Peninsula residents need more positive changes in lifestyles

Posted: Tuesday, April 20, 2004

Though a recently released survey points out some negative health trends among central Kenai Peninsula residents, there is an upside to the findings. The report will be used by health care industry leaders to identify and combat those negative trends to improve the overall health of the peninsula's population.

After all, the first step to recovery often is admitting there is a problem.

The survey was designed to identify key health care service needs in the Central Peninsula General Hospital Service Area, which covers Clam Gulch to Nikiski, Kenai to Sterling and Funny River and the Sunrise area near Hope.

Information garnered from the service area was compared to statistics for Fairbanks which was determined to have similar population, socioeconomic and health care delivery system characteristics the state and the nation.

The peninsula did not measure up well in some areas. For instance, the percentage of central peninsula residents with diabetes is more than twice as high as the percentage of people with diabetes in Fairbanks and the state.

Adult-onset diabetes is the most common form of the disease found on the peninsula, which is linked more to lifestyle factors, like obesity, than genetics. Making exercise programs more easily accessible might be a way to combat obesity and the many chronic illnesses it contributes to, according to Ronald Deprez, president of Public Health Resource Group Inc. of Portland, Maine, which prepared the survey.

"Exercise is a key thing," he said. "Exercise works, we know it works, but you have to structure programs people can get to. If it's not easy, people won't do it."

The risk of developing cardiovascular disease was found to be elevated due to tobacco use and obesity among central peninsula residents. Tobacco use among Kenai area residents also contributes to high risks of developing respiratory disease and cancer. The percentage of adults with asthma also is high in the Kenai region compared to the national average, though it is about the same as in Fairbanks and the state.

Dental care also was identified as an area in need of improvement. According to survey findings, more than one in three central peninsula adults did not visit a dentist in the past year, which was higher than in Fairbanks, the state and the nation. Cost was identified as the main reason for these people not getting dental care.

Medical care costs in general were found to be a health care issue among central peninsula residents, due to economic factors and a lack of health insurance. The survey found the proportion of adults who are unemployed in the Kenai region and the proportion of adults without health insurance coverage was high. The proportion of uninsured Kenai area adults was calculated at 20 percent, compared to 15.2 percent in Fairbanks, 19.1 percent in Alaska and 14.1 percent in the United States.

"Twenty percent of the population doesn't have medical insurance. That's high. That's a big barrier to access to care," Deprez said.

Another health trend of concern is the central peninsula's aging population as it relates to chronic conditions including diabetes, emphysema or any illness that can be managed but not cured.

As people age, they are more likely to develop chronic conditions, Deprez said. Almost one in five adults in the Kenai region has multiple chronic conditions, according to the survey findings.

The survey did not include an assessment of health care services available in the central peninsula, so survey findings don't mean there is a lack of services available for patients with chronic illnesses. However, there have been changes in how the health care industry is dealing with chronic care issues, according to Deprez.

"Chronic care is not about hospital care, it's really about the patient," Deprez said. "The patient has to be self-motivated to want to improve their condition."

Along with doctors and medical care, patients need education about their chronic illness and must have access to information about how to manage their condition themselves, Deprez said. Along those lines, it is important to integrate chronic care services in a community so chronic illnesses can be managed as efficiently as possible.

"You have to link providers that's a big challenge," Deprez said. "It's a huge challenge, but that's where we're going with chronic care in this community."

Survey conductor Public Health Resource Group Inc. is an independent health care research and planning firm that specializes in planning projects in public health, emergency preparedness and community assessment, according to the group's identity statement.

The survey was conducted by phoning adults in 600 households in the hospital service area during January and February.

The Central Peninsula General Hospital Service Area Board commissioned the survey in August and spent about $50,000, total, for the service. The purpose was to assess health care service needs in the community, especially in light of the hospital's pending expansion.

The results of the survey will be useful to area health care organizations in future planning and in applying for grant funding and other resources for new or ongoing projects.

Deprez was in Soldotna last week presenting and discussing survey results with the service area board and interested members of the local health care industry.

He recommended industry leaders focus on one or two issues identified in the report instead of trying to tackle it all at once.

"We need to declare war on cancer or whatever and really focus on it," said Stan Steadman, executive director of Central Peninsula Health Centers Inc., which provides medical and dental care to uninsured and underinsured area residents, at a meeting with Deprez on Wednesday.

Ellen Adlam, chair of the service area board, said if anyone wants a copy of the report they can get it from the board. She also recommended anyone with specific health care concerns contact the board.

"People are not aware what the service area board even does," she said. "... People can come to us if they feel like they're not being represented or not heard or listened to. We're the place to go."

The hospital service area board differs from the Central Peninsula General Hospital Inc. Board of Directors, which governs the hospital. Service area board members are elected by service area residents and oversee the hospital and hospital board's operation and report to the Kenai Peninsula Borough Assembly.

The board meets the second Monday of every month in the Iliamna room at the hospital. For more information, call Ellen Adlam at 262-0669 or Ken Mayer at 283-5262.

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