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Features Health & Wellness Report points to strengths and weakness in county health

The Franklin Community Care Clinic, now in its tenth month, was cited as one of the positive impacts to health in Macon County in 2010. Above, the clinic’s core staff (LR): Francis Oviedo, Clinic Assistant; Margaret Tolley, Family Nurse Practioner; Jean Jordan, Clinic Administrator.After the first of the year, the Macon County Department of Public Health and Healthy Carolinians of Macon County issued the State of the County’s Health Report for 2010. The annual report provides the most current data on a number of leading health indicators, including county demographics, leading causes of death, chronic disease mortality rates, injury prevention efforts, access to care, maternal and child health indicators and health promotion efforts in the county. The report helps inform community leaders, support organizations and others about the county’s progress on various health issues.

“We use the reports ... to help develop policy and plan programs so that we can use our resources efficiently and put them where we need them the most,” explained Becky Barr of the Macon County Department of Public Health.

Barr noted that every four years, the county is also required to do a Community Health Assessment (CHA), a more comprehensive report that sets the long-term health priorities for the county. It will also be used as the standard for measuring progress in future State of the County Health Reports. The Community Health Assessment will be conducted using many data collection techniques, including telephone interviews, focus groups, key informant surveys, as well as statistical analysis. The next CHA is scheduled for 2011, and a committee that will execute the assessment has already been assembled.

This year’s State of the County Health Report (also known as a SOTCH report) highlights both the county’s progress and challenges during the year in regards to the health priorities identified in the 2007 CHA. The report also touts the accomplishments of local coalitions and programs that have made an impact on the county’s health, whether through prevention of chronic disease or increased access to care. In addition, in order to isolate areas which need improvement, the report compares Macon County to four peer counties with similar population and demographic characteristics, as well as to the state as a whole.

Barr noted that one of the most positive things highlighted by the 2010 report was the opening of the Franklin Community Care Clinic. “That had been a big need for many years,” she said.

A satellite of the Highlands Community Care Clinic which has been operating since 2005, the Franklin clinic opened in February of 2010. It was established after the Highlands-Cashiers clinic and the county health department applied jointly for a grant to expand services.

The clinic offers primarily adult healthcare for low-income and uninsured residents needing care for both chronic and episodic health issues. Two clinics are offered each week: Monday and Wednesday evenings from 5 to 9 p.m. On Mondays the clinic can accept some walk-in patients who have not been able to call ahead and get an appointment, but appointments are strongly recommended.

According to Jean Jordan, coordinator of the Community Care Clinic, though there were some challenges during the first months of operations, things are now running very smoothly.

“There’s been a learning curve to find what sort of hours and follow-up work best for our clients,” explained Jordan. She noted that when the clinic first opened there was such an overwhelming demand in the community that some people had to wait more than a month for an appointment. Now that the clinic is ten months in, however, the situation has improved. “We’re getting better.”

The other challenge has been developing and maintaining a consistent group of volunteers. The clinic operates with a small staff supported by a cadre of volunteers who assist in registering patients and doing patient intake. In addition, six physicians volunteer at the clinic at least once a month.

“We could not run the clinic without physician support and volunteer support from the community,” Jordan said, adding, “We have great volunteers, but you always need to be out there increasing your volunteer base.” Individuals interested in volunteering should contact Jordan at (828)349-2085.

The clinic works closely with the Medication Assistance Program (MAP) of Angel Medical Center which assists people in obtaining prescriptions free of charge directly from pharmaceutical companies. Jordan also noted that several area churches and restaurants have supported the clinic by providing meals to the volunteers who stay late into the evening to assist patients. “The clinic very much appreciates all the local support that we’ve seen,” she said.

The clinic does not accept Medicaid or Medicare or any other insurance programs, explained Jordan. “We’re the fall-back for people who don’t qualify for those programs: unemployed individuals and those supporting family members who just don’t have any other recourse for their own healthcare.”

Room for improvement

The SOTCH report also notes the priority areas in which Macon County has room for improvement in terms of the health of its residents and the resources available to them. For example, the report notes that suicide rates in the county were significantly higher than state rates during the same period last year.

According to Kathy McGaha, program director of Healthy Carolinians of Macon County, it is difficult to connect a cause to such statistics, but she says there has been a consistent trend in recent years indicating that higher rates of both unintentional injury and suicide have been seen among middleaged males in particular. McGaha also noted that improving mental health services in the community and in the region has been a priority issue for the county for several years.

Another long-term priority has been developing a senior-friendly environment in the county. The SOTCH report notes that the growth rate of residents 75 and older continues to exceed the growth rate of health care services in the community.

“Obviously this area is very appealing to individuals who are retiring,” noted McGaha. Although the economy has slowed down the rate of retirees moving to the area, McGaha says the county still needs to prepare for them to come in the future. Sheila Southard of Macon County Senior Services added that there is already a large population within the county approaching retirement age.

“The community needs to prepare to provide services and care for that group,” said McGaha. We need to consider everything from transportation to access to businesses to how homes are built.”

The Senior Services agency has taken the lead in trying to implement a senior-friendly community in compliance with a governor's plan mandating that all counties look at readiness for the growing senior population. In addition, Healthy Carolinians has an Elder Care and Caregiver committee that also looks at planning for the senior community.

A press release announcing the SOTCH report noted that the Macon County Department of Public Health values the public’s input, questions, and comments about the SOTCH report as well as the Community Assessment process. To access current and historical SOTCH reports and CHA reports, please visit http://www.maconnc.org/healthy-carolinians.html or contact Becky Barr at (828)349-2437 for more information.

Macon County's 2010 State of the County Health Report

Positive highlights
• The Franklin Community Care Clinic opened in February, 2010, improving access to health care for low-income and uninsured residents.
• Self-reported data collected from youth surveys indicated improvements in tobacco use initiation, consumption of fruits, and cocaine and inhalant use.
• The rate (per 1000) of teen pregnancies (ages 15 -19) dropped from 59.6 in 2006 to 53.4 by the end of 2009.
• Body mass index (BMI) trends were favorable when measured at Macon County elementary school health fairs.
• Macon County’s rates for bacteria positive well water samples fell from 70% in July, 2008 to less than 30% in July, 2010, an improvement due to changes in chlorination practices.

Opportunities for further improvement:
• More than half of deaths in Macon County between 2005 and 2009 were due to chronic diseases such as cancer and heart disease.
• Macon County’s death rates attributable to unintentional injury and suicide were significantly higher than state rates during the same period.
• The latest available data on maternal smoking showed that Macon County’s rate of live births where the mother smoked was 22.3%, more than double the state’s rate of 11%.
• The 75 and older population growth rate is exceeding the growth rate of health care services in the community.


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