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Wellspan reports highlight behavioral determinants of poor health

Wellspan Health has released its 2022 Community Health Needs Assessment  and its 2023–2025 Community Health Improvement Plan. The reports detail health trends in South Central Pennsylvania including Adams County, and highlight the concerns of doctors, patients, and community members.

The reports indicate that although individual health behaviors including tobacco and alcohol use, diet, exercise, and sexual activities contribute to about 1/3 of negative individual health outcomes, community factors including education, job status, family, social support, and community safety contribute an even greater percentage.

The reports focus on the role that social, demographic, behavioral, and economic issues play in the overall health of people in the region and address the ways WellSpan hopes to foster community change in the next five years to improve community health.

While treatment for health problems is a priority for WellSpan, these reports emphasize that there are influences and barriers that impact health and lessen the need for treatment. “Efforts to educate people on the importance of exercise will do little to change behaviors if people lack safe, affordable, and accessible places to exercise,” the report says.

The reports focus on Adams, Franklin, Lebanon, York, and some parts of Lancaster Counties, and are based on data from Wellspan’s patient database, a WellSpan health provider survey, local, state, and national databases, a community survey, and a special populations data collection that targeted underrepresented and marginalized communities.

According to the reports, Adams is the 11th healthiest county in Pennsylvania, but struggles when it comes to obesity, poor eating, exercise, and mental health. Its population of around 105,000 has a median household income of $68,411, and 8% of residents live in poverty, which is concentrated in Gettysburg Borough.

Compared to Pennsylvania averages, South-Central Pennsylvania can improve health by reducing the rate of adult smokers, reducing adult obesity, increasing access to locations for physical activity, decreasing the ratio of population to healthcare providers, providing adults with more post-secondary education, and reducing air pollution. Communities have also faced rising mental health issues and unprecedented death due to the pandemic.

The Health Needs Assessment Report said the leading individual behaviors that lead to death and disability are diet, smoking and alcohol use, and a high body mass index (obesity). These behaviors lead to cancer, diabetes, cardiovascular and circulatory disorders, and respiratory diseases.

Important community factors include poverty, lack of transportation, failing behind on a rent or mortgage, skipping or reducing meals, facing unfair treatment, stress about money, economic hardship due to the Coronavirus, not trusting Coronavirus vaccines, and eating fast food three or more times in a week.

In terms of demographic variables, the report pointed out racial disparities in income and housing opportunities for Blacks and Latinos, and said a lack of health insurance was twice as high among African Americans and 3 to 4 times as high among Latinos, in comparison to Whites.

The reports say many Adams county residents lack health literacy, which may be because Adams county has the lowest rate of internet access among the counties assessed – about 40%.

Many Adams county residents are elderly, with a median age of 43.6, higher than that in the neighboring counties. The number of residents under 20 years of age is declining across all counties.

The report found relationships between age and eating fast food three or more times in a week, having a high-deductible health plan, economic hardship, not receiving a yearly physical exam, not receiving the Coronavirus vaccine, poor mental health, and economic worries.

Adams county also had a higher rate of obesity in children, and 3 out of 10 people ages 10-17 are overweight or obese.

Overall, there has been little change in the county’s behavioral health since the last report was published 2017, but respondents reported being less physically active and more overweight this year.

Compared to neighboring counties, more people in Adams have enrolled in a health insurance plan, but fewer residents had a physical exam or dentist appointment in the last year.

Based on the report, Gettysburg Hospital’s 2023-2025 Community Health Improvement Plan will prioritize healthcare access, health equity, mental health, addiction, public health, children’s health, and community health variables.

As a whole for 2023-2025, WellSpan wants to provide communities with preventative care and overall healthy behaviors. They also hope to create safety net programs for marginalized communities so that they receive equitable care. For mental health, WellSpan wants to build-up community resilience, decrease pandemic exacerbated mental health issues, and address drug use and vaping. They hope to bridge gaps between resources, providers, treatment and patients, address food insecurity as a health problem, and design approaches to prevent poor health in marginalized communities. Finally, WellSpan hopes to ensure that children are healthy and ready or school, and to engage with the community to help all residents.

WellSpan said $556.5 million was invested in subsidizing healthcare costs over the past 5 years and a $131,000 grant was established for children’s health. Wellspan also opened the first Specialized Treatment and Recovery Team (START) Clinic for mental health and addiction in York.

WellSpan emphasized that the health of our communities is a collaborative effort. Their aim is to solve societal problems that contribute to poor health. For instance, they point to how better hygiene and sanitation practices throughout history have eradicated many illnesses. These practices were aimed at protecting society as a whole, rather than treating individuals.

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Sophia is a rising junior at Gettysburg College and is originally from New York City. She is an English and Business double major and in her free time enjoys writing and going to museums.

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