Download - Redington-Fairview General Hospital Community Assessment · The following 2019 Redington -Fairview General Hospital Community Health Needs Assessment (CHNA) is the hospital’s way

Redington-Fairview General Hospital

2019 Community Health Needs Assessment

Original Community Needs Assessment: November 2007 Updated: January 2010; April 2012, September 2013; August 2015; July 2016 July 2019

2 Redington-Fairview General Hospital Community Health Needs Assessment, 2019

Table of Contents Executive Summary Page 3 Community Health Assessment History Page 3 - 4 2019 Assessment Process Page 5 County Health Rankings Page 6 Demographics Page 7 Social Determinants of Health Page 7-10 Mental Health Page 10 Substance Use Page 11 Chronic Disease Page 12-15 Environmental Health Page 16 Infectious Disease & Immunization Page 17 Injuries Page 18 Summary Page 18


EXECUTIVE SUMMARY

The following 2019 Redington -Fairview General Hospital Community Health Needs Assessment (CHNA) is the hospital’s way of identifying and prioritizing the significant health needs of the community that Redington Fairview General Hospital serve. In doing so, the hospital takes into consideration our mission, community engagement strategies, and community health goals. The intent of the community health assessment is to use it as a planning tool to assist in initiating strategic initiatives to meet the needs of citizens whose health need are at risk in our community. RFGH Mission – to develop, provide, and facilitate high quality, comprehensive, cost-effective health services for the people we serve. We affirm a commitment to maintain our unique community hospital identity, offering personalized services. RFGH Community Engagement Strategies Community Health Improvement – Directly, or in collaboration with others, identify and provide health, prevention and education services throughout the community. Offer community education, disease prevention and wellness initiatives based on community need. Public Health Infrastructure Development – As a member and fiscal agent for Somerset Public Health, RFGH works collaboratively with regional health and wellness providers to deliver public health services. RFGH works in collaboration with numerous organizations and community partners to work on preventative health services in our community. Community Health Goals

a. to promote healthy behaviors (promote nutrition and weight status, promote physical activity and fitness, reduce tobacco use and reduce use of alcohol and other drugs)

b. to promote healthy and safe communities (improve environmental health, increase vaccinations, prevent injuries, and promote educational and community based programs)

c. to improve systems (access to primary care, specialty care and emergency care) improve maternal, infant and child care, improve health communication and technology, improve public health infrastructure)

d. to prevent; reduce; and manage diseases and disorders (cancer, cardiovascular/ heart disease and stroke, chronic diseases, infectious diseases, pulmonary and respiratory health)

COMMUNITY HEALTH ASSESSMENT HISTORY

Assessments and / or updates to assessments were completed in 2007, 2010, 2012, 2013. A completed Community Health work-plan with identified Healthy 2020 National Goals, Maine Goals, and RFGH Goals and strategies to meet goals with each assessment and / or update as above.

Somerset Public Health completed a Mobilizing for Action through Planning and Partnerships (MAPP) assessment process in 2011 as part of the strategic approach to community health improvement. “Bearing the Fruits of Our Labor” is an evaluation Framework for Somerset Public Health was completed in 2013.

A Somerset County Community Health Needs Assessment was completed in August 2014 (EMHS) with RFGH as partnering / collaborating hospital.


September, 2015 annual report and community health work-plan completed. In addition; RFGH collaborated with the Maine Shared Health Needs Assessment & Planning Process (SHNAPP) Project - a collaborative of Central Maine Healthcare, Eastern Maine Healthcare Systems, MaineGeneral Health, MaineHealth and the Maine Center for Disease Control and Prevention. RFGH had active representation on the Community Engagement team of the project and actively participated in identifying forum focuses and developing feedback opportunities from the forums.

In September 2015, Somerset Public Health invited the community to a forum to have conversation about what is causing Somerset County to have the lowest ranking in Maine, “Moving up the Ranks”. The Director of the Health Index Initiative (MMC) presented County Health Ranking information (data) participants worked on action planning for changing our health status.

