Summary of Data
Local county health departments and hospital systems conduct Community Health Needs Assessments to create a plan to improve health outcomes. Every county is not on the same cycle and each county has designed the assessment based on their county’s needs. This results in different questions being asked and different plan formats being used. Therefore, these alone could not be used to create the Maryland Rural Health Plan; rather it is one piece contributing to its development. Below is a summary of key findings from all of Maryland’s rural Community Health Needs Assessments broken down by the Robert Wood Johnson Foundation framework from page 2. MRHA used the Community Health Needs Assessments from each rural county that were available as of June 1, 2017.
Social & Economic Factors (40%) and Physical Environment (10%)
Education, employment, income, family and social support, community safety, air and water quality, and housing
and transit all impact health and can contribute to the presence or prevention of health conditions. Ensuring a community has a supportive infrastructure is crucial to improving the health and wellness of the community.
The following were identified by most Community Health Needs Assessments as priorities:
- Access to care and providers
- Social determinants of health
Accessing care and providers is the first step in receiving quality health care. Inadequate access to care and providers can be caused by a variety of factors such as lack of transportation, insufficient providers, poor provider retention, and hours of service that are incompatible with residents’ schedules. Access to care can also include affordability and literacy of the health care system. Access to care and providers is a broad term to describe a large problem that has been identified as a priority in rural Maryland.
Finally, addressing social determinants of health are noted as high importance to many communities. Social determinants include affordable housing, access to affordable and healthy food, and social support for those seeking health care. Addressing any of the previously listed social determinants of health not only improves health, but also can direct a community towards health and wellness.
Health Behaviors (30%) and Clinical Care (20%)
Rural Maryland counties identified the following as their most concerning health conditions: obesity, diabetes, heart disease, behavioral health, and cancer. Obesity is a risk factor for many chronic health conditions and adverse health outcomes. In order to address this concern, health care providers may focus on nutrition education, creating an environment compatible with physical activity, and increasing social support for weight loss.
Diabetes was also identified as a priority health condition. For those who already have diabetes, complications can be minimized through proper nutrition, exercise, and diligent monitoring of blood glucose levels. Rural Marylanders would benefit greatly from diabetes management, prevention programs, and community support.
The next priority health condition is heart disease. Heart disease risk can be decreased by exercise and proper nutrition. Smoking is another risk factor that should be examined in order to decrease the prevalence of heart disease in rural Maryland. Physical activity programs, nutrition education, and smoking cessation programs have the potential to go a long way in preventing heart disease.
Behavioral health is discussed by many counties as being a top health concern. Behavioral health includes mental health, substance abuse, and other behavioral risk factors such as sexual practices and preventative screenings. Intervention at a young age is critical for many behavioral health problems. Understanding the root of behavioral health conditions, and setting up a supportive environment for those suffering from behavioral health conditions, will greatly improve the life of rural Marylanders. Many counties expressed a desire for more screening and prevention services within their counties. Counties wanted to offer annual screenings for diseases such as diabetes and cancer, expand outreach and health education, and emphasize safety in order to minimize health risk behaviors.
Rural Marylanders are also concerned with cancer prevalence in their communities. There are many different types of cancer and those diagnosed with cancer have varying outcomes. Cancer screenings, lifestyle changes such as smoking cessation and healthy eating, and HPV vaccinations are evidence-based ways to approach cancer prevention. Setting up an environment where these can be easily obtained may decrease new incidences of cancer or improve the outcome of those already diagnosed.