Health: From the voices of vulnerable

Ian Grant WEB

Ian Grant

Are you curious about your blood pressure? There are devices for that and they’re popping up everywhere, even in local grocery stores. Do you need to assess your risk for developing type 2 diabetes? There is a simple test for that here: Want to investigate the burden of chronic disease in our region? There is a website for that —

In our community, we have unprecedented access to a growing variety of personal health data and community health indicators. But suppose you wanted to investigate patients’ attitudes, behaviors, and experiences with health care? For that you must go directly to the patient, which is exactly what we did.

We called community residents on their cell-phones and landlines, and asked them questions about their personal health, lifestyles and socio-economic status. In the end, we talked to 1,800 men and women of the tri-county region from all age groups, income categories and educational backgrounds. From our group of 1,800 respondents, we found more than 230 individuals who live in very fragile economic conditions. This group spoke on behalf of those of us who live in poverty and are most in need of our support.

Census estimates inform us that the most recent 10-year poverty estimates for each of our three counties — 15 percent of the population in Jefferson; 13 percent in Lewis; 18 percent in St. Lawrence — are the highest they’ve been since the early ‘60s and ‘70s. This vulnerable and growing population typically suffers a disproportionate burden of poor health outcomes, low access to health care and insufficient social supports. To alleviate these burdens and develop an equitable health care system, we need a greater understanding of the scope of social and economic factors impacting their health.

Our 2016 Community Health Survey allowed us to explore these social and economic health determinants while confirming the county-level estimates of individuals impacted by poverty. The survey revealed that individuals with limited resources are 67 percent more likely to visit an emergency department and have a 27 percent higher rate of hospitalization than the general population.

Though there are numerous potential explanations for these higher emergency department visits and hospitalizations, the survey data established that these individuals are sicker than the general population. In fact, more than half of Medicaid enrollees reported a diagnosis of at least one of the following chronic conditions: diabetes, prediabetes, high blood pressure, heart disease, chronic obstructive pulmonary disease (COPD), or obesity — while just 38 percent of non-Medicaid enrollees report having one of these illnesses.

In addition to battling the challenges of finding the appropriate level of health care, 43 percent of Medicaid enrollees expressed that they do not always understand the instructions they receive during a clinical appointment. Significantly fewer non-Medicaid enrollees — 31 percent — expressed similar challenges. Health literacy, or the ability to obtain, process, and understand health information to make informed health decisions, affects all economic classes but disproportionately affects impoverished members of our community. Low health literacy is associated with increased risk of mortality, poor overall health and lower rates of preventive screening and immunizations.

Arguably the most startling statistic from the survey indicates that only 29 percent of Medicaid enrollees have five or more close friendships, while 41 percent of non-enrollees enjoy the benefit of large social networks. In other words, more than 70 percent of the individuals living in poverty within our community do so while experiencing low levels of social engagement and isolation. Notably, high levels of positive social engagement are associated with improved physical health and mental well-being.

Documenting the voices of the vulnerable is only half of the battle. Our extensive network of partners — including community coalitions, local health departments, community health centers, hospitals and social services agencies — will leverage these findings to tackle these challenges. These stories will continue to motivate action by all sectors of our community. The data underscore our duty to support our vulnerable brothers and sisters.

To learn more about poverty and health in our community and how you can take control of your own health visit the North Country Health Compass at

-Ian Grant is the population health program manager for Fort Drum Regional Health Planning Organization, Watertown. Contact him at or 755-2020. Visit to learn more. A column from Fort Drum Regional Health Planning Organization staff appears every other month in NNY Business.

June 2016: Economically Speaking

Understanding changes in health care

Columnist, Brian Marcolini

Brian Marcolini

Health care in the North Country has undergone significant transformation. Fortunately, these changes have created many positive enhancements to our health care system. Policy changes by the state and federal governments have contributed to changes in how health care is delivered. Historically, policy changes have been used to improve health care systems. Building upon that fundamental idea, many new, innovative approaches and plans have emerged that focus on improving patient care and reducing costs. [Read more…]

April 2016: Economically Speaking

Local health care reform sees progress

Erika Flint

Erika Flint

While the health care community has known of the Delivery System Reform Incentive Payment Program for some time, community members of the Tug Hill region are now also beginning to recognize this acronym and the work being accomplished. DSRIP has been labeled both unprecedented change and unprecedented opportunity, but the point has finally arrived when planning has become doing, and as changes happen, opportunities are being realized. So it is my pleasure to highlight just some of the critical work of more than 100 partners within the North Country Initiative Performing Providers System. [Read more…]

January 2016: Economically Speaking

A healthy community: our best investment

Ian Grant WEBWhen asked what surprised him most about humankind, accomplished writer and world traveler James L. Lachard expressed concern that “[people] lose their health to make money and then lose their money to restore health.” [Read more…]

October 2015: Economically Speaking

Hiring veterans: A positive impact

By Ray E. Moore III

While most veterans are highly competent, confident and agile, transitioning from an active duty service member to a veteran has major life-changing implications. Studies demonstrate that the transition to civilian life is the single hardest transition a veteran will make.