In December of 2015, community members were invited to additional forums across Somerset County as another method of gathering information from the community at large. The goal was people with diverse backgrounds would have the opportunity to share their perspective about the issues at hand. A summary of the key health issues identified and discussed during these forums are in the table below (may not be all inclusive of all comments). In September of 2016 the Board of Directors approved the RFGH Community Health Assessment and Improvement Plan. It may be viewed at rfgh.net .

Health Issues Barriers or need Potential solutions Available Resources Obesity Poverty,

transportation, funding, access to care

↑ programming for and access to physical activity and weight loss, access to healthy foods. Fund evidence based programs, organizations offer space for activities

Worksite wellness programs, school education, physical activity opportunities

Tobacco Transportation, poverty, stigma around substance abuse

Youth involvement in solutions, ↑ access to tobacco cessation, address health care professional shortage for screening and referral for services, those in need attend existing groups / Quit line

Youth, seniors, parents, businesses

Mental Health

Lack of behavioral health professionals, limited social support

Policy change, collaboration to improve referral processes, education and provider protocol

NAMI, support groups, assisted living and hospice providers, school support staff, Acadia hospital, 211

Drug and Alcohol Abuse

Transportation, poverty, stigma around substance abuse

↑ prevention education, improve partnerships among law enforcement and public safety, provide resources, cultural shift to reduce stigma, treat disease and engage youth in prevention

Treatment providers, support groups, school-based education, health care, law enforcement


2019 SOMERSET COUNTY AND REDINGTON FAIRVIEW GENERAL HOSPITAL ASSESSMENT PROCESS

Another round of assessment began in 2018. SHNAPP changed its name to Maine Community Health Needs Assessment (Maine CHNA) with much of the collaborative efforts remaining and over many months of development, gathering of data, and community input through forum process the priorities for Somerset County were identified as follows:

Health Issue Gaps or need Assets Mental Health Child Psychiatry, address mental health bias, not

enough providers, stigma, no reimbursement, lack of beds, community understanding of mental health, transportation, recreational trails/green space, first responders

Kennebec Behavioral Health, Northern Light Acadia Hospital (Bangor), Assistance Plus, Screening at Provider office for caregivers, 211 Maine, Somerset Public Health, Kennebec Valley Community Action Program

Older Adult Health / Healthy Aging

Transportation, safety concerns related to aging adults, support for community volunteers, healthcare worker shortage, lack of geriatricians, follow up support, health literacy, home adaption, polypharmacy, housing / home maintenance, structural support for caregivers,, primary care support

Area Agency on Aging, 211 Maine, Spectrum Generations, care managers, primary care support, YMCA, AARP, local resources for older adults

Substance Use Stigma reduction, opiate bias trainings, education on marijuana, more trained workers, money, more training for law enforcement, recovery programs and treatment funding, every primary care provider providing opiate and behavioral health treatment, more creativity in prevention efforts, more access to measures to treat addiction

Primary care provider efforts for substance use disorder prevention, Kennebec Behavioral Health, Maine General Behavioral Health/Addiction Medicine, First Responders, Behavioral health agents, access to Narcan

Social Determinants of Health

School staff training, nutrition education, gap in child protective services / DHHS, lack of understanding, gap in transportation to resources, need jobs with livable wages, parent education in schools, resource gap, stigma surrounding being able to afford food, gap in food access, books

211 Maine, Kennebec Valley Community Action, YMCA, Local food pantries, United Way food drives, Boys and Girls Club of Somerset County, Soup kitchens, community gardens, child and adult care food program, United Way of Mid-Maine food project, Meals on Wheels, Food bags at primary care practices, Supplemental Nutrition Assistance Program,, School programs

Food Insecurity See above (social determinants) Youth / Adverse Childhood Experiences

Oral health, screen time, obesity, youth mental health, substance use, and youth who self -identify as LGBTQ face higher rates of depression, obesity

Additional health issues that were identified were access to care, physical activity, nutrition, and weight, and chronic disease. This Redington - Fairview General Hospital Community Health Needs Assessment and Improvement / Implementation plan will address all these health issues.

