Earlier this month, Southern Illinois Healthcare released its 2018 Community Health Needs Assessment.
The Affordable Care Act requires the three SIH hospitals, Memorial Hospital of Carbondale, Herrin Hospital and St. Joseph Memorial Hospital, to assess the health needs of people in the region they serve. This is the third assessment since passage of the act in 2012.
The primary service region for SIH is Jackson, Williamson, Perry, Franklin, Union, Johnson and Saline counties. While each county is unique, they share the same challenges. Of the 241,366 people living in the seven-county region, more than 18 percent live in poverty. Only two counties graduate 90 percent or more of their high school students. More than half the students in kindergarten through high school qualify for free lunch program.
The 2018 Community Health Needs Assessment identifies five priority health issues and a plan to address them. The issues are: Reducing barriers to improved health or healthcare; behavioral health, including mental illness and substance abuse; cancer, focusing on lung and bronchus, colorectal, oral cavity and pharynx; chronic disease prevention, management and treatment; and improving health behaviors, specifically reducing the rates of obesity and tobacco use.
Barriers to improved health and healthcare are issues of poverty and access. In the seven-county region, 14.1 to nearly 18 percent of adults have been unable to fill a prescription because of cost. Up to 23 percent of adults have no primary care physician. Between 18.7 and 33 percent of adults report having a disability.
The indicators of the impact of these barriers include food insecurity, eligibility determinations for Social Security disability and SNAP, a shortage of providers and non-emergency medical transportation.
The goal is to improve health and access to healthcare, particularly among low income individuals with chronic health conditions.
Local hospital emergency departments have high volumes of patients seeking both routine and crisis mental health disorders and substance misuse which suggest limited access and other barriers to mental health and substance misuse health services.
In Southern Illinois, the rate of suicide is more than 16 percent, much higher than the state average of 9.7 percent or the national average of 12.5 percent. Depression affects 19.5 percent of Medicare beneficiaries in the region (15.1 in Illinois, 16.7 in the U.S.) and between 18 and nearly 26 percent of all adults (15.3 in Illinois).
A quick look at substance abuse shows some staggering numbers. SIH saw 22,306 patients with a substance abuse diagnosis in Fiscal Year 2018. A total of 227,894 prescriptions were written for opioids and benzodiazepines in 2017. Between 24 and 36 of eighth graders reported use a substance such as alcohol, cigarettes, inhalants or marijuana in the past year, with 2 to 6 percent of them using a prescription drug to get high.
The goal is to reduce the rate of suicide and drug-related deaths in the seven-county region.
The incidence of cancer is greater in Southern Illinois than in the rest of the state. Most counties have higher rates than the state and nation for lung, colorectal, oral cavity and pharynx, and skin cancer.
Between 14 and 28 percent of adults say they are smokers. Smokeless tobacco is used by 4.5 to 10.5 percent of adults in the region. Between two and eight percent of eighth graders have smoked in the past 30 days.
However there is some good news. Death rates are stable or falling, except for lung and bronchus cancers in Franklin and Williamson counties. Also, there is something you can do about your risk. Stop smoking, lose weight and get up and take a walk.
The goal of SIH is to reduce rates of cancer in the region.
Issue number 4 is prevention, treatment and management of chronic diseases, including cardiovascular disease.
Cardiovascular disease is the leading cause of death for the SIH service region, with 24 percent of deaths due to a disease of the heart.
Let’s take a closer look at chronic diseases in the seven-county region that are risk factors for heart disease: 67 percent of adults 18 and older are overweight or obese. Nearly 55 percent have high cholesterol. Between 31.6 and 46.1 percent have been diagnosed with high blood pressure. Seven to 15.2 percent have diabetes.
Chronic conditions are associated with a higher rate of hospital readmission. For SIH, the top three conditions associated with readmissions are COPD, heart failure and kidney disease.
Dr. Vadzim Chyzhyk, a cardiologist specializing in clinical lipidology and invasive cardiology with Prairie Cardiovascular, suggests that those with chronic conditions or who want to lose weight cook for themselves. It is the only way to know what is in your food.
He also suggests doing a simple assessment.
“Open your fridge and look at what’s in the refrigerator. How much lean fish, lean meat and vegetables do you see? How much sugary beverages?” he said, adding that everyone should see at least some healthy food.
He said another way to take care of chronic disease is to spend 30 minutes each day walking.
“Don’t spend as much time watching television or on the internet,” he said.
Certain behaviors lead to better health. Across Southern Illinois, we do not exhibit those behaviors.
Sarah Patrick, administrator of Jackson County Health Department, talked about the statistics for Southern Illinois.
In the seven-county region: 80 percent of adults are not meeting recommended guidelines for fruits and vegetables; 19.6 did not participate in any physical activity in the past 30 days; 67.6 adults are overweight or obese; and 25.11 percent live in designated food deserts; 14 to 28 percent of adults smoke; 4.5 to 10.5 use smokeless tobacco. Ten to 34 percent use e-cigarettes.
“Youth don’t understand that vaping leads to nicotine addiction,” Patrick said.
She also said SIH and partners are developing new pilot and training to promote physical activity. Plan to increase access to health foods through the newly formed Southern Illinois Food Pantry Network and vouchers for farmers markets.
They also will utilize a detailed implementation plan for strategies through SIH Community Benefits, county health departments, school health programs and SIH Health Ministry.
Chyzhyk said a healthy diet and walking have benefits regardless of the disease, whether a patient has depression, heart disease, cancer or diabetes.
“It’s a lifelong effort,” Chyzhyk said. “It’s never too late to quit smoking. It’s never too late to go for walk. It’s never too late to eat an apple.”