Fall drive in the U.P.

Investing in the U.P.: Health Departments Working to Address Unique Concerns

Undisturbed wilderness and breathtaking natural features beckon nature enthusiasts and tourists to Michigan’s Upper Peninsula. It was even named a top-value destination globally – the only U.S. spot to make the list.

But beyond the people making the U.P. a top spot to visit are the 300,000 people who live there year-round, who face real challenges when it comes to economic opportunity, health care access and chronic disease.

An unprecedented, comprehensive 2018 report took stock of residents’ health in all 15 counties and identified four focus areas for public health officials.

  1. The U.P. is aging rapidly. Nearly 20% of the non-incarcerated population in the Upper Peninsula is age 65 or older, compared with 15% statewide. In some counties, that number rises to greater than 30%. With an aging population comes a higher chronic disease burden along with more need for home health services, assisted living and nursing home care. This means the demand for health care workers is also likely to rise.
  2. Prevention is key. The U.P. isn’t alone when it comes to chronic diseases such as cancer, heart disease, diabetes and stroke as the leading causes of death. Still, health officials note that curtailing tobacco use, obesity and the abuse of alcohol and other drugs would greatly reduce morbidity and mortality.
  3. Understanding the link between socio-economic status and health. According to the report, “although the U.P. spans over 16,000 square miles and comprises approximately one-third of Michigan’s land mass, its residents are more alike than they are different. In fact, the reader will note that income and education, i.e. socioeconomic status, are greater determinants of health status and access than geography in the U.P.” The report calls for non-traditional partners in health care to come to the table, including educators, volunteer organizations, business community leaders and governmental entities.
  4. A changing health care landscape. Since implementation of the Affordable Care Act, many more U.P. residents have health insurance, reducing one barrier to health care access. The impact of continuing uncertainty, however, remains to be seen.

With support from the Blue Cross Blue Shield of Michigan Foundation and other funders, representatives from the U.P.’s health departments are now working to conduct focus groups in specific counties to come up with and implement community health improvement plans. The broad-based effort is tapping expertise from community members and coalitions, diabetes educators, dietitians, local foundations, organizations that support the elderly, early childhood organizations, home care and hospice workers, behavioral health specialists, economic development experts, hospitals and colleges.

The deadline to have plans in place is December 2019.

Cathryn Beer, health officer and administrator, Western U.P. Health Department, helped spearhead the 2018 report and is leading focus groups in individual communities. She said a lot of the work centers on identifying existing community resources and determining where the need is greater than the support that exists, putting plans in place to fill in the gaps.

“We don’t need to reinvent the wheel,” she explained. “Just support some of the spokes.”

For example, in addressing the needs of an aging populace, groups are looking at the availability of nursing home and extended care living facilities as well as the prevalence of social supports such as programming that’s specific to seniors in local communities.

The focus group work allows each county to work on what is most important to them, with the hope that community involvement will drive momentum toward improvement.

“Each county has its own identity and slightly different issues,” Beers said. “We’re not going to move the needle on some of these indicators by the time the next assessment comes around, but we can put partnerships and networking in place that can move it in the next go-round.”

This grant was one of 14 grants made in the Upper Peninsula in 2018 and is a demonstration of the BCBSM Foundation’s commitment to improve health throughout the state. Following the development of plans through the focus group process, foundation staff plan to make additional investments in health interventions to bring plans to life.

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Photo credit: BobPalosaari

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