The public is welcome to download or view county and state reports and datasets available on the Maine CDC website at https://www.maine.gov/dhhs/mecdc/phdata/MaineCHNA/final-CHNA-reports.shtml


In addition to the Maine CHNA data, it is valuable to seek additional sources of information for the purpose of assessment. The data is similar in the following source; however this source provides additional information. The Health Rankings, published by the University of Wisconsin Population Health Institute, looks at health outcomes to see how healthy a county is and at health factors which influence the health of a county. Measures used are mortality, morbidity, health behaviors, access to care, quality of care, income, education, community safety, and environment. The indicators for health factors are similar to indicators throughout the Maine Community Health Needs Assessment. An individual’s health status is impacted by disparities such as income, education levels, and access to medical care. According to the 2019 national “Health Rankings” Somerset County currently ranks 14 out of 16 for health outcomes and 16 out of 16 for health factors. The flow chart below helps one understand the Health Rankings

Indicators for Health Factors

Adult Smoking Obesity Physical Inactivity Access to exercise opportunities Excessive drinking Alcohol impaired driving deaths STI – Chlamydia rate Teen Births

% Uninsured Population to provider ratios Preventable hospital stays Diabetic monitoring Mammography screening

High school graduation (in 4 yrs) Some college Unemployment Children in poverty Income inequality Children in single-parent households Social associations Violent crime Injury deaths

Air pollution – particulate matter Drinking water violations Severe housing problems Driving alone to work Long commute – driving alone


DEMOGRAPHICS Somerset County

Geography and demographic facts about Somerset County

• Somerset County has 23 towns, some large and some as small as 110 people living in them • Total population of Somerset County is 50,626, a decrease of about 1600 persons since 2010. • 4 of 5 individuals living in Somerset county live in a rural area

SOCIAL DETERMINANTS OF HEALTH

Social determinants of health are the conditions in which people learn, live, work and play that affect their health. Socioeconomic status factors such as availability to transportation, adequate housing, one’s beliefs, literacy, crime / violence, education, access to care, and access to food all influence one’s health. SOCIOECONOMIC FACTORS

For families and communities to do well, several socioeconomic factors need to be in place. Employment, educational achievement, and having an above poverty level income all affect healthy behavior engagement. Socioeconomic facts about Somerset County

• Somerset County is tied for the highest unemployment rate in the state • High poverty rates are present in all age groups. • Nearly one quarter of the children in Somerset County live below the federal poverty level • For the years 2013-2017 37% of our children lived in single parent families • As of the 3rd quarter of 2017 the average weekly income in Somerset County was of between $659 and

$749. The Maine average was $821; The US average was $1041. (Source US Department of Labor, Bureau of labor statistics County Employment and Wages In Maine — Third Quarter 2017 downloaded 4/6/2019).

• The median household income for Somerset County is approximately $10,000 less than the rest of the state at $40,484

EDUCATION Another important socioeconomic factor is educational achievement. The High School graduation rate is one indicator to look at. Somerset County on-time graduation rate (within four years) reported 86.4% which exceeds the goal of national Healthy People 2020 of 82.4%.


POOR PHYSICAL HEALTH According to county health rankings data of 2016 those reporting # of poor physical health Days in past 30 days was 3.9 with overall Maine reporting 4.2 days. In addition, adults the percent of adults who reported fair or poor health was 16% with Maine reporting 15.6% FOOD INSECURITY Food insecurity is the uncertain access or limited access to adequate nutritional food in a household for an active, healthy life. This makes it difficult for households to make choices between basic needs such as choosing between housing, paying medical bills or getting prescriptions filled, or purchasing nutritional food. According to Feeding America there were 8,030 people who were food insecure in Somerset County in 2016 for a rate of 15.6% of food insecurity. THE AGE OF PEOPLE IN SOMERSET COUNTY AND HOW IT IMPACTS THE OVERALL HEALTH OF OUR PEOPLE The percent of those 65 or older who lived alone for the years of 2012 – 2016 were 45.3%.

Source: Maine CHNA

Source 2019 Maine CHNA Source: Community Commons


The following chart is a demonstration of premature death in Somerset County – years of potential life lost. It is measured as a rate. All the years of potential life lost in a county during a 3-year period are added and divided by the total population of the county during that same 3 year time frame. This value is then multiplied by 100,000 to calculate the years of potential life lost under age 75 per 100,000 people.

