New Dialysis Centers Open In the Wayne County Area

 The first dialysis center in Wayne county has recently opened its doors in Newark, NY. This is a a wonderful thing for Wayne county.  The center, opened through the Rochester General Health System will fill a gap for those in Wayne county who had to travel to Monroe county for their dialysis services.  The new center includes 14 dialysis stations and is said to be state of the art, including heated chairs, personal televisions, and WiFi. I think this is a step forward for Wayne county medicine. Wayne county is a large county that includes extremely rural towns, quaint historical villages, and even a small "city" or two.  However, it is like many rural areas in the U.S. in that many residents must drive to neighboring counties for the medical services they require.  Therefore, I see this new center as not just good for the patients who require dialysis, but as a push for more services in rural areas.  Hopefully, this is the way of the future and under-served areas will continue to gain facilities and opportunities such as this.

http://www.waynetimes.com/community/rgh-opens-news-dialysis-center-in-newark/
http://www.waynepost.com/article/20130831/NEWS/130839996/10054/NEWS

Defining Environmental Hazards in Wayne County

While searching for articles about environmental hazards in Wayne county, my home county, I remembered the nuclear power plant located just one town away from my home.  I thought to myself, this is not a perfect match for the assignment - it isn't organophosphate poisoning, or Farmer's lung - but  it was always a very real potential hazard for the residents nearby.  I remember when I was growing up, there were always emergency drills preparing for the day when something would go wrong with the power plant.  The residents were issued iodine tablets which may help in minimizing damage from nuclear radiation.  The schools would do drills every couple of years, which usually entailed a few hours worth of herding students onto busses, driving them to the designated fallout location and then returning to school. So I thought to myself, this was a very real hazard that I faced in Wayne county, and it continues to be a potential hazard.  I started looking into the Ginna Nuclear Power Plant and found an article entitled, "The World's 10 Oldest Operating Nuclear Power Reactors." This was fairly concerning for me to read.  However, I cannot say whether the power plant being old is a good or a bad thing, because we all know things used to be made much sturdier than they are now. The article states that Ginna opened in 1970 and has been running largely without incident ever since.  However, in 1982 there was a break in a tube that leaked radioactive water, resulting in a temporary shutdown for the plant. Despite the fact that no one was hurt or evacuated, Ginna remains a potential hazard in Wayne county.

Now my curiosity is sparked to understand more about this power plant.  I found that it is a pressurized water reactor that is monitored through the Radiological Environmental Monitoring Program.  This program samples local water sources, food, air, and milk for detectable radiological activity. The results of the 2011 monitoring program indicate that there was no significant radiological impact from the operations at Ginna. So, this blog project may help me sleep at night knowing that so far, Ginna has not posed a huge threat to my home community. However, I still believe it has the potential to be a worrisome environmental hazard for Wayne county.  Let's hope it never lives up to that dangerous potential.

Childhood Obesity in Wayne County

 According to the Wayne County Public Health Department, the rates of childhood obesity are higher in Wayne County than the national rates. As obesity explodes as an epidemic in this nation and state, it is undeniably a problem encountered by school medical directors. This is typically a preventable condition in which the local experts are key for prevention.  As a local expert, education is the best means of prevention and intervention.  Organizing informational sessions on nutrition and fitness is a major means of impacting the community.  Furthermore, supporting fundraisers for various sports and activities may also help. Childhood impacts communities because obese children often become obese adults and are much more likely to develop comorbidities. As the level of health in the community declines, the healthcare costs increase.  None of this is good for communities. This is an epidemic in Wayne County and it is one in which the medical experts need to take seriously.


http://www.co.wayne.ny.us/departments/publichlth/Report%20Card%202009%20Wayne.pdf

Reflections on Medicine in Wayne County

As the academic year and Intro to Rural Medicine come to an end, I find that I have learned a great deal about medicine in  Wayne County.  I grew up in Wayne County and realized at a young age how difficult it can be to travel to receive healthcare.  However, there was much that I did not know about Wayne County's healthcare prior to the RMED blog and the research it entailed.  In the process, I found that while Wayne County ranked very poorly in terms of morbidity in NYS, there are a number of programs that indicate progress in bettering the delivery of healthcare. 

I was surprised to learn about NY Connects, a program which improves access to healthcare, has reached Wayne County. Furthermore, the Public Health department has some great programs in place for smoking awareness and education.  There is also a highly comprehensive substance abuse program in place.  It seems though, that Wayne County still needs to improve their health to reduce morbidity. 

Having lived in Wayne County for so long, I know that there is much to offer in terms of culture and history. However, I think that access to care will remain a problem. I think that one of the most important things a physician can offer, in addition to providing the best care, is to work in the community to improve access.  Technology will be one of the greatest tools in the future for allowing patients access to their information and care, and it is imperative that technology grow in rural areas like Wayne County.

Improving Access to Care in Wayne County with NY Connects

NY Connects is a statewide program that provides information and assistance about long term services and support.  Wayne County is one of many in NYS to implement this program.  NY Connects defines long term care as, "medical and non-medical support services needed to improve or maintain ones' health and/or daily function...[that]may be provided in individuals' homes or other community-based and residential settings."  

The program is available for people of all ages and is not limited by insurance carrier.  It is intended to help people who are might find accessing medical care confusing.  The local programs, including the program in Wayne County provide information and assistance specialists that personally counsel patients on making informed decisions about their medical care.  The specialists also assist patients in accessing long term services and supports for both existing and future healthcare needs.

