Health improvement plan for region targets five areas

A multi-agency group has identified five areas to focus resources and new initiatives to help the 10-town region of southern New London County become healthier.

The Southeastern Connecticut Health Improvement Collaborative, comprising health care, public health, education and nonprofit groups, this fall released its Community Health Assessment and Community Health Improvement Plan for the region. It comprises about 175,000 people in the towns of Lyme, Old Lyme, Montville, Ledyard, Waterford, East Lyme, Groton, New London, North Stonington and Stonington.

Leading the assessment and creation of the plan were Laurel Holmes, director of community partnership and population health at Lawrence + Memorial Hospital; Russell Melmed, supervisor of health education and community outreach and epidemiologist at Ledge Light Health District, and Jennifer Muggeo, supervisor for finance, administration and special projects in population health at Ledge Light.

“We understand this to be an important way to plan how to direct resources,” Holmes said.

Both the assessment and improvement plan were created as a requirement of the federal Affordable Care Act, which also requires communities to launch initiatives in response. Communities are required to develop new assessment plans every three years. The first one created under the Affordable Care Act was issued in 2013.

“We’re required to act on the findings and report on our actions,” Holmes said. The value of doing the assessment and the plan, she said, is that it focuses the community’s attention on specific problems and possible solutions.

Based on months of compiling data and meeting with focus groups of community members, the group decided to direct attention and resources to five areas with the greatest needs:

• Access to prenatal care and maternal care in response to a spike in infant mortality. The five-town region of Ledge Light — Ledyard, Groton, Waterford, New London and East Lyme — saw about 10 deaths of infants under 1 year old in 2013, more than twice the previous year and contrary to a long-term trend of declining infant deaths. Melmed said the reasons for the spike are unclear, and that more data has been requested from the state Department of Public Health for 2014 and 2015 to determine whether the trend has continued.

• Mental health services for Hispanics to address higher rates of depression and anxiety among Hispanics. Data show rates for depression and anxiety among this group are up to twice as high as the rest of the population.

• Coordination of services and data sharing among police and health and social service agencies to combat opioid abuse.

• Access to primary care and other health care for low-income residents. Low-income residents use hospital emergency departments nearly twice as often as wealthier residents.

• Diabetes rates among low-income residents of 22 percent, compared to rates as low as 4 percent for wealthier residents.

During an interview Monday, Holmes, Melmed and Muggeo said efforts have begun to address all five areas. To reduce infant mortality and improve prenatal care access, the group is working with Healthy Start and Nurturing Families, two organizations that promote infant and maternal health, as well as local obstetricians, to understand the reasons for the spike in 2013 and find ways to improve care for infants and mothers.

“Infant mortality is a good measure of the health of a society,” Melmed said.

To improve mental health services for Hispanics, the group is working with the Hispanic Alliance to create a list of therapists who are Hispanic or who serve Hispanics. Efforts also are needed to address the stigma about mental health services among this group, and reduce their feelings of social isolation, Holmes said.

“What we have heard is that it’s considered a very private matter,” Holmes said.

In addressing the opioid crisis, the group determined that there is heightened awareness about the problem in the community, but not enough coordination of services. There is also a need for groups working on the problem to share data.

“We’re at the point now in this area where we’re aware it’s a problem, but it’s time to start moving to action,” Melmed said.

To decrease emergency department use by low-income residents, the group will focus on fostering “health insurance literacy.” Since the Affordable Care Act took effect, more people are covered by Medicaid or private insurance, but many people are not using their insurance to access primary care, but instead waiting until health problems reach a crisis and seeking emergency care, they found.

Muggeo said the group plans to seek grant funding to create health insurance education programs.

To reduce diabetes rates, the group is working with the New London County Food Policy Council on programs to increase availability and consumption of fresh fruits and vegetables. They also are hoping to encourage people to get more exercise by working with municipal planners on making low-income communities more walkable, and improving transportation to parks and other areas for physical activity.

Melmed said the actions that will be taken in response to the plan will be long-term.

“We look at this as an ongoing process,” he said. “We’re committed to doing this for as long as it takes.”

j.benson@theday.com

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