Source: University of Wisconsin Population Health Institute. 2019 County Health Rankings Health Rankings UNINSURED ADULTS AND UNINSURED CHILDREN Lack of insurance contributes to poor health status as it can be a major barrier to receiving adequate care. In the 2019 County Health Rankings, it is stated 4% of Somerset County’s adults are uninsured and 4% of Somerset County children are uninsured. Source: University of Wisconsin Population Health Institute. 2019 County Health Rankings Health Rankings

CHILDREN ELIGIBLE FOR FREE/REDUCED PRICE LUNCH Children are a vulnerable population for food insecurity. In Somerset County there are 5280 children eligible for free or reduced school lunches. The chart below demonstrates an increase from 57.5% in 2010 to 71.2% in the 2019 school year.

Source: Kids count.org – data provided by Maine Children’s Alliance

CHILDREN RECEIVING SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) BENEFITS

Supplement Nutrition Assistance provides food to children who live in families with low incomes. The numbers fluctuate with the economy and also with changes in eligibility.

0102030405060708090

100

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Percent of children eligible for free school lunch


What the SNAP data shows:

Source: Kids count.org – data provided by Maine children’s alliance

ACCESS TO CARE / HEALTH CARE QUALITY Access to care contribute to one’s health status. Barriers to access to care may include transportation, cost, education, lack of usual source of care, lack of insurance, child care, or others. Somerset County residents have less access to primary care physicians and practicing dentists than do Maine residents.

PRIMARY CARE / DENTAL CARE ACCESS INDICATORS

MENTAL HEALTH Mental health has been identified as a priority area for Somerset County to work to implement strategies to improve upon the efforts to date. Understanding the issues and the barriers are important to this work. The following graphs help us recognize some issues.

Data source: 2019 Maine CHNA

01020304050

2011 2012 2015 2016 2017 2018

Percent of Somerset County children receiving SNAP benefits

0

10

20

30

40

2011 2012 2013 2014 2015 2016 2017

Mental Health

Suicide deaths per 100,000 population

14 or more days lost to poor mental health (%)

Sad/Hopeless for 2+ weeks in a row (High School)

Maine Community Health Needs Assessment Health Indicators

Data Year Somerset County Maine US

Ratio of primary care physicians to 100,000 population

2017 41.9 67.3 -

Ratio of practicing dentists to 100,000 population

2017 10 32.1 -


Of note, the closest in-patient facility for mental health may be up to as far as 100 miles away as depicted by the yellow circles on the map below. The green arrow is a location within Somerset County. SUBSTANCE ABUSE SUBSTANCE USE SUBSTANCE USE Substance use was the third health issue identified as a priority for the next three years to address based on the following information. Substance use for the purpose of this assessment shall include tobacco, alcohol, marijuana and nonmedical use of prescription pain relievers. According to the US Department of Health and Human Services, smoking does damage to many organs in the body and can lead to lung cancer, respiratory problems, heart disease, stroke and other health issues. According to the CDC, smoking causes diminished overall health, increased absenteeism from work and increased health care cost and utilization. The US DHHS source indicates alcohol in excess may increase the risk of serious health problem development. In addition there are concerns and issues associated with behaviors of intoxication and withdrawal symptoms. Marijuana has long-term use effects to include infections of the lungs, impaired memory and exposure to cancer-causing compounds. Opioids can produce not only the reduction in the perception of pain, but mental confusion, nausea, and drowsiness and if too much is taken it can depress the ability to breathe. By quitting smoking one can reduce cardiovascular risks. Just one year after quitting your risk for heart attack drops sharply. Within 2-5 years, one’s risk for stroke could fall to that of a non-smoker. If one quits smoking, the risk for cancer of the mouth, throat, esophagus and bladder drop by half in 5 years. And in 10 years after one quits smoking, the risk for lung cancer drops in half.

Source: 2019 Maine CHNA

The 2019 County Health Rankings reports adult smoking rate at 21 for 2016 data but also states not to compare to prior years. Whether 21 or 24 %, Somerset County smoking rates are way above the national rate of 17% and this initiative continues to be a priority for RFGH and Somerset Public Health.