The Wayne County NY Connects program is offered through the Wayne County Department of Aging and Youth.   Their specific program goal is to help people of all ages access reliable information regarding services and to assist in formulating a plan to ensure people can maintain as much independence as possible.

As a future practitioner, I see myself working within a patient centered medical home.  I think that this is the future of primary care overall, and I believe it will ensure better medical care to patients.  I think that NY Connects is a wonderful resource for people because navigating medical care can often be confusing and seemingly inaccessible. Therefore, in my practice I will encourage and promote such programs for patients. 

http://www.co.wayne.ny.us/Departments/AgeYouth/NYConnects.htm

http://www.nyconnects.ny.gov/nyprovider/consumer/indexNY.do

Wayne County Celebrates the DeMay Living Center Team Members

The DeMay Living Center team in Wayne County was just recognized in the Wayne Post for their years of service.  The DeMay Living Center is a skilled nursing center in Newark, NY that offers around-the-clock nursing care for long term patients, transitional patients, rehabilitation, ventilator dependent patients, and Alzheimer's patients.  The article highlighted the impressive time commitment of the staff, citing that the 96 individuals recognized had spent a collective 1,300 years  caring for patients and residents at Newark-Wayne Community Hospital and DeMay Living Center.  I find this to be incredibly impressive and indicative of the strength of the team caring for patients at this center. 

While the DeMay Living Center healthcare team is primarily comprised of nurses, I find many parallels between this system and the healthcare teams that are on the rise, which combine various types of medical professionals.  This center integrates various types of service under one roof, which I envision as the future of all healthcare.  With physicians, nurses, NPs, PAs, and other health professionals working together in a team aiming to better the patients' lives, I can only imaging a multitude of care types will be combined in single facilities, something that is already happening.


http://www.waynepost.com/feature/x1665844549/Hospital-DeMay-team-members-recognized-for-years-of-service
http://www.rochestergeneral.org/centers-and-services/senior-services/demay-living-center/about-us/

Wayne County Health Indicators Suggest Need for Change

Upon first glance of the Wayne County health rankings I was stricken by how poorly it compared to New York State as a whole and even the US.  For example, Wayne County ranked 46 out of 62 in terms of mortality in NYS.  This was measured based on premature death or years of potential life lost before age 75 per 100,000 population, where Wayne County was 6,516 versus, 5,812 in NYS, and 5,466 nationally.  This was surprising and disappointing but Wayne County is predominantly rural and access to healthcare is often sparse, which may be contributing factors.  While small primary care offices are scattered through rural towns in Wayne County, hospitals and even urgent care centers are few and far between, presenting a problem for people without cars to access such facilities.

Furthermore, Wayne County did not fare well in the measures of morbidity either, ranking 47 out of 62 in NYS.  16% of adults reported poor or fair health which is on par with NYS but higher than the 10% reported in the US.  Additionally, the average number of physically unhealthy days reported in past 30 days was 4.9 in Wayne County but only 3.5 in NYS and 2.6 in the US. Wayne County reported similar statistics for poor mental health days. The percentage of low birth weight was 6.7% in Wayne County but 6.0% in the US.  This compared favorably to 8.1% in NYS.  The high percentage of unhealthy days may reflect working conditions because many rural jobs are physically demanding, the quintessential example being farming.  It may also reflect the lack of access to healthcare because people who aren't receiving primary care may only seek care when a problem becomes acute.  Again, the poor mental health reported may be due to a lack of access to care.  Wayne County's percentage of low birth weight was good in comparison to the state overall, which surprises me based on the other statistics seen but it may reflect better pregnancy care initiatives than in other parts of the state. 

In terms of Social and Economic factors, Wayne County seems slightly better than NYS but worse than the US.  For example, the high school graduation percentage was 82% in Wayne County versus 65% in NYS.  The percentage of unemployment in the county was very similar to that of NYS but higher than the national percentage.  Similar patterns were seen for inadequate social support, but in regard to children in poverty and children in single-parent households, Wayne County fell between NYS and the US.  Surprisingly, violent crime was 178 per 100,000 in Wayne County and 399 per 100,000 in NYS, but only 73 per 100,000 nationally.  This was the most surprising social factor in my opinion because violent crime is often associated with urban areas. 

I was also surprised to see that Wayne County reported a teen birth-rate of 32 per 1,000 females 15-19, compared to 27 in NYS and 22 nationally.  I suspected this was a reflection of high school graduation rate but the graduation rate in Wayne County is actually much higher than in NYS.  Therefore, this may just reflect a need for better sex education.  It may indicate the influence of religion in rural areas, where it tends to be prominent.  As religiously influenced education may teach abstinence only, and abstinence teaching does not often prevent teenage sexual activity, there may be a correlation between religion and the high teen birth-rate in Wayne County, although this is just speculation.

In terms of clinical care, the statistics indicate that Wayne County has a much higher ratio of patients to physicians than NYS or the US (2,615:1 vs. 781:1 and 631:1respectively).  This indicates a serious lack of physicians which is a likely cause of diminished access to healthcare.  It may also be a cause of the higher rate of preventable hospital stays in Wayne County compared to NYS and the US. In fact, it seems to me that the lack of physicians in the county may be the nexus of many of the health problems in Wayne County.  Therefore, an initiative to bring more physicians to Wayne County may help the population in a myriad of ways. 

http://www.countyhealthrankings.org/app/new-york/2012/wayne/county/1/overall