After years of intense specialized training and education, technical skills development, developmental leadership and management and organizational loyalty, every veteran is faced with the same question: “what do I want to do with the rest of my life”?

The majority of veterans are concerned with finding a rewarding career after their selfless service to our nation while attempting to translate and convey their military skills and training to civilian skills and related education. Veterans have made a commitment to serving our country; now they are looking to enter the civilian workforce and make a commitment to private-sector employers.

Two questions business owners and executives alike should ask: How can our organization assist veterans in finding a rewarding career? How can we capitalize on the education and skillsets veterans bring to the workforce? Below I will highlight some of these skillsets and traits.

Leadership — Taught through multi-level tiered classroom instruction, mentorship and years of hands-on experience to become personally and professionally competent leaders with the candid ability to guide and direct appropriate resources to accomplish tasks, mentor and counsel lower-level employees and possess a unique degree of adaptability. Composed, confident, resilient, interpersonal tact, sound judgement, sriven, two-way communication.

Accountability — Effective utilization of available resources and equipment, strategic planning, the employment of resources, organizing and simultaneously directing and controlling complex multiple tasking’s.

Teamwork — The core of military performance is teamwork. Veterans have had to work effectively together as a unit, with people from diverse backgrounds, viewpoints, agendas, positions of authority and skillsets. Veterans exemplify teamwork and know that teamwork is a key ingredient to accomplishing strategic goals and objectives.

Dependability — Veterans report early for work, ready to work, maintain detailed calendars, arrive early for meetings, work until tasks are accomplished, rarely use sick-time and they can be relied upon to perform their assigned duties with minimal supervision.

Trainability / Adaptability — Recently separated veterans were contributing members of a highly-trained, highly-skilled modern workforce that can train, perform, and sustain in any global environment. Active duty service members regardless of the branch train on a daily basis to learn new skillsets.

Gen. George Washington said: “When we assumed the soldier, we did not lay aside the citizen.” As a result of being a Soldier, Sailor, Airman, or Marine our nation has highly skilled unemployed veterans — citizens — with experience in information technology, logistics, communications, accounting, human resources, management, security, science, medical, project management, contract management, finance, health management, command and control and more.

Incentives to Hire Veterans

The VOW to Hire Heroes Act of 2011, enacted Nov. 21, 2011, provides an expanded Work Opportunity Tax Credit to businesses that hire eligible unemployed veterans and for the first time also makes the credit available to certain tax-exempt organizations. The credit can be as high as $9,600 per veteran for for-profit employers or up to $6,240 for tax-exempt organizations. The amount of credit depends on a number of factors, including the length of the veteran’s unemployment before hire, hours a veteran works, and the amount of first-year wages paid. Employers who hire veterans with service-related disabilities may be eligible for the maximum credit.

Finally, hundreds of studies and anecdotal evidence directly support the advantages, positive impact, and value veteran service members bring to the civilian workforce. Veterans are agile, multi-skilled women and men who have strong moral character, broad knowledge, and keen intellect.

Hire a veteran today to improve a lifeline and positively impact your bottom line.

Ray E. Moore III is a project management officer for the North Country Initiative at the Fort Drum Rehional Health Planning Organization. He is a retired Army 1st Sergeant and Lean Six Sigma Master Black Belt.

September 2015: Economically Speaking

DANC at 30: Strengthening our area

Columnist Michelle Capone

Columnist Michelle Capone

The Development Authority of the North Country was created in 1985 under Article 8, Title 29 of the Public Authorities Law to provide infrastructure, services and economic development in Jefferson, Lewis and St. Lawrence counties. It is a self-supporting public benefit corporation overseen by a 13-member board of directors. This is its 30th year of operations. [Read more…]

August 2015: Economically Speaking

Building our best health workforce

Columnist Tracy Leonard

Columnist Tracy Leonard

The current emphasis of health care transformation focuses on the politics, benefits, challenges and costs of health care reform. One of the biggest areas of change involves the health care workforce, where employment is growing and work roles are evolving due to a combination of things such as the Affordable Care Act, the economy, provider shortages, retirements, an aging population that needs more and different kinds of care and market and regulatory pressures related to cost and quality of care, as well the new models of person-centered care. [Read more…]

June 2015: Economically Speaking

Embrace change as an opportunity

Columnist Tracy Leonard

Columnist Tracy Leonard

There is nothing more constant than change. It is happening all around us, every day, all of the time. Yet, why do so many people fear change? When things take us out of our comfort zone, we may feel uncomfortable or have difficulty adjusting. Our options are to embrace it as an opportunity or to resist it out of fear. [Read more…]

May 2015: Economically Speaking

North country is poised for growth

Columnist Michelle Capone

Columnist Michelle Capone

The north country is home to many successful businesses, and each day new businesses are born. They are born at the dinner table or in the college lab or on the back of a napkin. Several programs and services are available to assist start-up or existing businesses. [Read more…]

April 2015: Economically Speaking

Health care IT improves outcomes

Columnist Corey Zeigler

Columnist Corey Zeigler

As health care consumers, we are all concerned with the cost, quality and access to care. But business owners have additional concerns regarding employee satisfaction, retention, health and productivity. [Read more…]