Past 30 day alcohol use (HS students 2017 19.6 22.5 NA Past 30 day alcohol use (MS students 2017 4.3 3.7 NA Past 30 day marijuana use (HS students) 2017 19.2 19.3 Past 30 day marijuana use (MS students 2017 5.3 3.6 Past 30 day misuse of prescription drugs (HS students 2017 4.4 5.9 Past 30 day misuse of prescription drugs (MS students 2017 2.5 1.5 Current smoking adults 2016 24.1 19.8 17 Past 30 day cigarette smoking (HS students 2017 9.8 8.8 Past 30 day cigarette smoking (MS students 2017 2.3 1.9

. Map source: https://findtreatment.samhsa.gov/locator


Drug overdose deaths reported in the 2019 County Health Rankings were 28.

Buprenorphine physicians- closest is 50 miles Methadone physicians

Map source: https://findtreatment.samhsa.gov/locator

CHRONIC DISEASE (S) Chronic diseases include cardiovascular diseases (heart and stroke), cancer, chronic respiratory diseases, diabetes, and bone and joint disorders such as arthritis and osteoporosis.

Causes of chronic diseases may have underlying socioeconomic, cultural, political and environmental determinants. Individuals may have risk factors that place them at increase their likelihood for a particular chronic disease or injury. Very often there are common modifiable risk factors, non-modifiable risk factors, and intermediate risk factors that lead to the main chronic diseases mentioned above. The following chart will clarify those risk factors that one can modify and those one cannot.

Modifiable Risk Factors – those we as individuals we can impact

Non – modifiable risk factors – those as individuals we cannot impact

Intermediate risk factors – those as individuals we can make lifestyle changes that may impact

Unhealthy diet Age Raised blood pressure Physical inactivity Heredity Raised blood glucose Tobacco use Abnormal blood lipids (cholesterol) Overweight / obesity

Physical inactivity, poor nutrition and tobacco are modifiable risk factors most individuals can adjust in their

daily life and our community health programming can have an impact upon.

Tobacco use and exposure to tobacco, poor nutrition, and sedentary lifestyle or physically inactivity are the top three health behavior risk factors affecting people. These risk factors affect all of the chronic diseases: diabetes, cardiovascular health, cancer, chronic lung disease like COPD (chronic obstructive pulmonary disease) and other health issues as well and frequently start in one’s youth. Those with arthritis that are inactive or overweight tend to be more symptomatic (have increased pain and are not as able to move with as much ease). Nutrition /Weight and Physical Activity: sedentary lifestyle, overweight and obesity are risk factors for many of the chronic diseases.

Resources for those with substance use issues are limited for those in Somerset County.


PHYSICAL ACTIVITY Maine Community Health Needs Assessment Health Indicators Somerset

County Maine US

Sedentary lifestyle – no leisure time physical activity in past month (adults) (2016)

23% 20.65 23.2%

Source: 2019 Maine CHNA WEIGHT

SOURCE: https://www.stateofobesity.org/states/me/ YOUTH OBESITY

Note: the ranking is 1 is most obese, 43 is least obese

OBESITY RATES 2017 BY AGE GROUPS

Maine, 2016 Obese 13.9% in children ages 10 - 17

https://www.stateofobesity.org/states/me/


CARDIOVASCULAR HEALTH Cardiovascular disease or heart disease refers to a group of diseases and conditions affecting the heart and blood vessels. According to the Somerset County Maine Cardiovascular Health and Diabetes Plan (2011 – 2020) Heart Disease is the 2nd leading cause of death in Maine with Stroke the 4th leading cause of death. In Somerset County, according to the Maine Shared Health Needs Assessment, Heart disease was the leading cause of death in Somerset County in 2013. Risks of heart disease and stroke are 2-4 times greater in people with diabetes. According to the CDC, About 1 of 3 U.S. adults—or about 70 million people—have high blood pressure. Only about half (52%) of these people have their high blood pressure under control. This common condition increases the risk for heart disease and stroke.

