam, Rockland, Orange, Sullivan, Dutchess, and Ulster.  (There was a measles outbreak in late 2018 in Orange County. This may have influenced community and public health concerns and that county’s choice to also focus on communicable diseases.)

Mental Health Needs Prevail

Medical providers say it is not surprising that these issues prevail at this point in time, especially mental health needs, because the stress and strain of the pandemic exacerbated anxiety, depression, and substance misuse. Teens and young adults were especially hard hit. Fair Health looked at private healthcare claims for pediatric mental health, comparing month by month 2020 to 2019, and uncovered staggering results. In claim lines denoting overall mental health, intentional self-harm, overdoses and substance use disorders, incidence increased significantly.

Delayed Care Has Consequences

Delay in seeking care during the pandemic was more widespread than medical providers may have thought. For those with chronic diseases, which is 6 in 10 adults in the United States, delayed care often has negative and devastating consequences. In the earlier months of the pandemic, polls reflect delayed care for perceived serious medical issues and all types of medical care in general was widespread. Results of reviews of several polls found that one in five adults (20 percent) reported their household members delayed getting care.  That report is in the Journal of the American Medication Association (JAMA).

Since age is one of the leading indicators for chronic disease incidence, older adults are at greater risk of complications from chronic disease, if routine care is ignored. The National Poll on Healthy Aging found that in 2021, nearly one in three people over 50 with a scheduled procedure, primary care visit or dental visit in 2021 had a COVID-related delay and many had not gone back for care as of late January 2022, when the poll was conducted. Accessing preventive screenings – for cancers, high blood pressure, and diabetes – catches these diseases in early stages when they are more treatable and less costly. Regular physician visits help patients better manage their chronic conditions, leading to better outcomes and a better quality of life.  Hospitals and other providers in our suburban counties say visits for routine care are picking up. That’s good news.

Patient/Public Feedback Important

Gathering primary data on consumer perception is a requirement for every region. In Nassau and Suffolk counties on Long Island, an ongoing Community Health Assessment Survey (English, Spanish) is distributed to residents 18 years and older. It collects zip code-level, primary data about Long Islanders’ health concerns for themselves and their communities. The data is used by hospitals, county health departments, community-based organizations and other social and health services providers to offer programs that best meet the needs of communities

Results from the Long Island region survey show that communities are most concerned about cancer. Many cancers are now considered chronic conditions. This was followed by drug and alcohol abuse, mental health depression/suicide, with heart disease/stroke high on the list. The survey looked at responses collected January – December 2021.

To address these issues, survey respondents overwhelmingly want screenings, education, and information about mental health, substance misuse, and heart disease, particularly blood pressure and cholesterol screening. The usefulness of these results is not lost on hospitals and health departments. As they have in the past and will continue to do so in the future, hospitals and health departments create new programs and/or modify existing ones to meet the needs of communities. This is why it’s so important that everyone voice their concerns through assessment surveys, patient satisfaction surveys, in focus groups and via any other vehicles that solicit feedback.

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