About 70 community leaders lent their ideas to Cumberland Medical Center as the hospital works to complete a community health plan. The Community Health Needs Assessment is required for not-for-profit hospitals by the Internal Revenue Service as part of health care reform legislation.
"This is going to determine where we are going in health care in this community for the next three years," Dr. Barry Wagner, CEO at Cumberland Medical Center, told the community members as the program began.
The foundation of the study is a comprehensive evaluation and assessment of community statistics, demographics and consumer behavior, assessment of community health data and evaluation of community surveys. Using that information, members of the community summit identified 11 areas of health and wellness for the community.
Key areas were obesity, exercise and lifestyles, smoking, affordable health care, physicians and access, health care policy, health education in schools and the community, drug abuse, heart disease, diabetes and cancer.
"Our community assessment is not meant to produce a document that gets shoved onto a shelf to gather dust," Wagner said previously. "It is meant to create the foundation of an action plan to help us truly improve the lives of people in our community."
The community members took some first steps with that as they brainstormed ways to address each of the 11 areas of concern. For example, Tennessee is seeing increasing rates of obesity, though Cumberland County is faring better than many of the counties across the state. The group charged with brainstorming for that concern recommended schools increase the amount of daily physical activity and community groups increase knowledge of area facilities for exercise and physical activity, including gathering information on walking, running and biking trails. It was also suggested mandating educational training for those receiving food stamps on buying healthy foods, portion control, how to read a nutrition label and how to stretch food dollars with healthier choices. A community health challenge was recommended to help motivate the community to be more active.
Access to care and being able to afford care were two top concerns. Statistical studies of physician utilization in Cumberland County as well as community surveys found that people make great use of a primary care physician. Part of that is related to Cumberland County's median age, 48.6, which is significantly older than the median age for Tennessee, 38, and the nation, 37.2.
The percentage of the local population aged 65 to 74 is expected to grow dramatically over the next five years, as well, while the population of young people age 20 to 24 is expected to decline slightly.
Last year, there were more than 253,000 physician office visits in Cumberland County. According to the County Health Rankings, there is one primary care physician for every 1,144 residents. That's a ratio that's significantly higher than the national benchmark — one primary care physician for 631 people.
J. Tod Featherling, chairman and founder of Stratasan, the company contracted with the hospital to conduct the assessment, said, "Cumberland County is going to need more primary care physicians and specialists, particularly family practice physicians, internists and psychiatrists."
The affordable care and access tables recommended a 24-hour urgent care clinic for the community. This would make a physician available 24 hours a day, seven days a week, without requiring a visit to the emergency room. Community health fairs that offer low-cost screenings, such as blood tests to check cholesterol and other important preventative measures were also recommended
More physicians are going to be needed, and the groups suggested incentives be offered for those physicians to treat Medicare, Medicaid or low-income patients.
Another need in the community is more industry and jobs for the community that offer health care benefits that are affordable, and the groups recommended working with the Crossville-Cumberland County Chamber of Commerce, Industrial Development Board and local governments to help recruit new industry or promote expansion of existing industry. Incentives, such as educational reimbursement, were recommended to keep young people in the community to provide a labor force for industry.
In health care policy, it was recommended government allow each community to develop its own policies for providing better care, as each community is unique. An annual assessment of community needs was also recommended to keep the hospital and community on track with progress made and areas where improvement is needed.
Education was seen as the key to making strides in drug abuse and smoking, especially among young people. The group discussing smoking recommended a support group be offered through CMC to help those who are trying to quit.
In drug abuse, education for physicians in responsible prescribing practices for pain medication was recommended. Education for the community as a whole on the dangers and effects of drug abuse, particularly methamphetamine, was suggested, with the group adding, "Education needs to start early, not when they're teens. It needs to be early and ongoing."
Access to proper treatment was also recommended.
Education on risk factors, community screenings and proactive health care was recommended for heart disease, diabetes and cancer. Of note in the survey portion was that, while many individuals surveyed reported they already had a chronic health condition, the majority felt the community was in good health. Health care providers, however, did not share this optimistic view of the community's health.
This information and more will be used to prepare a final community report, expected within a few weeks.
"Today is the first step in health for our entire community," Wagner said. "Cumberland County is a wonderful place to live. It is one of the top rated retirement communities in the country. Whether you work, play or retire in Cumberland County, we want our community to be recognized as the healthiest in the state. We can only achieve this noble goal by working together: hospital, physicians, industry, newspaper, nonprofits, county health department, church and residents. We all have a hand in making our community strong and healthy."