RESPIRATORY HEALTH / PULMONARY DISEASE Respiratory health includes diseases such as Chronic Obstructive Pulmonary Disease (COPD) and asthma. As with other chronic diseases, risk factors include smoking and sedentary lifestyle. In addition, exposure to noxious particles or gases, recurrent infections, genetic factors and diet may be additional risk factors for COPD. Respiratory health includes diseases such as Chronic Obstructive Pulmonary Disease (COPD), pneumonia and asthma. Asthma is a chronic disease that affects the lungs and airways. There is no cure but it can be controlled. Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. COPD is a disease that is caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. Most people with COPD can achieve good symptom control and quality of life with proper management, as well as reduced risk of other associated conditions. As seen by the data below, Somerset County has a much higher rate of COPD than the rest of Maine or the US. RESPIRATORY HEALTH / PULMONARY DISEASE INDICATORS



COPD 2014-16 12.8 7.6% 6.3%


11.8 11.7

9

12.4

14.4

2011-2013 2014-2016

Perc

emt

Chronic Diseases Somerset County

Diabetes COPD Asthma

As seen by the chart, COPD is a disease that is affecting more adults each year. The rate of diabetes over the last few years has not changed. Ashma rates were last avalable in years 2011 – 2013.


CANCER Cancer is the 2nd leading cause of death in Somerset County. Cancer is a term used for diseases in which abnormal cells divide without control and can invade other tissues. Cancer cells can spread to other parts of the body through the blood and lymph systems. Cancer is not just one disease, but many diseases. There are more than 100 kinds of cancer. Early detection through screening (finding cancer or pre-cancerous changes before it can grow and spread into late-stage disease) makes a difference in health outcomes for many cancers. Not only does it save lives, provide quality of life, it also saves billions of dollars of healthcare treatment costs.

Data Source: 2019 Maine CHNA

DIABETES Diabetes is a disease that affects the way the body uses food. It is characterized by the inability to produce or properly use insulin, a hormone that helps control blood sugar levels. Every minute a person’s blood sugar is higher than it should be, the disease damages the nervous and circulatory systems, leading to blindness, amputations and increasing disability. Obesity is one of several risk factors linked to type 2 Diabetes. Both obesity and type 2 diabetes have contributing factors of socioeconomic, lack of physical activity, and an unhealthy diet. In addition, poorly controlled cholesterol, blood pressure, and blood sugar levels are associated in people with obesity in those with type 2 diabetes. The overweight or obese diabetic may experience more severe complications.

Complications of diabetes may include heart disease, kidney disease, eye disease, nerve disease, atherosclerosis, stroke, bone or gum infections, and birth defects in babies born to diabetic mothers. Early prevention, effective management, lifestyle changes, and treatment can often successfully prevent many complications of diabetes.

https://www.americashealthrankings.org/explore/annual/measure/Diabetes/state/ME ARTHRITIS

0

200

400

600

2007-2011 2012-2016

Cancer

All cancer new cases per 100,000 population

All cancer deaths per 100,000 population


Somerset County has a large population of older adults. Whereby age, physical inactivity, and overweight / obesity are all concerns of this county arthritis will be included in this assessment. According to the CDC the percent of adults with arthritis in Somerset County is 31.6%. Osteoarthritis is characterized by the breakdown of the joint’s cartilage. The breakdown of cartilage causes the bones to rub against each other, causing stiffness, pain and loss of movement in the joint. Rheumatoid arthritis) is a chronic disease, mainly characterized by inflammation of the lining, or synovium, of the joints. It can lead to long-term joint damage, resulting in chronic pain, loss of function and disability.

Source: https://cdc.gov/arthritis

ENVIRONMENTAL HEALTH Prevention and / or minimizing exposures to those environmental things that may have adverse health effects are important to the health of our community.

• Lead exposure: the reference level for lead for which the CDC recommends Public Health actions be taken are blood levels for > 5 micrograms per deciliter. Lead exposure can affect nearly every system in the human body. It often goes without symptoms, therefore is not easily recognized. The importance of testing is crucial for early intervention, especially in children ages 1-5 when they are rapidly growing physically and mentally. It is equally important to protect children from exposure to lead for their lifelong good health, academic achievement, IQ, and their ability to pay attention in school and in social settings.

• High arsenic levels in private wells may come from certain arsenic fertilizers used in the past or industrial waste. It also may indicate improper well construction or overuse of chemical fertilizers or herbicides in the waste. Heating or boiling water does not remove arsenic, nor does chlorine (bleach) use. One should test well water at least once a year and contact your state certification officer for a list of laboratories that will perform tests on your drinking water. There is a fee for this service.

