Despite a wealth of hospitals and health care providers, Richmond County fares poorly in health outcomes and is getting worse in an annual health ranking, which a community health activist called “terribly disturbing.”
The county ranked 135th this year among the state’s 159 counties, according to 2013 County Health Rankings.
Columbia County is among the healthiest in Georgia with an overall rank of No. 7. Two other Augusta area counties didn’t do as well – McDuffie County was ranked the fourth worst for health outcomes while Burke County was in the bottom 15.
The annual report, produced by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation, draws from a number of different data sources to look at more than 30 different measures and then creates overall rankings based on those for every county in each state. The measures include not only health care measures like the number of primary care physicians and preventable hospital stays but also social measures like teen birth rate, violent crime and access to healthy food. All of those can be a factor in health, said Michelle A. Larkin, assistant vice president and deputy director of the Health Group at the Robert Wood Johnson Foundation.
“These are all things that impact our health and influence how healthy we are,” she said.
Unhealthy counties often seem to have higher amounts of social woes, said Dr. Patrick Remington, Associate Dean for Public Health at the University of Wisconsin School of Medicine and Public Health.
“The counties with the highest premature death rates and lowest quality of life also have the highest rates of smoking, teen births and physical inactivity, as well as more preventable hospital stays. Teen births are more than twice as high in the least healthy counties than in the healthiest counties.”
To try and combat that, places like New Orleans, in rebuilding from Hurricane Katrina, is shifting away from hospital-based care and creating a primary care network that serves about 20 percent of the population, said New Orleans Health Commissioner Karen B. DeSalvo. Now as infrastructure such as a new road or library or community center is built, things such as being pedestrian- or bike-friendly are being factored in, as well as opportunities for the community for recreation, she said.
“We really are thinking about health in all policies,” DeSalvo said. It will take a while to impact socioeconomic problems such as children in poverty but the city is setting lofty goals.
Richmond County, however, seems to be headed in the wrong direction. The county went from 104th overall in 2011 to to 135th this year, probably due to the economic downturn, noted Dr. Lucy Marion, dean of the College of Nursing at Georgia Regents University and secretary and co-founder of the Greater Augusta Healthcare Network. The county dropped in measures looking at premature death from 132 to 146, and in terms of measures of the physical environment, such as access to recreational facilities or to healthy food, from 80 to 133, Marion said. That drop in just a few years is “terribly disturbing,” she said. “I’m sick to see it.”
This is despite many efforts in the community by her group, a coalition of hospitals and health care providers that is looking to address broader community problems, as well as many individual efforts by different groups, Marion said. For instance, just in the College of Nursing, there are 250 students at various levels all doing community projects, not to mention what students and faculty at other schools contribute, she said.
But “it’s not a focused effort at this point,” Marion said, and perhaps that will come about.
Knowing that they would soon be penalized for high readmission rates for patients, University Hospital last year began focusing on transition care for chronically ill patients such as those with diabetes or congestive heart failure, said President Marilyn Bowcutt.
Working with Christ Community Health Services, its disease management center worked with patients in the community to keep them healthier so that they wouldn’t need to be readmitted, she said. Before they even leave the hospital, many of those patients might go to a special floor to work with people like social workers, case managers and transition coaches to not only overcome barriers like access to medication but also to be educated about their disease and their treatment, Bowcutt said. Nurses follow up to make sure they are staying on treatment and staying healthy.
Congestive heart failure patients, for instance, are taught to weigh themselves consistently and can be put on medication to help them lose water weight if they start retaining it, Bowcutt said. That is helping to reduce the readmission rate and keep patients healthier, she said.
“Really that is our whole mission to provide health care services to the citizens of Augusta to achieve and maintain optimal health,” Bowcutt said. “Our goal is really to help them to be better and, if we can do that, we’re doing a good job for the community.”