Springfield was named the least healthy city in Ohio one year ago by a national website and since then Clark County leaders have worked to shed that image.
Their efforts have included proposed policy changes, improved infrastructure and increased programming.
The community must better that image for Springfield and Clark County to be successful in the long run, Clark County Health Commissioner Charles Patterson said.
“I’m very hopeful for the future,” he said. “There isn’t a question of whether we shake this or not — we have to shake it. We have to.”
The site 247wallst.com based its assessment on the local economy and the County Health Rankings and Roadmaps, national health surveys conducted annually by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.
That report generated a strong reaction in Springfield and lead the Springfield News-Sun to dedicate the past year to digging into the major health concerns facing the city and what the community has done to address them. That’s included stories ranging from local obesity rates to the biggest causes of deaths to women’s health.
If Springfield is seen as unhealthy, it will be less likely to attract businesses, he said. The changes can be lead by government entities like the health district, Patterson said, but the people in the community must act.
“If everybody does a little bit more, if everybody eats a little bit healthier, does a little more exercise and leaves the drugs alone, we can shake that,” Patterson said. “Instead of spiraling down, we can spiral up because the sky is the limit.”
The biggest factors affecting Clark County’s health continue to be smoking, obesity and teen birth rates — all of which are higher than both the state and national averages. About 20 percent of adults in Clark County are smokers, which is higher than both the state (19 percent) and top performers in the United States (14 percent).
Removing barriers in both private and public programs, especially for people with drug addictions, can change those rankings over time, said Attica Scott, a Louisville, Ky.-based community coach with the County Health Rankings.
“Policy systems and environmental changes are really where communities can focus if they want to improve health,” she said.
Clark County had its best performance on the annual County Health Rankings and Roadmaps earlier this year, ranking 67th out of 88 counties in Ohio for health outcomes.
The ranking is based on health outcomes, which measures both length and quality of life.
“We need it to be a trend,” Patterson said.
While the community has seen improvement, it will likely take time to make greater strides due to the heroin epidemic affecting life expectancy here, Patterson said.
“We’re probably going to drop back some (in the rankings),” he said. “In another year, if we start to clean up our act, we’re going to be back up there.”
Earlier this month 247wallst.com also ranked Springfield as the city with the shortest life expectancy in Ohio — 75.7 years — using methodology that included median household income ($47,963) and obesity rate (30.4 percent).
The county is trending downward for children in poverty, Scott said. By focusing on that need, she said it will have an impact on other areas.
The county should also celebrate some of its improvements, she said, including declines in unemployment, excessive drinking and residents without health insurance.
Communities who work together with people who are most vulnerable and struggling to achieve a culture of good health are often the most successful, Scott said. She worked with Scott County, Ind., during its HIV outbreak last year and often held meetings with people directly affected by addiction and HIV/AIDS.
“It wasn’t the folks who are the experts or the people who do the work everyday, but it was them in partnership with the people who are most directly affected,” Scott said.
Access to care
The health care industry in general, including the Rocking Horse Community Health Center in Springfield, needs to be very available to residents, CEO Kent Youngman said. Health organizations must do a better job of linking people internally with different services, he said.
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“We need to make sure that when someone walks in, they feel welcome, we address their needs and that we do it in a way that looks at not only physical health components, but also behavioral components and other social determinants that may be in place,” Youngman said.
The Affordable Care Act and the expansion of Medicaid in Ohio has allowed health providers like Rocking Horse to see more patients, especially adults who previously had no way of paying for services in the past, Youngman said. It’s possible the new a new federal administration could make changes to the program, he said.
“We’re hopeful that whatever action they take does not create additional barriers for folks that need health care, that need some assistance in being able to pay for that,” Youngman said.
Education is key to improving the health of the community, Youngman said. While it won’t happen overnight, it’s possible to change the community’s habits, he said. He spoke of the evolution of seat belts as example of policy that has saved lives over time.
“(Improving health) can occur over time, but it takes time and it takes a concerted effort,” he said.
The Community Health Improvement Plan approved by local health leaders last March included two proposed policy changes — adding fluoride to the city’s public drinking water and increasing the minimum smoking age from 18 to 21 in both Springfield and New Carlisle.