• Radon exposure is a health concern in Maine. Radon is a radioactive gas that everyone breaths and is a cause of lung cancer. You cannot see or smell the gas. . Testing is the only way to determine how much radon is present in your home.

INFECTIOUS DISEASE & IMMUNIZATION

• The influenza (flu) virus is a serious disease that can lead to hospitalization or even death. The best way to reduce the chance of getting the seasonal flu and spreading the flu to others is by getting the annual flu shot. When more people are vaccinated each year, less flu can spread throughout the community.


Somerset County is reported to have 42% vaccination rate for the influenza according to the 2019 Maine CHNA.

• Pneumonia may be caused by bacteria, fungi, or viruses. There are several vaccines that prevent infections that cause pneumonia. You can also help prevent pneumonia and other infections by washing your hands regularly. Pneumonia vaccines are generally recommended for specific age groups.

• Lyme disease is caused by a bacteria transmitted to humans through the bite of infected blacklegged ticks. Prevention: use insect repellent, remove ticks promptly, remove leaves and other habitat that ticks like to live in from your yard.

• Tuberculosis (TB) is caused by a bacterium which attacks the lungs most generally. If not treated, the disease can be fatal. In some people the disease can be asymptomatic for a long time. Maine has a very low incidence rate.

• Hepatitis C is a liver infection caused by the Hepatitis C virus, a blood borne virus. Many individuals infected may not know of their illness because they do not feel ill.

INFECTIOUS DISEASE INDICATORS

Maine Shared Community Health Needs Assessment Health Indicators


Lyme disease incidence per 100,000 population

2013-2017 68.5 96.5 11.3 (2016)


INJURIES INJURY INDICATORS



Fall related deaths (unintentional) per 100,000 population

2012-2016 10.1 9.6 9.1

Injury deaths per 100,000 2012-2016 77.9 67.9 69 Motor vehicle traffic crash deaths perr 100,000 (unintentional)

2012-2016 16.2 17.6 19.4

Fall related injury (unintentional) emergency department rater per 10,000 population

2012-2014 448.8 340.9

Traumatic brain injury emergency department rate per 10,000 population

2012-2014 124.4 85.1

Always wear seatbelt (HS students) 2013 /2017 50.0%/60.2% 68.2% - Source: 2019 Maine CHNA PREGNANCY AND BIRTH OUTCOMES Prenatal care helps to keep the pregnant woman and baby healthy. According to womenshealth.gov, babies of mothers who do not get prenatal care are three times more likely to have a low birth weight and five times more likely to die than those born to mothers who do get care. Health problems may be prevented or treated. According to the data, teen births (age 15 – 19) were the same in 2016 as they were in 2012.


SUMMARY

The health issues of Somerset County since the 2016 Community Health Needs Assessment remain similar although those giving input into prioritizing the concerns rank them a little differently. RFGH and SPH have placed commitment and resources to improving the health of Somerset County by addressing the priorities. Please see the 2018 – 2019 annual report for a snapshot of initiatives.

A key factor that plays a role into making positive change in health issues such as mental health, obesity, and chronic disease include the social determinants of health (aging population, rural area, food insecurity, lower employment than other areas in Maine, etc.). It is difficult to have an impact on all of the social determinants that affect the health of our county. What can be impacted upon is to educate in an effort to reduce substance use (including tobacco), healthier eating lifestyles, increasing physical activity levels, and providing resources such as immunizations.

Redington-Fairview General Hospital and Somerset Public Health strive to make an impact on our residents through outreach to our community. Through the Community Health education programs Redington-Fairview strives for prevention of chronic disease. Somerset Public Health is also dedicated to the prevention of chronic disease as a local resource to help Somerset County members lead a healthier life through prevention work, policy, and environmental change. The impact is wide reaching throughout schools, municipalities, community meeting places, and on site at RFGH.

The indicators and other data provided in this assessment is not all inclusive. The public is welcome to download or view both state and county level reports at

https://www.maine.gov/dhhs/mecdc/phdata/MaineCHNA/final-CHNA-reports.shtml

Please review the attached RFGH work-plan to review the specific topic areas that Community Health focuses on, goals / objectives, and accomplishments or outcomes for 2018/2019.