“We have the possibility of putting some really important measures in place that don’t require behavior change,” Patterson said.
Springfield is the largest city in Ohio without fluoridated water, he said. It could also be one of a few cities to pass Tobacco 21 legislation, Patterson said.
EARLIER COVERAGE: Clark County teen birth rates see big drop, still among worst in Ohio
“Those efforts tell future possible employers this is a progressive community,” Patterson said. “This is a community that wants to get better. This is a community that’s trying to heal itself.”
A greater amount of people can be affected by policy changes over time, he said, which will lead to better public health.
An even bigger impact can be made if access to care in certain areas — such as smoking cessation, primary care follow-up for congestive heart failure patients and oral health — can also be increased, he said.
“Through research, we know that there are better outcomes for each one of those,” Patterson said.
Several of the health district’s task force groups made progress this year, he said, including one group that offers American Diabetic Association training courses to educate local diabetics about making proper food choices.
“If they choose to change their behavior, they’re going to do it in the right manner,” Patterson said.
In October, Clark County went a full month without a drug overdose death.
“It may not be a trend, but it’s positive because we haven’t seen that since early 2015,” Patterson said.
Heroin has been a problem in recent years, but he said now the city is seeing more crystal meth.
“It destroys people just like heroin destroys people,” Patterson said.
The health district has yet to formally speak with city commissioners about a putting an issue on the ballot to add fluoride to the water, Springfield Mayor Warren Copeland said. While he’s in favor of fluoridation, the voters rejected the issue in 2005.
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“I’m quite willing to talk to him,” Copeland said. “It’s fine with me to let people decide. I think all of the medical evidence supports doing it, but thus far the people haven’t believed that.”
A decade ago, many of those opposed expressed concern about adding a potentially toxic chemical to Springfield’s water. Yellow Springs and Xenia voters have also rejected fluoridation in recent years.
The Clark County Board of Health is ready to move forward on the issue, Patterson said.
“They’re ready to let the citizens make a decision based on facts, not fallacy,” he said. “There are lots of myths out there and we just want to present the facts.”
Copeland is undecided on the tobacco issue, he said, because it will likely lead to more tobacco sales outside of the city limits. The state would have to pass a law for it to be illegal throughout Clark County, he said.
“I understand the data that suggests it would help some young people not get hooked on tobacco,” he said. “I think that works if we control the market, but we don’t so I’m not clear if it would work in a community like this where you wouldn’t have to go very far to get outside the city.”
Community members have worked hard to get healthier, Patterson said. A great example is the Fountain 5K held on Thanksgiving morning, which saw 940 people participate last month. They’re committing to exercise before their holiday feasts to help offset some the chance of weight gains, he said.
The health district must work to help people eliminate stress so they can make better diet and exercise choices, Patterson said. It’s one of the biggest deterrents in the community, he said.
“When people at every level, whether you’re impoverished or well to do, you have lots of pressure and different stressers, and you have to figure out how to set them aside so you can make right decisions,” Patterson said.
The Springfield community has slowly added workout facilities and personal trainers, he said. The community has added exercise options, such as the bike trail network, improvements to local parks and recreational facilities such as the EcoSports corridor and the Chiller ice skating rink.
“There are so many things you can do that cost little to nothing to have outdoor activity,” Patterson said. “If they make that choice, there’s a way to do it.”
The downtown Fitness Cellar has begun offering more classes to make it more affordable, owner Tammy Beam said. The new classes are more entertaining, such as a popular Dance Tone class. The gym has had several clients lose up to 100 pounds through dancing, she said.
“We’re getting that group who wants to exercise, but they don’t feel like they’re exercising,” she said. “It’s all about the atmosphere and being a part of something.”
It takes small lifestyle changes to see improvements over time, Beam said.
“It’s not going to happen overnight,” she said. “You’re not going to come into this gym and expect miracles.”
The health and wellness industry in Springfield must come together to offer better access to residents, she said. Each gym has a different niche, Beam said.
“We have to come together as a wellness community and everybody has to want it together,” she said. “Everybody has to step up to the plate.”
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